Pancreatic ductal adenocarcinoma: preoperative assessment with helical CT versus dynamic MR imaging.

Abstract

To compare helical computed tomography (CT) and dynamic, magnetic resonance (MR) imaging in the evaluation of pancreatic ductal adenocarcinoma. Dynamic MR images obtained with breath holding, 256 phase- and 512 frequency-encoding steps, 5-mm section thickness, phased-array multicoil, and double-dose gadolinium were available from 21 patients. Dynamic MR images were retrospectively compared with helical CT images in the evaluation of tumor detection, local tumor extension, and vascular involvement. Tumors were detected on dynamic MR images of 19 of 21 (90%) patients and on helical CT scans of 16 (76%) patients. Dynamic MR imaging had equal or better sensitivity, accuracy, and agreement of tumor grade than did helical CT in the comparison of imaging findings and histopathologic findings. Dynamic MR imaging also had equal or better specificity than had helical CT in determination of local tumor extension and vascular involvement, except in the factors of duodenal invasion and portal venous system involvement. However, there was no statistically significant difference among any of these measurements. Dynamic MR imaging may be better than helical CT in the preoperative detection and evaluation of local tumor extension and of vascular involvement of pancreatic ductal adenocarcinomas.