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Pancreatic adenocarcinoma: variability in measurements of tumor size among computed tomography, magnetic resonance imaging, and pathologic specimens

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Abstract

Purpose

To compare the tumor size measurements assessed by computed tomography (CT) and magnetic resonance imaging (MRI) versus measurements of resected pathologic specimens from patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

This study included 114 patients with histologically confirmed PDAC who underwent contrast-enhanced CT and MRI before surgery. The tumor sizes from CT, MRI, and pathologic specimens were compared by using Bland–Altman analyses and intraclass correlation coefficients (ICCs). The discrepancies in PDAC size between CT/MRI and pathologic specimens were calculated and contributing factors for the discrepancies, including tumor locations (pancreatic head/neck, body, or tail), T stages (T1, T2, or T3), and N stages (N0, N1, or N2), were analyzed with Pearson’s correlation coefficients and multivariable linear regression analyses.

Results

There was significant difference among the mean tumor sizes of three measurements (P < 0.001). The difference in mean tumor size between the pathologic sizes for PDAC was 4.3 mm (ICC 0.67) on CT and 5.8 mm (ICC 0.65) on MRI. Both CT and MRI showed wide ranges of limits of agreement (LOAs) between the pathologic specimens for tumor size measurements (LOAs, − 28.9 to 21.4 and − 29.4 to 17.8, respectively). The tumor size on CT or MRI was estimated to be smaller than that on pathology when the tumor was > 30 mm. The discrepancies in the tumor size estimated between CT/MRI and pathologic specimens were significantly different for tumors of different T stages (P < 0.001).

Conclusions

Both contrast-enhanced CT and MRI underestimate the mean tumor size by 4.3 mm and 5.8 mm, respectively, compared to the size of pathologic specimens. A larger tumor size indicates a greater discrepancy in the PDAC size measurements between CT/MRI and pathologic specimens.

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Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PDAC:

Pancreatic ductal adenocarcinoma

ICC:

Intraclass correlation coefficient

LOA:

Limits of agreement

EUS:

Endoscopic ultrasonography

PET:

Positron emission tomography

MDCT:

Multi-detector CT

AJCC:

American Joint Committee on Cancer

TNM:

Tumor, node, and metastases

RT:

Radiation therapy

T2WI:

T2-weighted imaging

DWI:

Diffusion-weighted magnetic resonance imaging

T1WI:

T1-weighted imaging

RECIST:

Response evaluation criteria in solid tumors

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Funding

This study was funded by Grants from the Key junior college of national clinical of China, National Natural Science Foundation of China (81601468, 81701689), Project of precision medical transformation application of SMMU (2017JZ42), and Science and Technology Innovation Foundation of Shanghai (17411952200).

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Authors and Affiliations

  1. Department of Radiology, Changhai Hospital of Shanghai, The Naval Military Medical University, No. 168 Changhai Road, Shanghai, 200433, China

    Chao Ma, Panpan Yang, Jing Li, Yun Bian, Li Wang & Jianping Lu

Authors
  1. Chao Ma
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  2. Panpan Yang
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  3. Jing Li
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  4. Yun Bian
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  5. Li Wang
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  6. Jianping Lu
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Correspondence to Jianping Lu.

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Ma, C., Yang, P., Li, J. et al. Pancreatic adenocarcinoma: variability in measurements of tumor size among computed tomography, magnetic resonance imaging, and pathologic specimens. Abdom Radiol 45, 782–788 (2020). https://doi.org/10.1007/s00261-019-02125-w

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  • DOI: https://doi.org/10.1007/s00261-019-02125-w

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