Abstract
Purpose
This study was done to compare the diagnostic accuracy of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the preoperative assessment of nonfunctioning pancreatic endocrine tumours (NFPET).
Materials and methods
Fifty-one patients (25 men, 26 women; mean age, 52 years), preoperatively investigated by both MDCT and MRI and subsequently operated on with a histological diagnosis of NFPET, were included in this study. MDCT and MRI accuracy in evaluating location, size, margins, baseline density/signal intensity, structure, pattern of enhancement, peak enhancement phase, involvement of main pancreatic duct, involvement of adjacent organs, infiltration of peritumoural vessels, involvement of locoregional lymph nodes, and liver metastases was compared using Pearson correlation, Mann-Whitney and chi-square tests. A value of p<0.05 was considered statistically significant.
Results
MDCT and MRI had similar accuracy in assessing size, margins, baseline density/signal intensity, structure, pattern of enhancement, peak enhancement phase, involvement of main pancreatic duct, involvement of adjacent organs, involvement of locoregional lymph nodes, and liver metastases (p>0.05). MDCT was superior to MRI in evaluating the infiltration of peritumoural vessels (p=0.025).
Conclusions
MDCT performed better than MRI in assessing vascular involvement and should be considered the best imaging tool for preoperative evaluation of NFPET.
Riassunto
Obiettivo
Scopo del presente lavoro è stato confrontare l’accuratezza diagnostica della tomografia computerizzata multidetettore (TCMD) e della risonanza magnetica (RM) nella valutazione preoperatoria dei tumori endocrini non funzionanti (TENF) del pancreas.
Materiali e metodi
Sono stati inclusi nello studio 51 pazienti (25 uomini, 26 donne, età media 52 anni) studiati nel preoperatorio mediante TCMD e RM e sottoposti a chirurgia con diagnosi istologica di TENF. L’accuratezza diagnostica di TCMD e RM nel valutare sede della lesione, dimensioni, margini, densità/intensità di segnale pre-contrastografica, struttura della lesione, pattern di enhancement, fase di massima impregnazione, coinvolgimento del dotto pancreatico principale, infiltrazione di organi viciniori, infiltrazione delle strutture vascolari peritumorali, coinvolgimento dei linfonodi locoregionali, metastasi epatiche, è stata comparata mediante test di Pearson, Mann-Whitney e chi-square test. I valori statistici sono stati considerati significativi per p<0,05.
Risultati
TCMD e RM hanno mostrato simile accuratezza nel valutare dimensioni tumorali, margini lesionali, densità/intensità di segnale pre-contrastografica, struttura lesionale, pattern di impregnazione, coinvolgimento del dotto pancreatico principale, infiltrazione degli organi contigui, linfonodi peripancreatici, metastasi epatiche (p>0,05). La TCMD è stata superiore alla RM nel valutare l’infiltrazione vascolare (p=0,025).
Conclusioni
La TCMD è stata superiore alla RM nel valutare il coinvolgimento vascolare e dovrebbe essere considerata l’indagine di prima scelta per la valutazione preoperatoria dei TENF pancreatici.
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Foti, G., Boninsegna, L., Falconi, M. et al. Preoperative assessment of nonfunctioning pancreatic endocrine tumours: role of MDCT and MRI. Radiol med 118, 1082–1101 (2013). https://doi.org/10.1007/s11547-013-0956-5
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DOI: https://doi.org/10.1007/s11547-013-0956-5
Keywords
- Multidetector computed tomography (MDCT)
- Magnetic resonance imaging (MRI)
- Pancreas
- Nonfunctioning pancreatic endocrine tumours (NFPET)