The role of magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis and assessment of resectability of pancreatic tumors
Aldona Turowska, Urszula Łebkowska, Bożena Kubas, Jacek R. Janica, Jerzy R. Ładny, Kazimierz Kordecki
Med Sci Monit 2007; 13(1): 90-97
Background: Carcinoma of the pancreas is one of the most malignant tumors. Symptoms are usually nonspecific and insidious, such that the cancer is advanced by the time of diagnosis. The aim of the study was to assess the usefulness of MRI and MRCP in the diagnosis of patients suspected of pancreatic carcinoma and to define the role of these methods in the evaluation of resectability of pancreatic cancer in comparison with surgical findings.
Material and Methods: Forty-seven patients (32 men and 15 women) aged 46–81 had undergone MRI and MRCP examination of the upper abdomen on a 1.5 T system with a standard flexible surface coil. The results of those tests were compared with surgical and histopathological findings. The capacity of MR and MRCP to detect pathological mass, assess the nature of the disease process, and accurately assess the resectability of the malignant lesion were evaluated. In the statistical analysis the chi-squared and Fisher’s precise tests were performed. Results: Statistical analysis showed 87% sensitivity, 97% specificity, and 95% accuracy of MRI and MRCP in the evaluation of the nature of tumors within the pancreas and 100% sensitivity, 90% specificity, and 93% accuracy in determining the resectability of the lesion. The positive predictive value came to 83%, while the negative predictive value was 100%. The kappa compatibility index in comparison with surgical findings was 0.85714.Conclusions: MR and MRCP is an important diagnostic method in assessing pancreatic tumors. It is very useful in differential diagnosis and determination of tumor resectability.
Keywords: Aged, 80 and over, Aged, Cholangiopancreatography, Magnetic Resonance, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pancreas - surgery, Pancreatic Neoplasms - surgery, Reproducibility of Results, Sensitivity and Specificity