title: Magnetic resonance imaging versus endoscopic ultrasonography for the detection of pancreatic tumours in multiple endocrine neoplasia type 1.
abstract: OBJECTIVE
  In multiple endocrine neoplasia type 1, the main risk factor for metastases is pancreatic tumour size. We and others recommend limiting surgery to non-functioning pancreatic tumors ≥20 mm or growing, based on their size measured with endoscopic ultrasonography. Because endoscopic ultrasonography is invasive, we compared endoscopic ultrasonography (EUS) to non-invasive magnetic resonance imaging (MRI) for the detection of pancreatic tumours ≥10 mm in multiple endocrine neoplasia type 1 patients.
  
  
  METHODS
  A prospective study was performed in nine participating centres; 90 patients with multiple endocrine neoplasia type 1 underwent EUS and MRI with gadolinium infusion. Gastroenterologists and radiologists were blinded to the results, magnetic resonance images were reviewed centrally.
  
  
  RESULTS
  EUS detected 86 tumours ≥10 mm, and 48 (53.3%) patients had at least one tumour ≥10 mm. MRI detected 67 tumours ≥10 mm, and 46 (51.1%) patients had at least one tumour ≥10 mm. EUS and MRI agreement was moderate for detection of tumours ≥10 mm (Kappa coefficient=0.49), and for selection of patients with tumours ≥10 mm (Kappa coefficient=0.55). EUS and MRI missed 11/24 and 4/24 lesions ≥20 mm, respectively. EUS failed to identify 9/57 (15.7%) patients with pancreatic tumours ≥10 mm, and MRI failed to identify 11/57 (19.3%) patients with pancreatic tumours ≥10 mm.
  
  
  CONCLUSIONS
  EUS and MRI are complementary and should be performed at initial evaluation in multiple endocrine neoplasia type 1 patients. Whether follow-up should be based on either technique or both, requires further evaluation.
authors.affiliation: Clinical Research Coordination Unit, Robert Debré Hospital, University Hospital of Reims, Reims, France. cbarbe@chu-reims.fr
authors.forename: Coralie
authors.initials: C
authors.lastname: Barbe
authors.forename: Arnaud
authors.initials: A
authors.lastname: Murat
authors.forename: Benoit
authors.initials: B
authors.lastname: Dupas
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
authors.forename: Antoine
authors.initials: A
authors.lastname: Tabarin
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Vullierme
authors.forename: Alfred
authors.initials: A
authors.lastname: Penfornis
authors.forename: Vincent
authors.initials: V
authors.lastname: Rohmer
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Marc
authors.initials: M
authors.lastname: Le Rhun
authors.forename: Delphine
authors.initials: D
authors.lastname: Gaye
authors.forename: Claude
authors.initials: C
authors.lastname: Marcus
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D019160:Endosonography; D005188:False Negative Reactions; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D011446:Prospective Studies; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium