Pancreatic adenocarcinoma: Assessment of vascular invasion with high- field MR imaging and a phased-array coil

Sandro Sironi, Francesco De Cobelli, Alessandro Zerbi, Enzo Angeli, Gianpaolo Balzano, Gianluca Taccagni, Valerio Di Carlo, Alessandro Del Maschio

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Abstract

OBJECTIVE. We performed this study to determine the value of MR imaging for assessing vascular invasion in preoperative staging of pancreatic carcinoma. SUBJECTS AND METHODS. In 73 consecutive patients with an established diagnosis of pancreatic duct adenocarcinoma, spin-echo T1- weighted and breath-hold multiplanar gradient-recalled (MPGR) images were obtained at 1.5 T with a phased-array coil before and after bolus injection of gadopentetate dimeglumine. Major peripancreatic vessels were evaluated for contiguity with tumor and tumor encasement. All patients subsequently underwent surgery. Results of unenhanced and enhanced MR imaging studies were compared with the histologic findings in the resected specimens of 49 tumors and with the surgical findings of 24 nonresected tumors. RESULTS. In 39 patients, tumor contiguity with adjacent vessels was found at pathologic examination. Of the remaining 34 patients, 10 had vascular encasement by tumor seen on pathologic examination of the resected specimen; the other 24 had unresectable tumors encasing adjacent vessels at surgical evaluation. In the assessment of vascular tumor contiguity, the accuracy was 85% for unenhanced spin-echo T1-weighted imaging, 87% for enhanced spinecho T1- weighted imaging, 67% for unenhanced MPGR imaging, and 69% for enhanced MPGR imaging. In the assessment of vascular tumor encasement, the accuracy was 91% for unenhanced spin-echo T1-weighted imaging, 94% for enhanced spin-echo T1- weighted imaging, 74% for unenhanced MPGR imaging, and 76% for enhanced MPGR imaging. CONCLUSION. MR imaging is helpful for preoperative assessment of vascular involvement caused by pancreatic carcinoma. For this purpose, unenhanced and enhanced spin-echo T1-weighted images seem to be more accurate than images obtained with other pulse sequences.

Original languageEnglish
Pages (from-to)997-1001
Number of pages5
JournalAmerican Journal of Roentgenology
Volume167
Issue number4
Publication statusPublished - 1996

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Blood Vessels
Adenocarcinoma
Neoplasms
Gadolinium DTPA
Pancreatic Ducts
Injections

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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Pancreatic adenocarcinoma : Assessment of vascular invasion with high- field MR imaging and a phased-array coil. / Sironi, Sandro; De Cobelli, Francesco; Zerbi, Alessandro; Angeli, Enzo; Balzano, Gianpaolo; Taccagni, Gianluca; Di Carlo, Valerio; Del Maschio, Alessandro.

In: American Journal of Roentgenology, Vol. 167, No. 4, 1996, p. 997-1001.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE. We performed this study to determine the value of MR imaging for assessing vascular invasion in preoperative staging of pancreatic carcinoma. SUBJECTS AND METHODS. In 73 consecutive patients with an established diagnosis of pancreatic duct adenocarcinoma, spin-echo T1- weighted and breath-hold multiplanar gradient-recalled (MPGR) images were obtained at 1.5 T with a phased-array coil before and after bolus injection of gadopentetate dimeglumine. Major peripancreatic vessels were evaluated for contiguity with tumor and tumor encasement. All patients subsequently underwent surgery. Results of unenhanced and enhanced MR imaging studies were compared with the histologic findings in the resected specimens of 49 tumors and with the surgical findings of 24 nonresected tumors. RESULTS. In 39 patients, tumor contiguity with adjacent vessels was found at pathologic examination. Of the remaining 34 patients, 10 had vascular encasement by tumor seen on pathologic examination of the resected specimen; the other 24 had unresectable tumors encasing adjacent vessels at surgical evaluation. In the assessment of vascular tumor contiguity, the accuracy was 85{\%} for unenhanced spin-echo T1-weighted imaging, 87{\%} for enhanced spinecho T1- weighted imaging, 67{\%} for unenhanced MPGR imaging, and 69{\%} for enhanced MPGR imaging. In the assessment of vascular tumor encasement, the accuracy was 91{\%} for unenhanced spin-echo T1-weighted imaging, 94{\%} for enhanced spin-echo T1- weighted imaging, 74{\%} for unenhanced MPGR imaging, and 76{\%} for enhanced MPGR imaging. CONCLUSION. MR imaging is helpful for preoperative assessment of vascular involvement caused by pancreatic carcinoma. For this purpose, unenhanced and enhanced spin-echo T1-weighted images seem to be more accurate than images obtained with other pulse sequences.",
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AU - Sironi, Sandro

