Author of 1 Presentation
SS 3.1 - Staging of pancreatic ductal adenocarcinoma: comparison between CT and MRI for accurate clinical practice (ID 778)
Abstract
Purpose
To compare CT and MRI for the staging of pancreatic ductal adenocarcinoma (PDAC); assessing differences between the evaluations of radiologists with different degrees of expertise.
Material and methods
38 patients with PDAC were prospectively enrolled between May 2018 and February 2019. All patients underwent contrast-enhanced CT and MRI performed close to each other, both before and after chemotherapy treatment. Main quantitative and qualitative CT and MRI parameters have been evaluated by two radiologists with different degrees of expertise in pancreatic imaging. Concordance between CT and MRI was tested both pre- and post-chemotherapy. Each CT parameter was compared with the corresponding MRI, considering one of them as the reference standard. Cohen’s K-coefficient (k) was calculated to evaluate the inter-observer agreement.
Results
CT and MRI agree in the evaluation of tumor size (p<0.01), with a mean discrepancy of 15%. Tumor dimension in diffusion-weighted imaging (DWI) was correlated to the CT lesion diameter with a variation within 15%. Concordance in the assessment of vessel involvement and retroperitoneal infiltration was good (p<0.01), higher for the more experienced radiologist. In the evaluation of hepatic metastases, there was 94% concordance, with differences between the two radiologists (k=0.59, p<0.01). CT and MRI reported good correlation in the assessment of lymphadenopathies at expert’s evaluation. An excellent correlation was observed between the two methods in the evaluation of healthy pancreatic parenchyma (p<0.01). Concordance values between CT and MRI were generally higher for the more experienced radiologist.
Conclusion
In PDAC staging, the pancreatic expert radiologist can use CT and MRI alternately, while a less skilled radiologist may prefer their parallel use.