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Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

An Editorial Comment to this article was published on 23 May 2018

A Correction to this article was published on 19 April 2018

This article has been updated

Abstract

Purpose

To investigate added value of MRI to preoperative staging MDCT for evaluation of focal liver lesions (FLLs) in potentially resectable pancreatic ductal adenocarcinomas (PDACs).

Materials and methods

In patients with potentially resectable PDACs after staging MDCT (n=167), characteristics of FLLs were scored as benign, indeterminate or metastases on an MDCT set and combined MDCT and MRI set by two readers, independently. Size of hepatic lesions was measured and detection rate of hepatic metastasis unsuspected by MDCT and diagnostic yield of MRI for FLLs were assessed.

Results

Reader-averaged figure-of-merit (FOM) of the combined set was significantly higher than that of MDCT alone (0.94 vs. 0.86, p=.028). In the negative-on-CT group, the diagnostic yield of MRI was 1.5–2.3% (2/133 and 3/133 for readers 1 and 2, respectively). In the indeterminate-on-CT group, MRI yield was 10.5–13.6% (2/19 and 3/22) and in patients with suspicious-metastasis-on-CT, 8.3–26.7% (1/12 and 4/15). All lesions with false-positive and false-negative CT findings were ≤1 cm.

Conclusion

In potentially resectable PDACs, addition of MRI with DWI can provide significantly better diagnostic performance in characterization of focal liver lesions, especially for small-sized (≤ 1 cm) MDCT-indeterminate or suspicious metastasis lesions, aiding in determination of appropriate operation candidates.

Key Points

• Addition of MRI provides better diagnostic performance in characterization of liver lesions.

• Combined interpretation of MRI and MDCT provided less frequent indeterminate liver lesions.

• Diagnostic yield of MRI was high in CT-indeterminate or suspicious metastatic lesions.

• Operation candidates can be determined with greater confidence in potentially resectable PDACs.

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Change history

  • 19 April 2018

    The original version of this article, published on 19 January 2018, unfortunately contained a mistake.

Abbreviations

3D:

Three dimensional

AP:

Arterial phase

BH:

Breath-hold

DWI:

Diffusion-weighted imaging

FLL:

Focal liver lesion

FS:

Fat-suppressed

GRE:

Gradient-echo

JAFROC:

Jack-knife free-response receiver operating characteristic analysis

MDCT:

Multi-detector row computed tomography

MR:

Magnetic resonance

MR-DWI Set:

MR imaging with DWI set

PDAC:

Pancreatic ductal adenocarcinoma

PVP:

Portal venous phase

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 03080, Korea

    Sun Kyung Jeon, Jeong Min Lee, Ijin Joo, Dong Ho Lee, Su Joa Ahn & Joon Koo Han

  2. Seoul National University College of Medicine, Seoul, Korea

    Sun Kyung Jeon, Jeong Min Lee, Ijin Joo, Dong Ho Lee, Su Joa Ahn & Joon Koo Han

  3. Institute of Radiation Medicine, Seoul National University Medical Research Cente, Seoul, Korea

    Jeong Min Lee & Joon Koo Han

  4. Department of Radiology, Seoul Metropolitan Government – Seoul National University Boramae Medical Center, Seoul, Korea

    Hyunsik Woo & Myoung Seok Lee

  5. Department of Surgery, Seoul National University Hospital, Seoul, Korea

    Jin-Young Jang

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  1. Sun Kyung Jeon
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Correspondence to Jeong Min Lee.

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The scientific guarantor of this publication is Jeong Min Lee.

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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.

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Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Jeon, S.K., Lee, J.M., Joo, I. et al. Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT. Eur Radiol 28, 3484–3493 (2018). https://doi.org/10.1007/s00330-017-5258-1

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  • DOI: https://doi.org/10.1007/s00330-017-5258-1

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