Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study.

Objectives: To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP).Methods: We p...

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Publicado en:European Radiology Vol. 28; no. 3; pp. 936 - 946
Autores principales: Shi, Yu, Gao, Feng, Li, Yue, Tao, Shengzhen, Yu, Bing, Liu, Zaiyi, Liu, Yanqing, Glaser, Kevin J., Ehman, Richard L., Guo, Qiyong
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Springer Nature Mar2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2018
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      pub: Springer Nature
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        atl: Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study.
      aug:
        au:
          Shi, Yu
          Gao, Feng
          Li, Yue
          Tao, Shengzhen
          Yu, Bing
          Liu, Zaiyi
          Liu, Yanqing
          Glaser, Kevin J.
          Ehman, Richard L.
          Guo, Qiyong
        affil: Department of Radiology, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, 110004, Shenyang, People’s Republic of China
      sug:
        subj:
          Imaging, Three-Dimensional Methods
          Ultrasonography Methods
          Magnetic Resonance Imaging Methods
          Tomography, X-Ray Computed Methods
          Carcinoma, Ductal Diagnosis
          Pancreatic Neoplasms Diagnosis
          Pancreatitis Diagnosis
          Pancreas
          Female
          ROC Curve
          Aged
          Prospective Studies
          Middle Age
          Male
          Adult
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
          Male
      ab: Objectives: To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP).Methods: We performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC).Results: The final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702; P = 0.026, P < 0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745; P = 0.026, P = 0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9.Conclusions: MRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties.Key Points: • 3D MRE is useful for calculating stiffness of solid pancreatic tumours. • Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP. • Incorporation of 3D MRE into a standard MRI protocol is recommended.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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