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European Radiology
Published in: European Radiology 12/2018

01-12-2018 | Hepatobiliary-Pancreas

Comparison of diagnostic performance between CT and MRI in differentiating non-diffuse-type autoimmune pancreatitis from pancreatic ductal adenocarcinoma

Authors: Sunyoung Lee, Jin Hee Kim, So Yeon Kim, Jae Ho Byun, Hyoung Jung Kim, Myung-Hwan Kim, Moon-Gyu Lee, Seung Soo Lee

Published in: European Radiology | Issue 12/2018

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Abstract

Objectives

To intraindividually compare the diagnostic performance of CT and MRI in differentiating non-diffuse-type autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDA).

Methods

Sixty-one patients with non-diffuse-type AIP and 122 patients with PDA, who underwent dynamic contrast-enhanced CT and MRI with MR pancreatography, were included. Two blinded radiologists independently rated their confidence in differentiating the two diseases on a 5-point scale, and the diagnostic performances of CT and MRI were compared. The presence of key imaging features to differentiate AIP and PDA were compared between CT and MRI.

Results

The area under the receiver operating characteristic curve was significantly greater on MRI (0.993–0.995) than on CT (0.953–0.976) for both raters (p≤0.035). The sensitivities of MRI were higher than those of CT for the diagnosis of AIP (88.5–90.2% vs. 77–80.3%, p≤0.07) and PDA (97.5–99.2% vs. 91.8–94.3%, p≤0.031) for both raters, although the difference for AIP was statistically marginal (p=0.07) for rater 1. In AIP, multiple pancreatic masses, delayed homogeneous enhancement of the pancreatic mass, and multiple main pancreatic duct (MPD) strictures were observed significantly more frequently using MRI than CT (p≤0.008). In PDA, discrete pancreatic mass and MPD stricture were observed significantly more frequently using MRI than CT (p≤0.012).

Conclusions

The diagnostic performance of MRI is better for differentiating non-diffuse-type AIP from PDA, which is due to the superiority of MRI over CT in demonstrating the key distinguishing features of both diseases.

Key Points

• Imaging differential diagnosis of non-diffuse-type AIP and PDA is challenging.
• MRI has better diagnostic performance than CT in differentiating non-diffuse-type AIP from PDA.
• MRI is superior to CT in demonstrating key distinguishing features of non-diffuse-type AIP and PDA.
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Metadata
Title
Comparison of diagnostic performance between CT and MRI in differentiating non-diffuse-type autoimmune pancreatitis from pancreatic ductal adenocarcinoma
Authors
Sunyoung Lee
Jin Hee Kim
So Yeon Kim
Jae Ho Byun
Hyoung Jung Kim
Myung-Hwan Kim
Moon-Gyu Lee
Seung Soo Lee
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5565-1

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