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Published in: European Radiology 2/2015

01-02-2015 | Hepatobiliary-Pancreas

Differentiation of noncalculous periampullary obstruction: comparison of CT with negative-contrast CT cholangiopancreatography versus MRI with MR cholangiopancreatography

Authors: Bin Li, Lei Zhang, Zhui-Yang Zhang, Jian-Ming Ni, Feng-qi Lu, Wen-Juan Wu, Chun-juan Jiang

Published in: European Radiology | Issue 2/2015

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Abstract

Objectives

The purpose of this study was to compare CT with negative-contrast CT cholangiopancreatography (nCTCP) using subvolume minimum intensity projection (MinIP) versus MRI with MRCP in differentiating noncalculous periampullary obstruction.

Methods

Sixty-four patients with clinically proven noncalculous periampullary obstructions who had undergone both MDCT and MR examinations before operation were reviewed retrospectively. Two reviewers independently interpreted the two image sets (the CT with nCTCP set [CT set] vs. the MRI with MRCP set [MRI set]) in differentiating both benign from malignant obstruction and pancreatic head carcinoma (PHC) from non-PHC, and the results were compared to the final clinical records.

Results

In this study, no statistically significant differences were observed in the accuracy of differentiating benign from malignant periampullary obstruction (p = 0.754 for reviewer 1 and p = 0.508 for reviewer 2) on the two image sets. The accuracy of differentiating PHC from non-PHC was also statistically insignificant (p = 0.125 for reviewer 1 and p = 1.000 for reviewer 2) on the two image sets.

Conclusion

The CT set provides a comparable performance to that of the MRI set in differentiating noncalculous periampullary obstruction.