AU - De Cobelli, Francesco

AU - Zerbi, Alessandro

AU - Angeli, Enzo

AU - Balzano, Gianpaolo

AU - Taccagni, Gianluca

AU - Di Carlo, Valerio

AU - Del Maschio, Alessandro

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N2 - OBJECTIVE. We performed this study to determine the value of MR imaging for assessing vascular invasion in preoperative staging of pancreatic carcinoma. SUBJECTS AND METHODS. In 73 consecutive patients with an established diagnosis of pancreatic duct adenocarcinoma, spin-echo T1- weighted and breath-hold multiplanar gradient-recalled (MPGR) images were obtained at 1.5 T with a phased-array coil before and after bolus injection of gadopentetate dimeglumine. Major peripancreatic vessels were evaluated for contiguity with tumor and tumor encasement. All patients subsequently underwent surgery. Results of unenhanced and enhanced MR imaging studies were compared with the histologic findings in the resected specimens of 49 tumors and with the surgical findings of 24 nonresected tumors. RESULTS. In 39 patients, tumor contiguity with adjacent vessels was found at pathologic examination. Of the remaining 34 patients, 10 had vascular encasement by tumor seen on pathologic examination of the resected specimen; the other 24 had unresectable tumors encasing adjacent vessels at surgical evaluation. In the assessment of vascular tumor contiguity, the accuracy was 85% for unenhanced spin-echo T1-weighted imaging, 87% for enhanced spinecho T1- weighted imaging, 67% for unenhanced MPGR imaging, and 69% for enhanced MPGR imaging. In the assessment of vascular tumor encasement, the accuracy was 91% for unenhanced spin-echo T1-weighted imaging, 94% for enhanced spin-echo T1- weighted imaging, 74% for unenhanced MPGR imaging, and 76% for enhanced MPGR imaging. CONCLUSION. MR imaging is helpful for preoperative assessment of vascular involvement caused by pancreatic carcinoma. For this purpose, unenhanced and enhanced spin-echo T1-weighted images seem to be more accurate than images obtained with other pulse sequences.

AB - OBJECTIVE. We performed this study to determine the value of MR imaging for assessing vascular invasion in preoperative staging of pancreatic carcinoma. SUBJECTS AND METHODS. In 73 consecutive patients with an established diagnosis of pancreatic duct adenocarcinoma, spin-echo T1- weighted and breath-hold multiplanar gradient-recalled (MPGR) images were obtained at 1.5 T with a phased-array coil before and after bolus injection of gadopentetate dimeglumine. Major peripancreatic vessels were evaluated for contiguity with tumor and tumor encasement. All patients subsequently underwent surgery. Results of unenhanced and enhanced MR imaging studies were compared with the histologic findings in the resected specimens of 49 tumors and with the surgical findings of 24 nonresected tumors. RESULTS. In 39 patients, tumor contiguity with adjacent vessels was found at pathologic examination. Of the remaining 34 patients, 10 had vascular encasement by tumor seen on pathologic examination of the resected specimen; the other 24 had unresectable tumors encasing adjacent vessels at surgical evaluation. In the assessment of vascular tumor contiguity, the accuracy was 85% for unenhanced spin-echo T1-weighted imaging, 87% for enhanced spinecho T1- weighted imaging, 67% for unenhanced MPGR imaging, and 69% for enhanced MPGR imaging. In the assessment of vascular tumor encasement, the accuracy was 91% for unenhanced spin-echo T1-weighted imaging, 94% for enhanced spin-echo T1- weighted imaging, 74% for unenhanced MPGR imaging, and 76% for enhanced MPGR imaging. CONCLUSION. MR imaging is helpful for preoperative assessment of vascular involvement caused by pancreatic carcinoma. For this purpose, unenhanced and enhanced spin-echo T1-weighted images seem to be more accurate than images obtained with other pulse sequences.

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