An MRI-driven practice: a new perspective on MRI for the evaluation of adenocarcinoma of the head of the pancreas

J Gastrointest Surg. 2010 Aug;14(8):1292-7. doi: 10.1007/s11605-010-1221-z. Epub 2010 May 14.

Abstract

Objectives: The purpose of the study was to describe the MRI-driven management of masses at the head of the pancreas.

Main outcome measures: The main outcome measure was tumor resectability.

Methods: A retrospective review of prospective radiographic diagnoses was undertaken.

Results: Between 2004 and 2008, we have treated 124 patients for a radiographic diagnosis of adenocarcinoma of the head of the pancreas. This diagnosis was correct in 96.0% of the time. MRI was 100% sensitive in determining resectability, 73.2-78.9% specific, and had an overall accuracy of 86.3-87.5%. MRI could detect venous and arterial involvement with 95% and 95.9% accuracy, respectively, and missed only six metastases.

Conclusion: MRI is a useful tool in the preoperative imaging of pancreatic head lesions that is highly sensitive and very specific for resectable disease. Prospective trials of MRI in this setting are indicated.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / surgery
  • Aged
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy
  • Prognosis
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Time Factors