Pancreatic Malignancy: Value of Arterial, Pancreatic, and Hepatic Phase Imaging with Multi–Detector Row CT

Fletcher, Joel G.; Wiersema, Maurits J.; Farrell, Michael; Fidler, Jeff L.; Burgart, Lawrence J.; Koyama, Takashi; Johnson, C. Daniel; Stephens, David H.; Ward, Ellen MacDonald; Harmsen, William S.

doi:10.1148/radiol.2291020582

Cited by 257 publications

(144 citation statements)

References 16 publications

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“…Among them, CT is currently the most widely used tool for the diagnosis of pancreas cancer since the introduction of multidetector row CT (MDCT) (17)(18)(19)(20). However, with recent MR technological developments such as parallel acquisition imaging, high performance gradient phased array coils as well as rapid imaging sequences, MR developed into a useful imaging modality for the abdomen (21,22).…”

mentioning

confidence: 99%

Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT

Park

Lee

Choi

et al. 2009

Magnetic Resonance Imaging

139

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Purpose:To determine the accuracy of magnetic resonance imaging (MRI) including dynamic imaging using three-dimensional gradient-echo (3D-GRE) sequences and MR cholangiopancreatograpy (MRCP) compared with that of multidetector row CT (MDCT) with regard to resectability in pancreas cancer. Materials and Methods:From February 2004 to July 2008, 54 patients (32 men, 22 women: age range, 28 -83 years; mean age, 63.1 years old) with surgically proven pancreatic carcinoma, who had undergone preoperative gadolinium-enhanced 3D-GRE MRI with MRCP and triplephase MDCT, were included in this retrospective study. Two, clinically experienced attending radiologists independently reviewed the two image sets. These readers evaluated the tumor conspicuity, presence of vascular invasion, choledochal and duodenal invasion, lymph node metastases, distant metastasis, and tumor resectability. The results were compared with the surgical and histopathologic findings using receiver operating characteristic analysis (Az) and kappa statistics. Results:Curative resections were performed on 42 patients. Regarding the tumor conspicuity, MRI had a significantly higher Az value compared with MDCT according to both reviewers (P Ͻ 0.05). The accuracy of resectability was Az ϭ 0.753 and 0.768 on MRI and Az ϭ 0.829 and 0.762 on MDCT for each reviewer, and the difference in the accuracy of resectability was not significant between MRI and MDCT for either reviewer (P Ͼ 0.05). Two imaging sets showed a similar diagnostic performance in the evaluation of vascular involvement, lymph node metastasis, and distant metastasis.Conclusion: Dynamic 3D-GRE MRI with MRCP shows superior tumor conspicuity and similar diagnostic performance compared with MDCT in evaluating the resectability of pancreatic cancer.

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confidence: 99%

Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT

Park

Lee

Choi

et al. 2009

Magnetic Resonance Imaging

139

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“…CT, in particular, is the method of choice in the assessment of normal pancreatic parenchyma and in the detection and staging of pancreatic adenocarcinoma 9,12,20 . The majority of standard CT protocols 9,11,12,[31][32][33][34] , entails an unenhanced acquisition followed by pancreatic parenchymal phase (PPP), portal venous phase (PVP) and delayed phase.…”

Section: Discussionmentioning

confidence: 99%

“…PPP during the standard bior triphasic CT, is the most sensitive phase for the evaluation of pancreatic parenchyma 9,20 . An average volume of 135 mL of contrast material delivered at a flow rate of 4 mL/sec, provides a pancreatic enhancement ranging from 82.2 HU to 122 HU (average 105.7 HU) 9 .…”

Section: Discussionmentioning

confidence: 99%

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Value of split-bolus multidetector-row CT technique in the quantitative assessment of pancreatic enhancement

Scialpi¹,

Rondoni²,

Recchia³

et al. 2017

MMJ

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“…Computed tomography (CT) is well established for the diagnosis and staging of malignant tumors. The introduction of multi-detector row computed tomography (MDCT) has allowed further refinements in detecting malignant tumors (McNulty et al 2001;Fletcher et al 2003). One of the most important advantages of MDCT scanners is their ability to generate multiplanar reformatted (MPR) images or 3-dimensional (3D) volume-rendered images.…”

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confidence: 99%

Combined Imaging with Multi-Detector Row Computed Tomography and Diffusion-Weighted Imaging in the Detection of Pancreatic Cancer

Yasui¹,

Sato²

2011

Tohoku J. Exp. Med.

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Pancreatic cancer is one of the most aggressive malignant tumor types. Its prognosis is extremely poor without early detection, and an accurate diagnosis with imaging techniques is vital for any chance of long-term survival after treatment. Despite the great technical advances that have been made with various kinds of imaging equipment, detection of pancreatic cancer is unsatisfactory, and new modalities are required. Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) has high sensitivity and specificity for the detection of pancreatic cancer; however, it does not provide anatomic information. Quite often, the necessary spatial correlation of a high-intensity area with anatomic structures is constrained. If it becomes possible to combine the imaging technique of DWI with multi-detector row computed tomography (MDCT), such as is done with positron emission tomography (PET) and computed tomography (CT), it is expected that the early diagnostic capability will improve. The objective of this study was to introduce combined imaging with DWI and CT into clinical practice to improve the diagnosis of pancreatic cancer. In the current report, we demonstrate a clinical attempt to combine DWI on MRI with the anatomical accuracy of MDCT for two patients of pancreatic adenocarcinoma. Analysis of these two patients revealed that the combined images corresponded precisely to the operative findings. Thus, the combined imaging with DWI and MDCT is useful for the detection of the pancreatic cancer.

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Pancreatic Malignancy: Value of Arterial, Pancreatic, and Hepatic Phase Imaging with Multi–Detector Row CT

Abstract: Routine acquisition of images in the arterial phase is unnecessary for detection of pancreatic adenocarcinoma. Images of the pancreas obtained in the hepatic phase with multi-detector row CT most accurately display vascular invasion.

Cited by 257 publications

References 16 publications

Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT

Preoperative evaluation of pancreatic cancer: Comparison of gadolinium‐enhanced dynamic MRI with MR cholangiopancreatography versus MDCT

Value of split-bolus multidetector-row CT technique in the quantitative assessment of pancreatic enhancement

Combined Imaging with Multi-Detector Row Computed Tomography and Diffusion-Weighted Imaging in the Detection of Pancreatic Cancer

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