Skip to main content
Erschienen in: Abdominal Radiology 8/2020

04.04.2020 | Pancreas

Detection of pancreatic ductal adenocarcinoma and liver metastases: comparison of Gd-EOB-DTPA-enhanced MR imaging vs. extracellular contrast materials

verfasst von: Yoshifumi Noda, Satoshi Goshima, Yukiko Takai, Nobuyuki Kawai, Hiroshi Kawada, Yukichi Tanahashi, Masayuki Matsuo

Erschienen in: Abdominal Radiology | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the detectability of pancreatic ductal adenocarcinoma (PDAC) and liver metastases between Gd-EOB-DTPA- and extracellular contrast materials (ECCMs) contrast-enhanced MR imaging contrast.

Methods

Two hundred seventy-two patients with suspected pancreatic disease underwent Gd-EOB-DTPA-enhanced MR imaging (EOB group, n = 79) or ECCMs-enhanced MR imaging (ECCM group, n = 193). The ECCM group were administered the following contrast agents: Gd-DTPA (n = 158), Gd-BT-DO3A (n = 28), Gd-DOTA (n = 5), and Gd-DTPA-BMA (n = 2). Signal intensities of pancreatic parenchyma, paraspinal muscle, PDAC (if present), and background noise were measured. The signal intensity ratio (SIR) of the pancreas and tumor-to-pancreas contrast-to-noise ratio (CNR) were also calculated. If present, the conspicuity of PDAC was evaluated with the arterial dominant phase images. Liver metastases, if present, were also evaluated for all sequences. Qualitative and quantitative imaging parameters were compared between EOB and ECCM groups.

Results

SIR of the pancreas (P < 0.001) and CNR (P = 0.0037) were significantly lower in EOB group when compared with the ECCM group. However, the sensitivity (97.1% vs. 93.5%, P = 0.42) and specificity (100.0% vs. 99.2%, P = 1.00) for detecting PDAC were not significant between EOB and ECCM groups. The EOB group showed a significantly greater sensitivity for detecting liver metastases compared with the ECCM group (95.0% vs 84.5%, P = 0.04) when evaluating on a lesion-by-lesion basis.

