Magnetic resonance imaging versus endoscopic ultrasonography for the detection of pancreatic tumours in multiple endocrine neoplasia type 1

  • Barbe C
  • Murat A
  • Dupas B
 et al. 
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Abstract

Objective: In multiple endocrine neoplasia type 1, the main risk factor for metastases is pancreatic tumour size. We and others recommend limiting surgery to non-functioning pancreatic tumors ≥20 mm or growing, based on their size measured with endoscopic ultrasonography. Because endoscopic ultrasonography is invasive, we compared endoscopic ultrasonography (EUS) to non-invasive magnetic resonance imaging (MRI) for the detection of pancreatic tumours ≥10 mm in multiple endocrine neoplasia type 1 patients. Methods: A prospective study was performed in nine participating centres; 90 patients with multiple endocrine neoplasia type 1 underwent EUS and MRI with gadolinium infusion. Gastroenterologists and radiologists were blinded to the results, magnetic resonance images were reviewed centrally. Results: EUS detected 86 tumours ≥10 mm, and 48 (53.3%) patients had at least one tumour ≥10 mm. MRI detected 67 tumours ≥10 mm, and 46 (51.1%) patients had at least one tumour ≥10 mm. EUS and MRI agreement was moderate for detection of tumours ≥10 mm (Kappa coefficient=0.49), and for selection of patients with tumours ≥10 mm (Kappa coefficient=0.55). EUS and MRI missed 11/24 and 4/24 lesions ≥20 mm, respectively. EUS failed to identify 9/57 (15.7%) patients with pancreatic tumours ≥10 mm, and MRI failed to identify 11/57 (19.3%) patients with pancreatic tumours ≥10 mm. Conclusions: EUS and MRI are complementary and should be performed at initial evaluation in multiple endocrine neoplasia type 1 patients. Whether follow-up should be based on either technique or both, requires further evaluation. © 2011 Editrice Gastroenterologica Italiana S.r.l.

Author-supplied keywords

  • Contrast Media
  • Endosonography
  • False Negative Reactions
  • Humans
  • Magnetic Resonance Imaging
  • Malignancy
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 1
  • Pancreatic Neoplasms
  • Pancreatic neuroendocrine tumours
  • Prospective Studies
  • Single-Blind Method
  • Surgery
  • Tumour size
  • Young Adult
  • adolescent
  • adult
  • aged
  • article
  • cancer diagnosis
  • cancer size
  • controlled study
  • diagnostic accuracy
  • diagnostic value
  • endoscopic echography
  • female
  • follow up
  • gadolinium
  • human
  • image analysis
  • intermethod comparison
  • major clinical study
  • male
  • multiple endocrine neoplasia
  • nuclear magnetic resonance imaging
  • pancreas tumor
  • priority journal
  • prospective study
  • radiologist

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Authors

  • C Barbe

  • A Murat

  • B Dupas

  • P Ruszniewski

  • A Tabarin

  • M.-P. Vullierme

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