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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

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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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

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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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Authors and Affiliations

  1. Department of Radiology, Hanyang Medical Center, Hanyang University College of Medicine, Seoul, Republic of Korea

    Mimi Kim

  2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Kyung Mi Jang, Jae-Hun Kim, Woo Kyoung Jeong, Seong Hyun Kim, Tae Wook Kang, Young Kon Kim & Dong Ik Cha

  3. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul, 135-710, Korea

    Kyung Mi Jang

  4. Biostatics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea

    Kyunga Kim

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Correspondence to Kyung Mi Jang.

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Kim, M., Jang, K.M., Kim, JH. et al. 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. Eur Radiol 27, 1722–1732 (2017). https://doi.org/10.1007/s00330-016-4522-0

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  • DOI: https://doi.org/10.1007/s00330-016-4522-0

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