Conclusion

Gd-EOB-DTPA-enhanced MR imaging performed similarly to ECCMs-enhanced MR imaging in detecting PDAC but had better sensitivity in detecting liver metastases.
Literatur
1.
Zurück zum Zitat Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68:7-30CrossRef Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68:7-30CrossRef
2.
Zurück zum Zitat Willett CG, Czito BG, Bendell JC, Ryan DP. Locally advanced pancreatic cancer. J Clin Oncol 2005; 23:4538-4544CrossRef Willett CG, Czito BG, Bendell JC, Ryan DP. Locally advanced pancreatic cancer. J Clin Oncol 2005; 23:4538-4544CrossRef
3.
Zurück zum Zitat Pollom EL, Koong AC, Ko AH. Treatment Approaches to Locally Advanced Pancreatic Adenocarcinoma. Hematol Oncol Clin North Am 2015; 29:741-759CrossRef Pollom EL, Koong AC, Ko AH. Treatment Approaches to Locally Advanced Pancreatic Adenocarcinoma. Hematol Oncol Clin North Am 2015; 29:741-759CrossRef
4.
Zurück zum Zitat Motosugi U, Ichikawa T, Morisaka H, et al. Detection of pancreatic carcinoma and liver metastases with gadoxetic acid-enhanced MR imaging: comparison with contrast-enhanced multi-detector row CT. Radiology 2011; 260:446-453CrossRef Motosugi U, Ichikawa T, Morisaka H, et al. Detection of pancreatic carcinoma and liver metastases with gadoxetic acid-enhanced MR imaging: comparison with contrast-enhanced multi-detector row CT. Radiology 2011; 260:446-453CrossRef
5.
Zurück zum Zitat van Kessel CS, Veldhuis WB, van den Bosch MA, van Leeuwen MS. MR liver imaging with Gd-EOB-DTPA: a delay time of 10 minutes is sufficient for lesion characterisation. Eur Radiol 2012; 22:2153-2160CrossRef van Kessel CS, Veldhuis WB, van den Bosch MA, van Leeuwen MS. MR liver imaging with Gd-EOB-DTPA: a delay time of 10 minutes is sufficient for lesion characterisation. Eur Radiol 2012; 22:2153-2160CrossRef
6.
Zurück zum Zitat Suh CH, Kim KW, Park SH, et al. Performing Gadoxetic Acid-Enhanced MRI After CT for Guiding Curative Treatment of Early-Stage Hepatocellular Carcinoma: A Cost-Effectiveness Analysis. AJR Am J Roentgenol 2018; 210:W63-W69CrossRef Suh CH, Kim KW, Park SH, et al. Performing Gadoxetic Acid-Enhanced MRI After CT for Guiding Curative Treatment of Early-Stage Hepatocellular Carcinoma: A Cost-Effectiveness Analysis. AJR Am J Roentgenol 2018; 210:W63-W69CrossRef
7.
Zurück zum Zitat Nishie A, Goshima S, Haradome H, et al. Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan. Clin Ther 2017; 39:738-750 e734 Nishie A, Goshima S, Haradome H, et al. Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan. Clin Ther 2017; 39:738-750 e734
8.
Zurück zum Zitat Zech CJ, Justo N, Lang A, et al. Cost evaluation of gadoxetic acid-enhanced magnetic resonance imaging in the diagnosis of colorectal-cancer metastasis in the liver: Results from the VALUE Trial. Eur Radiol 2016; 26:4121-4130CrossRef Zech CJ, Justo N, Lang A, et al. Cost evaluation of gadoxetic acid-enhanced magnetic resonance imaging in the diagnosis of colorectal-cancer metastasis in the liver: Results from the VALUE Trial. Eur Radiol 2016; 26:4121-4130CrossRef
9.
Zurück zum Zitat Ito T, Sugiura T, Okamura Y, et al. The diagnostic advantage of EOB-MR imaging over CT in the detection of liver metastasis in patients with potentially resectable pancreatic cancer. Pancreatology 2017; 17:451-456CrossRef Ito T, Sugiura T, Okamura Y, et al. The diagnostic advantage of EOB-MR imaging over CT in the detection of liver metastasis in patients with potentially resectable pancreatic cancer. Pancreatology 2017; 17:451-456CrossRef
10.
Zurück zum Zitat Contreras CM, Stanelle EJ, Mansour J, et al. Staging laparoscopy enhances the detection of occult metastases in patients with pancreatic adenocarcinoma. J Surg Oncol 2009; 100:663-669CrossRef Contreras CM, Stanelle EJ, Mansour J, et al. Staging laparoscopy enhances the detection of occult metastases in patients with pancreatic adenocarcinoma. J Surg Oncol 2009; 100:663-669CrossRef
11.
