MRI The limitations noted above for studies regarding CT and the accuracy of assessing vascular involvement by tumor apply to MRI as well (with differences in criteria for defining a vessel as involved by tumor, differences in definitions of resectability, and varying generations of equipment, etc. ). Fewer studies are available on the topic of MRI and staging of pancreatic cancer than there are for CT. A study comparing 64-detector row MDCT versus 3T MRI showed for MRI a sensitivity for vascular infiltration of 50% to 80% and a specificity of 96% to 98% [11]. These findings are similar to those found on a meta-analysis of eight studies published between 1997 and 2004 that showed a pooled sensitivity of 67% and pooled specificity of 94% that was not significantly different Staging of Pancreatic Ductal Adenocarcinoma from CT [33]. Therefore, MRI and CT can be considered likely comparable with regard to assessment of vascular involvement by tumor. As noted above, assessment for nodal staging on cross-sectional imaging is limited because of its current inability to identify micrometastases. A critical review article on staging reportedly noted an accuracy ranging from 61% to 77% in radiology studies from 2004 to 2009 for the detection of nodal involvement by tumor [29]. In contrast, MRI has been shown to be likely superior for the detection of liver metastases. Two studies that compared 64-detector row MDCT with 3T MRI showed that CT had a sensitivity of 70% to 76% for the detection of liver metastases compared to 90% to 100% for MRI with either gadobenate dimeglumine or gadoxetic acid [33,36]. The literature search identified only very limited information with regard to MRI and pancreatic cancer peritoneal metastases. A study evaluating the usefulness of staging laparoscopy following staging MRI noted that the yield of staging laparoscopy was marginal and cost effectiveness was reportedly poor for use of this approach [40].
Staging of Pancreatic Ductal Adenocarcinoma. MRI The limitations noted above for studies regarding CT and the accuracy of assessing vascular involvement by tumor apply to MRI as well (with differences in criteria for defining a vessel as involved by tumor, differences in definitions of resectability, and varying generations of equipment, etc. ). Fewer studies are available on the topic of MRI and staging of pancreatic cancer than there are for CT. A study comparing 64-detector row MDCT versus 3T MRI showed for MRI a sensitivity for vascular infiltration of 50% to 80% and a specificity of 96% to 98% [11]. These findings are similar to those found on a meta-analysis of eight studies published between 1997 and 2004 that showed a pooled sensitivity of 67% and pooled specificity of 94% that was not significantly different Staging of Pancreatic Ductal Adenocarcinoma from CT [33]. Therefore, MRI and CT can be considered likely comparable with regard to assessment of vascular involvement by tumor. As noted above, assessment for nodal staging on cross-sectional imaging is limited because of its current inability to identify micrometastases. A critical review article on staging reportedly noted an accuracy ranging from 61% to 77% in radiology studies from 2004 to 2009 for the detection of nodal involvement by tumor [29]. In contrast, MRI has been shown to be likely superior for the detection of liver metastases. Two studies that compared 64-detector row MDCT with 3T MRI showed that CT had a sensitivity of 70% to 76% for the detection of liver metastases compared to 90% to 100% for MRI with either gadobenate dimeglumine or gadoxetic acid [33,36]. The literature search identified only very limited information with regard to MRI and pancreatic cancer peritoneal metastases. A study evaluating the usefulness of staging laparoscopy following staging MRI noted that the yield of staging laparoscopy was marginal and cost effectiveness was reportedly poor for use of this approach [40].