Magnetic Resonance Imaging with Magnetic Resonance Cholangiopancreatography Accurately Predicts Resectability of Pancreatic Carcinoma

Steven N. Hochwald, Neil M. Rofsky, Michael Dobryansky, Peter Shamamian, Stuart G. Marcus

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Accurate preoperative staging of pancreatic malignancy aids in directing appropriate therapy and avoids unnecessary invasive procedures. We evaluated the accuracy of magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) in determining resectability of pancreatic malignancy. Twenty-one patients with suspected pancreatic malignancy underwent dynamic, contrast-enhanced breath-hold MRI with MRCP prior to surgical evaluation. Results of this study were correlated with operative results and pathologic findings. The sensitivity, specificity, and accuracy of MRI with MRCP in detecting a mass, determining the nature of the mass, and predicting lymph node involvement and resectability were determined. MRI with MRCP correctly identified the presence of a pancreatic mass in all 21 of these patients. Following pathologic correlation, it was determined that MRI with MRCP was 81% accurate in determining the benign or malignant nature of the pancreatic mass and 43% accurate in predicting lymph node involvement. In predicting resectability, MRI with MRCP had a sensitivity of 100%, specificity of 83%, positive predictive value of 94%, negative predictive value of 100%, and accuracy of 95%. MRI with MRCP is an accurate, noninvasive technique in the preoperative evaluation of pancreatic malignancy. Information obtained from MRI with MRCP including identification of a mass and predicting tumor resectability may be of value in staging and avoiding unnecessary invasive diagnostic procedures in patients with pancreatic cancer.

Original languageEnglish (US)
Pages (from-to)506-511
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume3
Issue number5
StatePublished - Sep 1999

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Magnetic Resonance Cholangiopancreatography
Magnetic Resonance Imaging
Neoplasms
Lymph Nodes
Unnecessary Procedures
Sensitivity and Specificity
Pancreatic Carcinoma
Pancreatic Neoplasms

Keywords

  • Magnetic resonance cholangiopancreatography (MRCP)
  • Magnetic resonance imaging (MRI)
  • Pancreatic cancer

ASJC Scopus subject areas

  • Surgery

Cite this

Magnetic Resonance Imaging with Magnetic Resonance Cholangiopancreatography Accurately Predicts Resectability of Pancreatic Carcinoma. / Hochwald, Steven N.; Rofsky, Neil M.; Dobryansky, Michael; Shamamian, Peter; Marcus, Stuart G.

In: Journal of Gastrointestinal Surgery, Vol. 3, No. 5, 09.1999, p. 506-511.

Research output: Contribution to journalArticle

Hochwald, Steven N. ; Rofsky, Neil M. ; Dobryansky, Michael ; Shamamian, Peter ; Marcus, Stuart G. / Magnetic Resonance Imaging with Magnetic Resonance Cholangiopancreatography Accurately Predicts Resectability of Pancreatic Carcinoma. In: Journal of Gastrointestinal Surgery. 1999 ; Vol. 3, No. 5. pp. 506-511.
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abstract = "Accurate preoperative staging of pancreatic malignancy aids in directing appropriate therapy and avoids unnecessary invasive procedures. We evaluated the accuracy of magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) in determining resectability of pancreatic malignancy. Twenty-one patients with suspected pancreatic malignancy underwent dynamic, contrast-enhanced breath-hold MRI with MRCP prior to surgical evaluation. Results of this study were correlated with operative results and pathologic findings. The sensitivity, specificity, and accuracy of MRI with MRCP in detecting a mass, determining the nature of the mass, and predicting lymph node involvement and resectability were determined. MRI with MRCP correctly identified the presence of a pancreatic mass in all 21 of these patients. Following pathologic correlation, it was determined that MRI with MRCP was 81{\%} accurate in determining the benign or malignant nature of the pancreatic mass and 43{\%} accurate in predicting lymph node involvement. In predicting resectability, MRI with MRCP had a sensitivity of 100{\%}, specificity of 83{\%}, positive predictive value of 94{\%}, negative predictive value of 100{\%}, and accuracy of 95{\%}. MRI with MRCP is an accurate, noninvasive technique in the preoperative evaluation of pancreatic malignancy. Information obtained from MRI with MRCP including identification of a mass and predicting tumor resectability may be of value in staging and avoiding unnecessary invasive diagnostic procedures in patients with pancreatic cancer.",
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