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Pilot study of rapid MR pancreas screening for patients with BRCA mutation

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Purpose

To develop and optimize a rapid magnetic resonance imaging (MRI) screening protocol for pancreatic cancer to be performed in conjunction with breast MRI screening in breast cancer susceptibility gene (BRCA)–positive individuals.

Methods

An IRB-approved prospective study was conducted. The rapid screening pancreatic MR protocol was designed to be less than 10 min to be performed after a standard breast MRI protocol. Protocol consisted of coronal NT T2 SSFSE, axial NT T2 SSFSE and axial NT rFOV FOCUS DWI, and axial T1. Images were acquired with the patient in the same prone position of breast MRI using the built-in body coil. Image quality was qualitatively assessed by two radiologists with 12 and 13 years of MRI experience, respectively. The imaging protocol was modified until an endpoint of five consecutive patients with high-quality diagnostic images were achieved. Signal-to-noise ratio and contrast-to-noise ratio were assessed.

Results

The rapid pancreas MR protocol was successfully completed in all patients. Diagnostic image quality was achieved for all patients. Excellent image quality was achieved for low b values; however, image quality at higher b values was more variable. In one patient, a pancreatic neuroendocrine tumor was found and the patient was treated surgically. In four patients, small pancreatic cystic lesions were detected. In one subject, a hepatic mass was identified and confirmed as adenoma by liver MRI.

Conclusion

Rapid MR protocol for pancreatic cancer screening is feasible and has the potential to play a role in screening BRCA patients undergoing breast MRI.

Key Point

• Develop and optimize a rapid magnetic resonance imaging (MRI) screening protocol for pancreatic cancer to be performed in conjunction with breast MRI screening in BRCA mutation positive individuals.

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Abbreviations

ADC:

Apparent diffusion coefficient

ANOVA:

Analysis of variance

BRCA:

Breast-related cancer antigens

CI:

Confidence interval

CNR:

Contrast-to-noise ratio

EUS:

Endoscopic ultrasound

FNA:

Fine needle biopsy

FOCUS DWI:

Field-of-view optimized and constrained undistorted single-shot diffusion-weighted imaging

FSPGR:

Fast spoiled gradient echo

ICC:

Intra-class correlation coefficient

IPMN:

Intraductal papillary mucinous neoplasms

MRCP:

Magnetic resonance cholangiopancreatography

MRI:

Magnetic resonance imaging

NEX:

Number of excitations

NT:

Navigator-triggered

PDAC:

Pancreatic ductal adenocarcinoma

pNET:

Pancreatic neuroendocrine tumor

RC:

Repeatability coefficient

ROI:

Regions-of-interest

SNR:

Signal-to-noise ratio

SSFSE:

Single-shot fast spin echo

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Acknowledgements

The authors would like to thank Laura Tang, Department of Pathology, Memorial Sloan Kettering Cancer Center, for her assistance in the histopathological analysis.

Funding

- This work was supported by the National Institutes of Health (Grant P30 CA008748).

- Supported in part by a grant from the Lustgarten Foundation for Pancreas Cancer Research (DK).

- Work from Giuseppe Corrias was partially supported by a scholarship awarded by ISSNAF Imaging Science Chapter.

The funding sources had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Author information

Author notes

  1. Giuseppe Corrias and Mitchell C. Raeside contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Giuseppe Corrias, Mitchell C. Raeside, Andrea Agostini, Sandra Huicochea-Castellanos, Amita Shukla-Dave, Olga Smelianskaia, Richard K. G. Do & Lorenzo Mannelli

  2. Department of Radiology, University of Cagliari, Cagliari, Italy

    Giuseppe Corrias

  3. Department of Radiology, Università Politecnica delle Marche, Ancona, Italy

    Andrea Agostini

  4. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    David Aramburu-Nunez, Ramesh Paudyal & Amita Shukla-Dave

  5. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Marinela Capanu & Junting Zheng

  6. GE Healthcare, Global MR Applications and Workflow, New York, NY, USA

    Maggie Fung

  7. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    David P. Kelsen, Debra A. Mangino & Mark E. Robson

  8. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Deborah J. Goldfrank, Jean Carter & Peter J. Allen

  9. Policlinico Umberto I, Department of Radiology, Sapienza University of Rome, Rome, Italy

    Bettina Conti

  10. IRCCS SDN, Naples, Italy

    Serena Monti

Authors
  1. Giuseppe Corrias
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Corresponding author

Correspondence to Lorenzo Mannelli.

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Guarantor

The scientific guarantor of this publication is Lorenzo Mannelli.

Conflict of interest

The authors of this manuscript declare relationships with the following companies:

Maggie Fung, PhD works for GE Healthcare, Global MR Applications and Workflow, New York, NY, United States.

Statistics and biometry

Marinela Capanu, PhD, and Junting Zheng, MS, kindly provided statistical advice for this manuscript.

Marinela Capanu, PhD, and Junting Zheng, MS, are of the authors and have significant statistical expertise.

Informed consent

Only if the study is on human subjects:

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• observational

• performed at one institution

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Corrias, G., Raeside, M.C., Agostini, A. et al. Pilot study of rapid MR pancreas screening for patients with BRCA mutation. Eur Radiol 29, 3976–3985 (2019). https://doi.org/10.1007/s00330-018-5975-0

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  • DOI: https://doi.org/10.1007/s00330-018-5975-0

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