Superparamagnetic iron-oxide-enhanced diffusion-weighted magnetic resonance imaging for the diagnosis of intrapancreatic accessory spleen

  • Kousei IshigamiEmail author
  • Akihiro Nishie
  • Tomohiro Nakayama
  • Yoshiki Asayama
  • Daisuke Kakihara
  • Nobuhiro Fujita
  • Yasuhiro Ushijima
  • Daisuke Okamoto
  • Takao Ohtsuka
  • Yasuhisa Mori
  • Tetsuhide Ito
  • Naoki Mochidome
  • Hiroshi Honda



To evaluate the diagnostic performance of superparamagnetic iron-oxide (SPIO)-enhanced diffusion-weighted image (DWI) for distinguishing an intrapancreatic accessory spleen from pancreatic tumors.

Materials and methods

Twenty-six cases of intrapancreatic accessory spleen and nine cases of pancreatic tail tumors [neuroendocrine tumor (n = 8) and pancreatic adenocarcinoma (n = 1)] were analyzed. Two blind reviewers retrospectively reviewed the SPIO-enhanced magnetic resonance imaging (MRI) scans. The lesion visibility grades were compared and the diagnostic performance of SPIO-enhanced DWI was compared to those of SPIO-enhanced T2WI and T2*WI with the use of a receiver operating characteristic (ROC) analysis.


The grade of lesion visibility was the highest on DWI [mean ± standard deviation (SD): 2.8 ± 0.3] followed by T2WI (2.3 ± 0.7, p < 0.001) and T2*WI (2.1 ± 0.7, p < 0.0001). Reviewers 1 and 2 correctly characterized the presence or absence of SPIO uptake in 34 of 35 cases (97.1%) on DWI, 24 (68.6%) and 25 (71.4%) cases on T2WI, respectively, and 16 (45.7%) and 17 (48.6%) cases on T2*WI. The area under the ROC curve (AUC) of DWI was 0.974 and 0.989 for reviewers 1 and 2, respectively. For Reviewer 1, the AUC of DWI was significantly higher than that of T2*WI (0.756, p < 0.01), although it was not significantly different from that of T2WI (0.868, p = 0.0857). For Reviewer 2, the AUC of DWI was significantly higher than those of T2WI (0.846, p < 0.05) and T2*WI (0.803, p < 0.01).


The diagnostic performance of SPIO-enhanced DWI was better than those of SPIO-enhanced T2*WI and T2WI for the diagnosis of intrapancreatic accessory spleen.


Intrapancreatic accessory spleen Superparamagnetic iron oxide Diffusion-weighted image Pancreatic tumor Diagnostic performance 



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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kousei Ishigami
    • 1
    Email author
  • Akihiro Nishie
    • 1
  • Tomohiro Nakayama
    • 1
  • Yoshiki Asayama
    • 1
  • Daisuke Kakihara
    • 1
  • Nobuhiro Fujita
    • 1
  • Yasuhiro Ushijima
    • 1
  • Daisuke Okamoto
    • 1
  • Takao Ohtsuka
    • 2
  • Yasuhisa Mori
    • 2
  • Tetsuhide Ito
    • 3
  • Naoki Mochidome
    • 4
  • Hiroshi Honda
    • 1
  1. 1.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan
  2. 2.Surgery and Oncology, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan
  3. 3.Medicine and Bioregulatory Science, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan
  4. 4.Anatomic Pathology, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan

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