Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study

Yu Shi, Feng Gao, Yue Li, Shengzhen Tao, Bing Yu, Zaiyi Liu, Yanqing Liu, Kevin J. Glaser, Richard Lorne Ehman, Qiyong Guo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP). Methods: We performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC). Results: The final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702; P = 0.026, P < 0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745; P = 0.026, P = 0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9. Conclusions: MRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties. Key Points: • 3D MRE is useful for calculating stiffness of solid pancreatic tumours.• Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP.• Incorporation of 3D MRE into a standard MRI protocol is recommended.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalEuropean Radiology
DOIs
StateAccepted/In press - Oct 6 2017

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Echo-Planar Imaging
Elasticity Imaging Techniques
Pancreatitis
Adenocarcinoma
Prospective Studies
Area Under Curve
Serum
ROC Curve
Neoplasms
Sensitivity and Specificity

Keywords

  • Diagnostic performance
  • Elastography
  • Magnetic resonance imaging
  • Pancreatic neoplasms
  • Pancreatitis, chronic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction : a prospective study. / Shi, Yu; Gao, Feng; Li, Yue; Tao, Shengzhen; Yu, Bing; Liu, Zaiyi; Liu, Yanqing; Glaser, Kevin J.; Ehman, Richard Lorne; Guo, Qiyong.

In: European Radiology, 06.10.2017, p. 1-10.

Research output: Contribution to journalArticle

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abstract = "Objectives: To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP). Methods: We performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC). Results: The final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702; P = 0.026, P < 0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745; P = 0.026, P = 0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9. Conclusions: MRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties. Key Points: • 3D MRE is useful for calculating stiffness of solid pancreatic tumours.• Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP.• Incorporation of 3D MRE into a standard MRI protocol is recommended.",
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AU - Gao, Feng

AU - Li, Yue

AU - Tao, Shengzhen

AU - Yu, Bing

AU - Liu, Zaiyi

AU - Liu, Yanqing

AU - Glaser, Kevin J.

AU - Ehman, Richard Lorne

AU - Guo, Qiyong

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N2 - Objectives: To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP). Methods: We performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC). Results: The final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702; P = 0.026, P < 0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745; P = 0.026, P = 0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9. Conclusions: MRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties. Key Points: • 3D MRE is useful for calculating stiffness of solid pancreatic tumours.• Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP.• Incorporation of 3D MRE into a standard MRI protocol is recommended.

AB - Objectives: To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP). Methods: We performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC). Results: The final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702; P = 0.026, P < 0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745; P = 0.026, P = 0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9. Conclusions: MRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties. Key Points: • 3D MRE is useful for calculating stiffness of solid pancreatic tumours.• Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP.• Incorporation of 3D MRE into a standard MRI protocol is recommended.

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KW - Elastography

KW - Magnetic resonance imaging

KW - Pancreatic neoplasms

KW - Pancreatitis, chronic

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