Pancreatic Masses: Does Diffusion Weighted MR Imaging Add to Contrast Enhanced CT in their Diagnosis and Staging?
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- Category: Vol. 85, June 2017
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Pancreatic Masses: Does Diffusion Weighted MR Imaging Add to Contrast Enhanced CT in their Diagnosis and Staging?, LAMIAA I.A. METWALLY, MARWA S.A. ELNAFRAWY and AHMED M. HUSSEIN
Abstract
Background: Pancreatic cancer is one of the most lethal human cancers that requires early diagnosis. Ultrasound, CT and MRI are different imaging modalities used for diagnosis of pancreatic masses. DW imaging can add to the diagnosis of pancreatic masses.
Objective: The purpose of the study is to compare between DW MRI (as a relatively recent modality) and CECT (as the standard protocol) regarding detection of pancreatic masses and proper staging. This would allow early detection of pancreatic cancer (for better therapeutic outcome) and accurate staging (for proper management) as a potential benefit.
Patients and Methods: 36 patients with clinical suspicion of having pancreatic pathology. Ages ranged between 38 to 86 years (mean age 55.2); 26 males & 10 females. CECT examinations were performed using 64 channels MSCT scanner (Toshiba). The MR examination was done using Philips 1.5 Tesla MRI (Intera). Diffusion imaging: using single-shot spin-echo planar imaging with (b=0,500,1000mm/s2) and ADC maps were created.
Results: The sensitivity and specificity of DWI and CECT in detection of pancreatic masses reached 100% considering bulky pancreatic head as a positive result. Extension beyond the pancreas and nodal involvement were equally detected in both.
Liver metastasis was detected in sixteen cases (44.4%) by DWI, and only ten cases (27.8%) by CECT.
Conclusion: DWI can detect pancreatic masses with high accuracy. Moreover it can detect small liver metastasis in cases of pancreatic carcinoma with higher accuracy than the contrast enhanced CT. Therefore it can alter the staging of pancreatic masses.