Kyung Mi Jang1, Seong Hyun Kim2, Young Kon Kim1, Kyoung Doo Song1, Soon Jin Lee1, Dongil Choi1. 1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Korea. 2. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Korea. Electronic address: sh6453.kim@samsung.com.
Abstract
OBJECTIVE: To investigate the early imaging findings and growth rate of pancreatic ductal adenocarcinoma (PDAC), and to assess whether MR imaging detects early PDAC better than CT. MATERIALS AND METHODS: The institutional review board approved this retrospective study and waived the requirement for informed consent. Twenty-two patients were included, and two radiologists, by consensus, assessed the presence of focal lesions, interruption of the main pancreatic duct (MPD), MPD dilatation, and pancreatitis, volume doubling time (VDT) of PDAC on prediagnostic MR imaging. Two other observers independently reviewed three image sets (CT images, unenhanced MR images, and unenhanced and contrast-enhanced MR images) for the detection of early PDAC. Paired Wilcoxon signed rank test and receiver operating characteristic (ROC) curve analysis were used for statistical analyses. RESULTS: In 20 (90.9%) patients, prediagnostic MR exams showed abnormality, and all of them showed focal lesions on the first abnormal prediagnostic MR exams. Thirteen lesions (65%) showed no MPD interruption and one lesion (5%) was accompanied by pancreatitis. The mean VDT of PDAC was 151.7 days (range, 18.3-417.8 days). Diagnostic performance of unenhanced MR images (Az, 0.971-0.989) and combined unenhanced and contrast-enhanced MR images (Az, 0.956-0.963) was significantly better than that of CT images (Az, 0.565-0.583; p<0.01) for both observers, CONCLUSION: The most common early imaging finding of PDAC on prediagnostic MR exams was a focal lesion with no MPD interruption with a mean volume doubling time of five months. MR imaging was superior to CT for the detection of early PDAC.
OBJECTIVE: To investigate the early imaging findings and growth rate of pancreatic ductal adenocarcinoma (PDAC), and to assess whether MR imaging detects early PDAC better than CT. MATERIALS AND METHODS: The institutional review board approved this retrospective study and waived the requirement for informed consent. Twenty-two patients were included, and two radiologists, by consensus, assessed the presence of focal lesions, interruption of the main pancreatic duct (MPD), MPD dilatation, and pancreatitis, volume doubling time (VDT) of PDAC on prediagnostic MR imaging. Two other observers independently reviewed three image sets (CT images, unenhanced MR images, and unenhanced and contrast-enhanced MR images) for the detection of early PDAC. Paired Wilcoxon signed rank test and receiver operating characteristic (ROC) curve analysis were used for statistical analyses. RESULTS: In 20 (90.9%) patients, prediagnostic MR exams showed abnormality, and all of them showed focal lesions on the first abnormal prediagnostic MR exams. Thirteen lesions (65%) showed no MPD interruption and one lesion (5%) was accompanied by pancreatitis. The mean VDT of PDAC was 151.7 days (range, 18.3-417.8 days). Diagnostic performance of unenhanced MR images (Az, 0.971-0.989) and combined unenhanced and contrast-enhanced MR images (Az, 0.956-0.963) was significantly better than that of CT images (Az, 0.565-0.583; p<0.01) for both observers, CONCLUSION: The most common early imaging finding of PDAC on prediagnostic MR exams was a focal lesion with no MPD interruption with a mean volume doubling time of five months. MR imaging was superior to CT for the detection of early PDAC.
Authors: Andrea S Kierans; Alexander Gavlin; Natasha Wehrli; Laura M Flisnik; Sarah Eliades; Meredith E Pittman Journal: Abdom Radiol (NY) Date: 2022-02-23
Authors: Amanda L Blackford; Marcia Irene Canto; Alison P Klein; Ralph H Hruban; Michael Goggins Journal: J Natl Cancer Inst Date: 2020-11-01 Impact factor: 13.506