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Vascular involvement and resectability of pancreatic ductal adenocarcinoma on contrast-enhanced MRI: comparison with pancreatic protocol CT

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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the diagnostic performance for detecting vascular involvement and determining resectability differences regarding pancreatic ductal adenocarcinoma (PDAC) between contrast-enhanced CT and MRI.

Methods

This retrospective study evaluated 82 patients (73 years, 46 men) with PDAC who underwent both preoperative contrast-enhanced CT and MRI from January 2008 to March 2021. Two radiologists independently categorized vascular involvements for celiac, superior mesenteric, splenic, and common hepatic arteries, and portal, superior mesenteric, and splenic veins into no tumor contact, solid soft-tissue contact ≤ 180°, or solid soft-tissue contact > 180°. The radiologists also classified resectability into resectable, borderline resectable, or locally advanced. Receiver-operating-characteristic (ROC) analysis was conducted to evaluate the diagnostic performances for detecting vascular involvements which were confirmed by pathological or intraoperative findings. The proportion of resectability classifications was compared between CT and MRI by the Fisher’s exact test.

Results

No statistical difference was found in the diagnostic performances for detecting vascular involvement in CT (area under the ROC curve [AUC], 0.50–0.89) and MRI (AUC, 0.51–0.75) (P = 0.06–> 0.99). Resectability on CT were 79% and 68%, 20% and 26%, and 1% and 6% for resectable, borderline resectable, and locally advanced tumors for reviewers 1 and 2; those on MRI were 87% and 81%, 12% and 13%, and 1% and 6%, respectively. The proportion of resectability classifications was not different between CT and MRI (P = 0.48 and = 0.15 for reviewers 1 and 2, respectively).

Conclusion

The diagnostic performance for detecting vascular involvement and determining resectability of PDAC on contrast-enhanced MRI were comparable with pancreatic protocol CT.

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Authors and Affiliations

  1. Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan

    Yoshifumi Noda, Nobuyuki Kawai, Tetsuro Kaga, Hiroki Kato & Masayuki Matsuo

  2. Innovative and Clinical Research Promotion Center, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan

    Takuma Ishihara

  3. Institute for Advanced Study, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan

    Fuminori Hyodo

  4. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Avinash R. Kambadakone

Authors
  1. Yoshifumi Noda
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  2. Nobuyuki Kawai
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  3. Tetsuro Kaga
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  4. Takuma Ishihara
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  5. Fuminori Hyodo
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  6. Hiroki Kato
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  7. Avinash R. Kambadakone
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  8. Masayuki Matsuo
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Corresponding author

Correspondence to Yoshifumi Noda.

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Conflict of interest

AK: Grant support for research activities from Philips, GE Healthcare, and PanCAN. Other authors report no relevant disclosures or conflicts of interest.

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Noda, Y., Kawai, N., Kaga, T. et al. Vascular involvement and resectability of pancreatic ductal adenocarcinoma on contrast-enhanced MRI: comparison with pancreatic protocol CT. Abdom Radiol 47, 2835–2844 (2022). https://doi.org/10.1007/s00261-022-03581-7

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  • DOI: https://doi.org/10.1007/s00261-022-03581-7

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