title: An MRI-driven practice: a new perspective on MRI for the evaluation of adenocarcinoma of the head of the pancreas.
abstract: OBJECTIVE
  The purpose of the study was to describe the MRI-driven management of masses at the head of the pancreas.
  
  
  METHODS
  The main outcome measure was tumor resectability.
  
  
  METHODS
  A retrospective review of prospective radiographic diagnoses was undertaken.
  
  
  RESULTS
  Between 2004 and 2008, we have treated 124 patients for a radiographic diagnosis of adenocarcinoma of the head of the pancreas. This diagnosis was correct in 96.0% of the time. MRI was 100% sensitive in determining resectability, 73.2-78.9% specific, and had an overall accuracy of 86.3-87.5%. MRI could detect venous and arterial involvement with 95% and 95.9% accuracy, respectively, and missed only six metastases.
  
  
  CONCLUSIONS
  MRI is a useful tool in the preoperative imaging of pancreatic head lesions that is highly sensitive and very specific for resectable disease. Prospective trials of MRI in this setting are indicated.
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Elliot B
authors.initials: EB
authors.lastname: Tapper
authors.forename: Diego
authors.initials: D
authors.lastname: Martin
authors.forename: N Volkan
authors.initials: NV
authors.lastname: Adsay
authors.forename: David
authors.initials: D
authors.lastname: Kooby
authors.forename: Bobby
authors.initials: B
authors.lastname: Kalb
authors.forename: Juan M
authors.initials: JM
authors.lastname: Sarmiento
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
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