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European Radiology

, Volume 29, Issue 8, pp 3976–3985 | Cite as

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

  • Giuseppe Corrias
  • Mitchell C. Raeside
  • Andrea Agostini
  • Sandra Huicochea-Castellanos
  • David Aramburu-Nunez
  • Ramesh Paudyal
  • Amita Shukla-Dave
  • Olga Smelianskaia
  • Marinela Capanu
  • Junting Zheng
  • Maggie Fung
  • David P. Kelsen
  • Debra A. Mangino
  • Mark E. Robson
  • Deborah J. Goldfrank
  • Jean Carter
  • Peter J. Allen
  • Bettina Conti
  • Serena Monti
  • Richard K. G. Do
  • Lorenzo MannelliEmail author
Oncology

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.

Keywords

Early detection of cancer Pancreatic neoplasm Breast cancer Magnetic resonance imaging Screening 

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

Notes

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.

Compliance with ethical standards

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

Supplementary material

330_2018_5975_MOESM1_ESM.docx (1.7 mb)
ESM 1 (DOCX 1768 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Giuseppe Corrias
    • 1
    • 2
  • Mitchell C. Raeside
    • 1
  • Andrea Agostini
    • 1
    • 3
  • Sandra Huicochea-Castellanos
    • 1
  • David Aramburu-Nunez
    • 4
  • Ramesh Paudyal
    • 4
  • Amita Shukla-Dave
    • 1
    • 4
  • Olga Smelianskaia
    • 1
  • Marinela Capanu
    • 5
  • Junting Zheng
    • 5
  • Maggie Fung
    • 6
  • David P. Kelsen
    • 7
  • Debra A. Mangino
    • 7
  • Mark E. Robson
    • 7
  • Deborah J. Goldfrank
    • 8
  • Jean Carter
    • 8
  • Peter J. Allen
    • 8
  • Bettina Conti
    • 9
  • Serena Monti
    • 10
  • Richard K. G. Do
    • 1
  • Lorenzo Mannelli
    • 1
    Email author
  1. 1.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of RadiologyUniversity of CagliariCagliariItaly
  3. 3.Department of RadiologyUniversità Politecnica delle MarcheAnconaItaly
  4. 4.Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  5. 5.Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  6. 6.GE Healthcare, Global MR Applications and WorkflowNew YorkUSA
  7. 7.Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA
  8. 8.Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  9. 9.Policlinico Umberto I, Department of RadiologySapienza University of RomeRomeItaly
  10. 10.IRCCS SDNNaplesItaly

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