Pancreatic cancer MRI
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American Roentgen Ray Society Images of Pancreatic cancer MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
MRI is considered when there is a diagnostic difficulty even after performing a CT scan. MRI is helpful in staging the extent and spread of pancreatic carcinoma rather than for detecting tumors or lesions less than 2 cm in size. MRI scan while determining pancreatic adenocarcinoma relies on the assessment of the size, shape, contour of the gland. MRI is helpful in characterizing cystic lesions of the pancreas and can aid in arriving at the diagnosis. MRI scan of the pancreas while assesing for pancreatic cancer presents as hypointense on T1-weighted images and hyperintense or isointense on T2-weighted images. During dynamic MR imaging, the tumor of pancreatic cancer in the early phase shows diminished enhancement and in the late phase shows gradual enhancement.
MRI
- MRI is considered when there is a diagnostic difficulty even after performing a CT scan.
- MRI is helpful in staging the extent and spread of pancreatic carcinoma rather than for detecting tumors or lesions less than 2 cm in size.
- MRI also helps in avoiding the radiation exposure when compared to a CT scan.
- MRI scan while determining pancreatic adenocarcinoma relies on the assessment of the size, shape, contour of the gland.
- Gadolinium is the contrast material most commonly used in the contrast MRI scan of the pancreas.
- MRI is helpful in characterizing cystic lesions of the pancreas and can aid in arriving at the diagnosis.
- Pancreatic cancer shows hypointense lesions on gadolinium-enhanced T1-weighted images.
- For the complete evaluation of the pancreatic parenchyma and the pancreaticobiliary ductal system, the following magnetic resonance sequences is advised:
- T1-weighted gradient-echo; T2-weighted axial and coronal sequences, usually turbo spin-echo; two dimensional (2D) and three dimensional (3D) MRCP
- T1-weighted 3D gradient-echo (GRE) before and after intravenous administration of gadolinium.
- Diffusion-weighted imaging (DWI) nowadays is being widely used.
- MRI scan of the pancreas while assesing for pancreatic cancer presents as:[5] [6]
- Hypointense on T1-weighted images
- Hyperintense or isointense on T2-weighted images.
- During dynamic MR imaging, the tumor of pancreatic cancer in the early phase shows diminished enhancement and in the late phase shows gradual enhancement.
References
- ↑ Tummala P, Junaidi O, Agarwal B (2011). "Imaging of pancreatic cancer: An overview". J Gastrointest Oncol. 2 (3): 168–74. doi:10.3978/j.issn.2078-6891.2011.036. PMC 3397617. PMID 22811847.
- ↑ Lee ES, Lee JM (2014). "Imaging diagnosis of pancreatic cancer: a state-of-the-art review". World J Gastroenterol. 20 (24): 7864–77. doi:10.3748/wjg.v20.i24.7864. PMC 4069314. PMID 24976723.
- ↑ Sahani DV, Bonaffini PA, Catalano OA, Guimaraes AR, Blake MA (2012). "State-of-the-art PET/CT of the pancreas: current role and emerging indications". Radiographics. 32 (4): 1133–58, discussion 1158-60. doi:10.1148/rg.324115143. PMID 22786999.
- ↑ Schima W (2006). "MRI of the pancreas: tumours and tumour-simulating processes". Cancer Imaging. 6: 199–203. doi:10.1102/1470-7330.2006.0035. PMC 1766565. PMID 17208676.
- ↑ Gabata T, Matsui O, Kadoya M, Yoshikawa J, Miyayama S, Takashima T; et al. (1994). "Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement". Radiology. 193 (3): 683–8. doi:10.1148/radiology.193.3.7972808. PMID 7972808.
- ↑ Vellet AD, Romano W, Bach DB, Passi RB, Taves DH, Munk PL (1992). "Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging at 1.5 T." Radiology. 183 (1): 87–95. doi:10.1148/radiology.183.1.1312736. PMID 1312736.