MRI with mangafodipir trisodium in the detection of pancreatic tumours: comparison with helical CT

The aim was to compare spiral CT and MRI enhanced with mangafodipir trisodi um (Mn-DPDP) in the detection and staging of pancreatic lesions. 20 patient s with suspected pancreatic cancer were included in a phase III study. Trip hasic spiral CT (4 ml s(-1)) and MRI (axial T-1 weighted turbo spin echo wi th and without fat suppression, T-1 weighted gradient echo and T-2 weighted turbo spin echo at 1.5 T) were performed. All sequences were repeated foll owing contrast medium using the same instrument settings as in the unenhanc ed sequences. Mn-DPDP was administered by slow injection of 5 mu mol kg(-1) body weight. Imaging results were correlated with surgery, laparoscopy, bi opsy and/or follow-up. Eight pancreatic adenocarcinomas were present. Ten p atients had chronic pancreatitis, and two showed a stenosing papillitis. CT detected eight malignant lesions and MRI detected seven. One pancreatic ca ncer was not detected with MRI. CT and MRI excluded malignancy in nine pati ents. MRI and CT returned three false positive results. Mn-DPDP improved de lineation of the lesion, resulting in a higher level of diagnostic confiden ce. Differentiation between pseudotumorous lesions in chronic pancreatitis and pancreatic carcinoma was difficult due to similar slight contrast enhan cement. Owing to better delineation of the lesion and the higher confidence in diagnosis, MRI with Mn-DPDP may have the potential to improve the detec tion rate and the staging accuracy of focal pancreatic lesions. These resul ts need to be confirmed in a larger patient trial.