Key Points

nCTCP with subvolume MinIP is a practical tool in evaluating biliary obstruction
Two image sets have a comparable performance in differentiating noncalculous periampullary obstruction
MDCT could serve as an alternative in patients not eligible for MRI
Literature
1.
go back to reference Kim JH, Kim MJ, Chung JJ et al (2002) Differential diagnosis of periampullary carcinoma at MR imaging. Radiographics 22:1335–1352PubMedCrossRef Kim JH, Kim MJ, Chung JJ et al (2002) Differential diagnosis of periampullary carcinoma at MR imaging. Radiographics 22:1335–1352PubMedCrossRef
2.
go back to reference Baron RL, Tublin ME, Peterson MS (2002) Imaging the spectrum of biliary tract disease. Radiol Clin N Am 40:1325–1354PubMedCrossRef Baron RL, Tublin ME, Peterson MS (2002) Imaging the spectrum of biliary tract disease. Radiol Clin N Am 40:1325–1354PubMedCrossRef
3.
go back to reference Hekimoglu K, Ustundag Y, Dusak A et al (2008) MRCP vs. ERCP in the evaluation of biliary pathologies: review of current literature. J Dig Dis 9:162–169PubMedCrossRef Hekimoglu K, Ustundag Y, Dusak A et al (2008) MRCP vs. ERCP in the evaluation of biliary pathologies: review of current literature. J Dig Dis 9:162–169PubMedCrossRef
4.
go back to reference Chung YE, Kim MJ, Kim HM et al (2011) Differentiation of benign and malignant ampullary obstructions on MR imaging. Eur J Radiol 80:198–203PubMedCrossRef Chung YE, Kim MJ, Kim HM et al (2011) Differentiation of benign and malignant ampullary obstructions on MR imaging. Eur J Radiol 80:198–203PubMedCrossRef
5.
go back to reference Chang S, Lim JH, Choi D et al (2008) Differentiation of ampullary tumor from benign papillary stricture by thin-section multidetector CT. Abdom Imaging 33:457–462PubMedCrossRef Chang S, Lim JH, Choi D et al (2008) Differentiation of ampullary tumor from benign papillary stricture by thin-section multidetector CT. Abdom Imaging 33:457–462PubMedCrossRef
6.
go back to reference Wray CJ, Ahmad SA, Matthews JB et al (2005) Surgery for pancreatic cancer: recent controversies and current practice. Gastroenterology 128:1626–1641PubMedCrossRef Wray CJ, Ahmad SA, Matthews JB et al (2005) Surgery for pancreatic cancer: recent controversies and current practice. Gastroenterology 128:1626–1641PubMedCrossRef
7.
go back to reference Abbott DE, Baker MS, Talamonti MS (2010) Neoadjuvant therapy for pancreatic cancer: a current review. J Surg Oncol 101:315–320PubMedCrossRef Abbott DE, Baker MS, Talamonti MS (2010) Neoadjuvant therapy for pancreatic cancer: a current review. J Surg Oncol 101:315–320PubMedCrossRef
8.
go back to reference Kim MJ, Mitchell DG, Ito K et al (2000) Biliary dilatation: differentiation of benign from malignant causes―value of adding conventional MR imaging to MR cholangiopancreatography. Radiology 214:173–181PubMedCrossRef Kim MJ, Mitchell DG, Ito K et al (2000) Biliary dilatation: differentiation of benign from malignant causes―value of adding conventional MR imaging to MR cholangiopancreatography. Radiology 214:173–181PubMedCrossRef
9.
go back to reference Andersson M, Kostic S, Johansson M et al (2005) MRI combined with MR cholangiopancreatography versus helical CT in the evaluation of patients with suspected periampullary tumors: a prospective comparative study. Acta Radiol 46:16–27PubMedCrossRef Andersson M, Kostic S, Johansson M et al (2005) MRI combined with MR cholangiopancreatography versus helical CT in the evaluation of patients with suspected periampullary tumors: a prospective comparative study. Acta Radiol 46:16–27PubMedCrossRef
10.
go back to reference Park HS, Lee JM, Choi HK et al (2009) Preoperative evaluation of pancreatic cancer: comparison of gadolinium-enhanced dynamic MRI with MR cholangiopancreatography versus CT. J Magn Reson Imaging 30:586–595PubMedCrossRef Park HS, Lee JM, Choi HK et al (2009) Preoperative evaluation of pancreatic cancer: comparison of gadolinium-enhanced dynamic MRI with MR cholangiopancreatography versus CT. J Magn Reson Imaging 30:586–595PubMedCrossRef
11.
go back to reference Zandrino F, Benzi L, Ferretti ML, Ferrando R, Reggiani G, Musante F (2002) Multislice CT cholangiography without biliary contrast agent: technique and initial clinical results in the assessment of patients with biliary obstruction. Eur Radiol 12:1155–1161PubMedCrossRef Zandrino F, Benzi L, Ferretti ML, Ferrando R, Reggiani G, Musante F (2002) Multislice CT cholangiography without biliary contrast agent: technique and initial clinical results in the assessment of patients with biliary obstruction. Eur Radiol 12:1155–1161PubMedCrossRef
12.
go back to reference Denecke T, Degutyte E, Stelter L et al (2006) Minimum intensity projections of the biliary system using 16-channel multidetector computed tomography in patients with biliary obstruction: comparison with MRCP. Eur Radiol 16:1719–1726PubMedCrossRef Denecke T, Degutyte E, Stelter L et al (2006) Minimum intensity projections of the biliary system using 16-channel multidetector computed tomography in patients with biliary obstruction: comparison with MRCP. Eur Radiol 16:1719–1726PubMedCrossRef
13.
go back to reference Zhang ZY, Li JP, Hu CH et al (2009) Improvement in imaging time and quality of 3D negative-contrast computed tomography cholangiography with minimum intensity projections: application of vari-slice manual cut and erosion functions. Clin Imaging 33:213–220PubMedCrossRef Zhang ZY, Li JP, Hu CH et al (2009) Improvement in imaging time and quality of 3D negative-contrast computed tomography cholangiography with minimum intensity projections: application of vari-slice manual cut and erosion functions. Clin Imaging 33:213–220PubMedCrossRef
