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Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of the study was to evaluate contrast-enhanced MRI, diffusion-weighted MRI (DW MRI), and 68Ga-DOTATATE positron emission tomography (PET)/CT in the detection of intermediate to well-differentiated neuroendocrine tumors (NET) of the pancreas.

Methods

Eighteen patients with pathologically proven pancreatic NET who underwent MRI including DW MRI and PET/CT within 6 weeks of each other were included in this retrospective study. Two radiologists evaluated T2-weighted (T2w), T2w + DW MRI, T2w + contrast-enhanced T1-weighted (CE T1w) MR images, and PET/CT for NET detection. The sensitivity and level of diagnostic confidence were compared among modalities using McNemar’s test and a Wilcoxon signed rank test. Apparent diffusion coefficients (ADC) of pancreatic NETs and normal pancreatic tissue were compared with Student’s t test.

Results

Of the NETs, 8/23 (34.8 %) and 9/23 (39.1 %) were detected on T2w images by observers 1 and 2, respectively. Detection rates improved significantly by combining T2w images with DW MRI (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p < 0.05) or CE T1w images (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p < 0.05). Detection rates of pancreatic NET with PET/CT (both observers: 23/23 = 100 %) were statistically significantly higher than with MRI (p < 0.05). The mean ADC value of NET (1.02 ± 0.26 × 10−3 mm2/s) was statistically significantly lower than that of normal pancreatic tissue (1.48 ± 0.39 × 10−3 mm2/s).

Conclusion

DW MRI is a valuable adjunct to T2w imaging and comparable to CE T1w imaging in pancreatic NET detection, quantitatively differentiating between NET and normal pancreatic tissue with ADC measurements. 68Ga-DOTATATE PET/CT is more sensitive than MRI in the detection of pancreatic NET.

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Authors and Affiliations

  1. Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany

    Christine Schmid-Tannwald, Christoph M. Schmid-Tannwald, Ralph Neumann, Konstantin Nikolaou, Nicolai Schramm, Maximilian F. Reiser & Carsten Rist

  2. Department of Radiology, Scott and White Hospital Temple, 2401 S. 31st Street, Temple, TX, 76508, USA

    John N. Morelli

  3. Department of Nuclear Medicine, Ludwig Maximilians University Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany

    Alexander R. Haug & Nathalie Jansen

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  1. Christine Schmid-Tannwald
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Correspondence to Carsten Rist.

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Schmid-Tannwald, C., Schmid-Tannwald, C.M., Morelli, J.N. et al. Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas. Eur J Nucl Med Mol Imaging 40, 897–907 (2013). https://doi.org/10.1007/s00259-013-2371-5

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  • DOI: https://doi.org/10.1007/s00259-013-2371-5

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