Author of 1 Presentation
SS 12.9 - Ultra-small superparamagnetic iron oxide-enhanced MRI for pre-operative lymph node staging in patients with pancreatic and periampullary carcinoma: a feasibility study
Abstract
Purpose
An important negative prognostic factor for adenocarcinomas of the pancreas and periampullary region is the presence of para-aortic lymph node (LN) metastases, which are regarded as distant metastases. Determining LN status is challenging but may be possible with MRI with ultra-small superparamagnetic iron oxide (USPIO) particles, which have proven valuable for detecting LN metastases of solid tumors. The aim is to validate USPIO-MRI for pathology in patients with pancreatic or periampullary cancer.
Material and methods
Analysis of an ongoing feasibility study in patients undergoing resection of pancreatic or periampullary adenocarcinoma (N=14). LNs are scored on MRI, divided between regional and distant, and matched to histopathology of resected specimens.
Results
One patient was excluded due to perioperative peritoneal metastases. In the remaining 13 patients, in total 307 LNs were detected on MRI. In total, 293 LNs were analyzed histopathologically. On MRI, 28/78 regional and 58/229 distant LNs were suspected for metastases. On histopathology, 35/260 regional and 3/33 distant LNs were positive for metastases. Not all suspected distant LNs were resected. The regional LNs were assessed on a per-patient basis. Five patients had suspicious LNs with positive LNs histopathologically, 4 patients had negative LNs on MRI, but positive LNs histopathologically and 4 patients had negative LNs on MRI with negative LNs histopathologically.
Conclusion
The preliminary results show that on patient basis it is possible to detect regional LN metastases with USPIO-MRI. Further analysis of the data, including node-to-node analysis and follow-up, will provide more insight into the value of USPIO-MRI in these patients.
Video-on-demand
Author of 1 Presentation
SS 12.9 - Ultra-small superparamagnetic iron oxide-enhanced MRI for pre-operative lymph node staging in patients with pancreatic and periampullary carcinoma: a feasibility study (ID 928)
Abstract
Purpose
An important negative prognostic factor for adenocarcinomas of the pancreas and periampullary region is the presence of para-aortic lymph node (LN) metastases, which are regarded as distant metastases. Determining LN status is challenging but may be possible with MRI with ultra-small superparamagnetic iron oxide (USPIO) particles, which have proven valuable for detecting LN metastases of solid tumors. The aim is to validate USPIO-MRI for pathology in patients with pancreatic or periampullary cancer.
Material and methods
Analysis of an ongoing feasibility study in patients undergoing resection of pancreatic or periampullary adenocarcinoma (N=14). LNs are scored on MRI, divided between regional and distant, and matched to histopathology of resected specimens.
Results
One patient was excluded due to perioperative peritoneal metastases. In the remaining 13 patients, in total 307 LNs were detected on MRI. In total, 293 LNs were analyzed histopathologically. On MRI, 28/78 regional and 58/229 distant LNs were suspected for metastases. On histopathology, 35/260 regional and 3/33 distant LNs were positive for metastases. Not all suspected distant LNs were resected. The regional LNs were assessed on a per-patient basis. Five patients had suspicious LNs with positive LNs histopathologically, 4 patients had negative LNs on MRI, but positive LNs histopathologically and 4 patients had negative LNs on MRI with negative LNs histopathologically.
Conclusion
The preliminary results show that on patient basis it is possible to detect regional LN metastases with USPIO-MRI. Further analysis of the data, including node-to-node analysis and follow-up, will provide more insight into the value of USPIO-MRI in these patients.