Zurück zum Zitat Maithel SK, Maloney S, Winston C, et al. Preoperative CA 19-9 and the yield of staging laparoscopy in patients with radiographically resectable pancreatic adenocarcinoma. Ann Surg Oncol 2008; 15:3512-3520CrossRef Maithel SK, Maloney S, Winston C, et al. Preoperative CA 19-9 and the yield of staging laparoscopy in patients with radiographically resectable pancreatic adenocarcinoma. Ann Surg Oncol 2008; 15:3512-3520CrossRef
12.
Zurück zum Zitat Hammerstingl R, Huppertz A, Breuer J, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol 2008; 18:457-467CrossRef Hammerstingl R, Huppertz A, Breuer J, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol 2008; 18:457-467CrossRef
13.
Zurück zum Zitat . Ooka Y, Kanai F, Okabe S, et al. Gadoxetic acid-enhanced MRI compared with CT during angiography in the diagnosis of hepatocellular carcinoma. Magn Reson Imaging 2013; 31:748-754CrossRef . Ooka Y, Kanai F, Okabe S, et al. Gadoxetic acid-enhanced MRI compared with CT during angiography in the diagnosis of hepatocellular carcinoma. Magn Reson Imaging 2013; 31:748-754CrossRef
14.
Zurück zum Zitat Lowenthal D, Zeile M, Lim WY, et al. Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging. Eur Radiol 2011; 21:832-840CrossRef Lowenthal D, Zeile M, Lim WY, et al. Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging. Eur Radiol 2011; 21:832-840CrossRef
15.
Zurück zum Zitat Ringe KI, Boll DT, Husarik DB, Bashir MR, Gupta RT, Merkle EM. Lesion detection and assessment of extrahepatic findings in abdominal MRI using hepatocyte specific contrast agents–comparison of Gd-EOB-DTPA and Gd-BOPTA. BMC Med Imaging 2013; 13:10CrossRef Ringe KI, Boll DT, Husarik DB, Bashir MR, Gupta RT, Merkle EM. Lesion detection and assessment of extrahepatic findings in abdominal MRI using hepatocyte specific contrast agents–comparison of Gd-EOB-DTPA and Gd-BOPTA. BMC Med Imaging 2013; 13:10CrossRef
16.
Zurück zum Zitat Tamada T, Ito K, Sone T, et al. Dynamic contrast-enhanced magnetic resonance imaging of abdominal solid organ and major vessel: comparison of enhancement effect between Gd-EOB-DTPA and Gd-DTPA. J Magn Reson Imaging 2009; 29:636-640CrossRef Tamada T, Ito K, Sone T, et al. Dynamic contrast-enhanced magnetic resonance imaging of abdominal solid organ and major vessel: comparison of enhancement effect between Gd-EOB-DTPA and Gd-DTPA. J Magn Reson Imaging 2009; 29:636-640CrossRef
17.
Zurück zum Zitat Rohrer M, Bauer H, Mintorovitch J, Requardt M, Weinmann HJ. Comparison of magnetic properties of MRI contrast media solutions at different magnetic field strengths. Invest Radiol 2005; 40:715-724CrossRef Rohrer M, Bauer H, Mintorovitch J, Requardt M, Weinmann HJ. Comparison of magnetic properties of MRI contrast media solutions at different magnetic field strengths. Invest Radiol 2005; 40:715-724CrossRef
18.
Zurück zum Zitat Winston CB, Mitchell DG, Outwater EK, Ehrlich SM. Pancreatic signal intensity on T1-weighted fat saturation MR images: clinical correlation. J Magn Reson Imaging 1995; 5:267-271CrossRef Winston CB, Mitchell DG, Outwater EK, Ehrlich SM. Pancreatic signal intensity on T1-weighted fat saturation MR images: clinical correlation. J Magn Reson Imaging 1995; 5:267-271CrossRef
19.
Zurück zum Zitat Donati OF, Fischer MA, Chuck N, Hunziker R, Weishaupt D, Reiner CS. Accuracy and confidence of Gd-EOB-DTPA enhanced MRI and diffusion-weighted imaging alone and in combination for the diagnosis of liver metastases. Eur J Radiol 2013; 82:822-828CrossRef Donati OF, Fischer MA, Chuck N, Hunziker R, Weishaupt D, Reiner CS. Accuracy and confidence of Gd-EOB-DTPA enhanced MRI and diffusion-weighted imaging alone and in combination for the diagnosis of liver metastases. Eur J Radiol 2013; 82:822-828CrossRef
Metadaten
Titel
Detection of pancreatic ductal adenocarcinoma and liver metastases: comparison of Gd-EOB-DTPA-enhanced MR imaging vs. extracellular contrast materials
verfasst von
Yoshifumi Noda
Satoshi Goshima
Yukiko Takai
Nobuyuki Kawai
Hiroshi Kawada
Yukichi Tanahashi
Masayuki Matsuo
Publikationsdatum
04.04.2020
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 8/2020
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02511-9

Weitere Artikel der Ausgabe 8/2020

Abdominal Radiology 8/2020 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.