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European Radiology

, Volume 27, Issue 4, pp 1722–1732 | Cite as

Differentiation of mass-forming focal pancreatitis from pancreatic ductal adenocarcinoma: value of characterizing dynamic enhancement patterns on contrast-enhanced MR images by adding signal intensity color mapping

  • Mimi Kim
  • Kyung Mi JangEmail author
  • Jae-Hun Kim
  • Woo Kyoung Jeong
  • Seong Hyun Kim
  • Tae Wook Kang
  • Young Kon Kim
  • Dong Ik Cha
  • Kyunga Kim
Hepatobiliary-Pancreas

Abstract

Objectives

To evaluate the value of dynamic enhancement patterns on contrast-enhanced MR images by adding signal intensity colour mapping (SICM) to differentiate mass-forming focal pancreatitis (MFFP) from pancreatic ductal adenocarcinoma (PDAC).

Methods

Forty-one clinicopathologically proven MFFPs and 144 surgically confirmed PDACs were enrolled. Laboratory and MR imaging parameters were used to differentiate MFFP from PDAC. In particular, enhancement patterns on MR images adding SICM were evaluated. By using classification tree analysis (CTA), we determined the predictors for the differentiation of MFFP from PDAC.

Results

In the CTA, with all parameters except enhancement pattern on SICM images, ductal obstruction grade and T1 hypointensity grade of the pancreatic lesion were the first and second splitting predictor for differentiation of MFFP from PDAC, in order. By adding an enhancement pattern on the SICM images to CTA, the enhancement pattern was the only splitting predictor to differentiate MFFP from PDAC. The CTA model including enhancement pattern on SICM images has sensitivity of 78.0 %, specificity of 99.3 %, and accuracy of 94.6 % for differentiating MFFP from PDAC.

Conclusion

The characterization of enhancement pattern for pancreatic lesions on contrast-enhanced MR images adding SICM would be helpful to differentiate MFFP from PDAC.

Key Points

SICM was useful to characterize enhancement pattern.

Enhancement pattern on SICM was the only splitting predictor on CTA.

This model may be useful for differentiating MFFP from PDAC.

Keywords

Pancreatic ductal adenocarcinomas Mass-forming focal pancreatitis Magnetic resonance imaging Signal intensity colour mapping Classification tree analysis 

Abbreviations

PDAC

Pancreatic ductal adenocarcinomas

MFFP

Mass-forming focal pancreatitis

CBD

Common bile duct

MPD

Main pancreatic duct

SICM

Signal intensity colour mapping

MR

Magnetic resonance

DWI

Diffusion-weighted imaging

ADC

Apparent diffusion coefficient

CTA

Classification tree analysis

Notes

Acknowledgments

The scientific guarantor of this publication is Won Jae Lee, the head of radiology department. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise, Kyunga Kim. Institutional review board approval was obtained. Written informed consent was waived by the Institutional review board. No study subjects or cohorts have been previously reported

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Mimi Kim
    • 1
  • Kyung Mi Jang
    • 2
    • 3
    Email author
  • Jae-Hun Kim
    • 2
  • Woo Kyoung Jeong
    • 2
  • Seong Hyun Kim
    • 2
  • Tae Wook Kang
    • 2
  • Young Kon Kim
    • 2
  • Dong Ik Cha
    • 2
  • Kyunga Kim
    • 4
  1. 1.Department of Radiology, Hanyang Medical CenterHanyang University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology and Center for Imaging Science, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  4. 4.Biostatics and Clinical Epidemiology Center, Research Institute for Future MedicineSamsung Medical CenterSeoulRepublic of Korea

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