ASSESSMENT OF RESECTABILITY OF PANCREATIC-CANCER WITH DYNAMIC CONTRAST-ENHANCED MR-IMAGING - TECHNIQUE, SURGICAL CORRELATION AND PATIENT OUTCOME

The aim of our work was to investigate the use of a dynamic contrast-e nhanced MR (DCEMR) technique for staging apparently localised pancreat ic cancer, and to determine the patterns of tumour and vascular enhanc ement with this technique. Thirty-five consecutive patients were exami ned. The MR findings were correlated with surgical findings in 13 pati ents and with clinical outcome in 22 patients. Breath-hold gradient-ec ho fast low angle shot (TR = 100, TE = 4, flip angle 80 degrees) acqui sitions were obtained at 10 and 40 s (right anterior coronal oblique p lane) and at 90 s (axial plane) following intravenous gadolinium. Mean contrast-to-noise ratio was higher on the fist than the second acquis ition (p<0.001) and higher on the second acquisition than the third (p <0.005). Tumour conspicuity was greatest and arterial anatomy was best demonstrated on the first acquisition and the portal venous anatomy o n the second. Small tumours were isointense by the third acquisition. Maximal intensity projections were helpful. The MR findings correctly predicted the surgical findings in 11 of 13 cases (85% and the clinica l course in the other 22 patients. The DCEMR imaging technique is valu able in the staging of patients with pancreatic cancer. Capillary and portal venous phase images are both required for complete local stagin g.