Yoon Jeong Hee, Bae Jae Seok, Jeon Sunkyung, Chang Won, Lee Sang Min, Park Jin Young, Lee Jeong Sub, Lee Eun Sun, Cho In Rae, Lee Sang-Hyub, Lee Jeong Min
Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea.
J Magn Reson Imaging. 2022 Dec;56(6):1757-1768. doi: 10.1002/jmri.28189. Epub 2022 Apr 7.
Pancreatobiliary MRI is often recommended for patients at risk of developing pancreas cancer. But the surveillance MRI protocol has not yet been widely accepted.
To establish an accelerated MRI protocol targeting the table time of 15 minutes for pancreatic cancer surveillance and test its performance in lesion characterization.
Prospective.
A total of 30 participants were enrolled, who were undergoing follow-up care for intraductal papillary mucinous neoplasms or newly diagnosed pancreatic cysts (≥10 mm) and were scheduled for or had recently undergone contrast-enhanced CT (CECT).
FIELD STRENGTH/SEQUENCE: A 3 T; heavily T2WI, 3D MRCP, DWI, dynamic T1WI, two-point Dixon.
In-room time and table time were measured. Seven radiologists independently reviewed image quality of MRI and then the presence of high-risk stigmata and worrisome features in addition to diagnostic confidence for accelerated MRI, CECT, and the noncontrast part of accelerated MRI (NC-MRI).
Fisher's exact test was used for categorical variables and either the Student's t-test or Mann-Whitney test was performed for continuous variables. The generalized estimated equation was used to compare the diagnostic performance of examinations on a per-patient basis. Interobserver agreement was evaluated via Fleiss kappa. A P value of <0.05 was considered to be statistically significant.
The in-room time was 18.5 ± 2.6 minutes (range: 13.7-24.9) and the table time was 13.9 ± 1.9 minutes (range: 10.7-17.5). There was no significant difference between the diagnostic performances of the three examinations (pooled sensitivity: 75% for accelerated MRI and CECT, 68% for NC-MRI, P = 0.95), with the highest significant diagnostic confidence for accelerated MRI (4.2 ± 0.1). With accelerated MRI, the interobserver agreement was fair to excellent for high-risk stigmata (κ = 0.34-0.98).
Accelerated MRI protocol affords a table time of 15 minutes, making it potentially suitable for cancer surveillance in patients at risk of developing pancreatic cancer.
2 TECHNICAL EFFICACY STAGE: 2.
对于有患胰腺癌风险的患者，通常推荐进行胰胆管磁共振成像（MRI）检查。但监测MRI方案尚未被广泛接受。
建立一种针对胰腺癌监测的加速MRI方案，目标扫描时间为15分钟，并测试其在病变特征识别方面的性能。
前瞻性研究。
共纳入30名参与者，他们因导管内乳头状黏液性肿瘤或新诊断的胰腺囊肿（≥10mm）正在接受随访，且计划进行或最近已接受过对比增强CT（CECT）检查。
场强/序列：3T；重T2加权成像（T2WI）、三维磁共振胰胆管造影（3D MRCP）、扩散加权成像（DWI）、动态T1加权成像、两点 Dixon 法。
测量扫描室内时间和扫描时间。7名放射科医生独立评估MRI图像质量，然后评估加速MRI、CECT以及加速MRI的非增强部分（NC-MRI）中高危征象、可疑特征的存在情况以及诊断置信度。
分类变量采用 Fisher 精确检验，连续变量采用 Student t检验或 Mann-Whitney 检验。采用广义估计方程在个体患者层面比较各项检查的诊断性能。通过 Fleiss kappa 评估观察者间一致性。P值<0.05被认为具有统计学意义。
扫描室内时间为18.5±2.6分钟（范围：13.7 - 24.9分钟），扫描时间为13.9±1.9分钟（范围：10.7 - 17.5分钟）。三种检查的诊断性能无显著差异（加速MRI和CECT的合并敏感度：75%，NC-MRI为68%，P = 0.95），加速MRI的诊断置信度最高（4.2±0.1）。对于加速MRI，观察者间对高危征象的一致性评价为中等至优秀（κ = 0.34 - 0.98）。
加速MRI方案的扫描时间为15分钟，使其有可能适用于有患胰腺癌风险患者的癌症监测。
2 技术效能阶段：2。