14.
go back to reference Park MS, Kim TK, Kim KW et al (2004) Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: findings at MRCP versus ERCP. Radiology 233:234–240PubMedCrossRef Park MS, Kim TK, Kim KW et al (2004) Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: findings at MRCP versus ERCP. Radiology 233:234–240PubMedCrossRef
15.
go back to reference Kim S, Lee NK, Lee JW et al (2007) CT evaluation of the bulging papilla with endoscopic correlation. Radiographics 27:1023–1038PubMedCrossRef Kim S, Lee NK, Lee JW et al (2007) CT evaluation of the bulging papilla with endoscopic correlation. Radiographics 27:1023–1038PubMedCrossRef
16.
go back to reference Kim TU, Kim S, Lee JW et al (2008) Ampulla of Vater: comprehensive anatomy, MR imaging of pathologic conditions, and correlation with endoscopy. Eur J Radiol 66:48–64PubMedCrossRef Kim TU, Kim S, Lee JW et al (2008) Ampulla of Vater: comprehensive anatomy, MR imaging of pathologic conditions, and correlation with endoscopy. Eur J Radiol 66:48–64PubMedCrossRef
17.
go back to reference Pham DT, Hura SA, Willmann JK et al (2009) Evaluation of periampullary pathology with CT volumetric oblique coronal reformations. AJR Am J Roentgenol 193:W202–W208PubMedCrossRef Pham DT, Hura SA, Willmann JK et al (2009) Evaluation of periampullary pathology with CT volumetric oblique coronal reformations. AJR Am J Roentgenol 193:W202–W208PubMedCrossRef
18.
go back to reference Park HS, Lee JM, Choi JY et al (2008) Preoperative evaluation of bile duct cancer: MRI combined with MR cholangiopancreatography versus CT with direct cholangiography. AJR Am J Roentgenol 190:396–405PubMedCrossRef Park HS, Lee JM, Choi JY et al (2008) Preoperative evaluation of bile duct cancer: MRI combined with MR cholangiopancreatography versus CT with direct cholangiography. AJR Am J Roentgenol 190:396–405PubMedCrossRef
19.
go back to reference Schima W, Függer R, Schober E et al (2002) Diagnosis and staging of pancreatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CT. AJR Am J Roentgenol 179:717–724PubMedCrossRef Schima W, Függer R, Schober E et al (2002) Diagnosis and staging of pancreatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CT. AJR Am J Roentgenol 179:717–724PubMedCrossRef
20.
go back to reference Choi JY, Kim MJ, Lee JM et al (2008) Magnetic resonance cholangiography: comparison of two-and three-dimensional sequences for assessment of malignant biliary obstruction. Eur Radiol 18:78–86PubMedCrossRef Choi JY, Kim MJ, Lee JM et al (2008) Magnetic resonance cholangiography: comparison of two-and three-dimensional sequences for assessment of malignant biliary obstruction. Eur Radiol 18:78–86PubMedCrossRef
21.
go back to reference Kim HC, Park SJ, Park SI et al (2005) Multislice CT cholangiography using thin-slab minimum intensity projection and multiplanar reformation in the evaluation of patients with suspected biliary obstruction. Preliminary experience. Clin Imaging 29:46–54PubMed Kim HC, Park SJ, Park SI et al (2005) Multislice CT cholangiography using thin-slab minimum intensity projection and multiplanar reformation in the evaluation of patients with suspected biliary obstruction. Preliminary experience. Clin Imaging 29:46–54PubMed
22.
go back to reference Tamm EP, Balachandran A, Bhosale P et al (2009) Update on 3D and multiplanar CT in the assessment of biliary and pancreatic pathology. Abdom Imaging 34:64–74PubMedCrossRef Tamm EP, Balachandran A, Bhosale P et al (2009) Update on 3D and multiplanar CT in the assessment of biliary and pancreatic pathology. Abdom Imaging 34:64–74PubMedCrossRef
23.
go back to reference Zhang ZY, Wang D, Ni JM et al (2012) Comparison of three-dimensional negative-contrast CT cholangiopancreatography with three-dimensional MR cholangiopancreatography for the diagnosis of obstructive biliary diseases. Eur J Radiol 81:830–837PubMedCrossRef Zhang ZY, Wang D, Ni JM et al (2012) Comparison of three-dimensional negative-contrast CT cholangiopancreatography with three-dimensional MR cholangiopancreatography for the diagnosis of obstructive biliary diseases. Eur J Radiol 81:830–837PubMedCrossRef
24.
go back to reference Buck JL, Elsayed AM (1993) Ampullary tumors: radiographic-pathologic correlation. Radiographics 13:193–212PubMedCrossRef Buck JL, Elsayed AM (1993) Ampullary tumors: radiographic-pathologic correlation. Radiographics 13:193–212PubMedCrossRef
25.
go back to reference Sukru ME, Tomoaki I, Hironobu S et al (2006) Pancreatic adenocarcinoma: MDCT versus MRI in the detection and assessment of locoregional extension. J Comput Assist Tomogr 30:583–590CrossRef Sukru ME, Tomoaki I, Hironobu S et al (2006) Pancreatic adenocarcinoma: MDCT versus MRI in the detection and assessment of locoregional extension. J Comput Assist Tomogr 30:583–590CrossRef
26.
go back to reference Fukushima H, Itoh S, Takada A et al (2006) Diagnostic value of curved multiplanar reformatted images in multislice CT for the detection of resectable pancreatic ductal adenocarcinoma. Eur Radiol 16:1709–1718PubMedCrossRef Fukushima H, Itoh S, Takada A et al (2006) Diagnostic value of curved multiplanar reformatted images in multislice CT for the detection of resectable pancreatic ductal adenocarcinoma. Eur Radiol 16:1709–1718PubMedCrossRef
Metadata
Title
Differentiation of noncalculous periampullary obstruction: comparison of CT with negative-contrast CT cholangiopancreatography versus MRI with MR cholangiopancreatography
Authors
Bin Li
Lei Zhang
Zhui-Yang Zhang
Jian-Ming Ni
Feng-qi Lu
Wen-Juan Wu
Chun-juan Jiang
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3430-4

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