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Incidental pancreatic cystic lesions: comparison between CT with model-based algorithm and MRI.
D Ippolito1, C Maino1, A Pecorelli1
1Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy.
Radiography (London, England : 1995)
|December 7, 2020
Summary
Low-kilovolt CT with MBIR reconstruction shows good agreement with MRI for detecting pancreatic cystic lesion features. This CT technique is a useful first-line tool for identifying worrisome signs and high-risk stigmata.
Area of Science:
- Radiology
- Medical Imaging
- Gastroenterology
Background:
- Pancreatic cystic lesions require accurate characterization for risk stratification.
- Magnetic Resonance Imaging (MRI) is the established standard for evaluating these lesions.
- Computed Tomography (CT) offers an alternative imaging modality.
Purpose of the Study:
- To compare low-kilovolt (kV) CT reconstructed with the Model-Based Iterative Reconstruction (MBIR) technique against MRI for detecting high-risk stigmata and worrisome features in pancreatic cystic lesions.
- To assess the diagnostic performance of low-kV CT-MBIR in characterizing pancreatic cystic lesions.
Main Methods:
- Retrospective enrollment of 75 patients who underwent low-kV CT with contrast and MRI with Magnetic Resonance Cholangiopancreatography (MRCP).
- Blinded review of imaging data to record lesion characteristics including size, location, calcifications, septa, solid components, main pancreatic duct (MPD) communication, and MPD dilatation.
- Statistical analysis using mean differences, 95% limits of agreement, Intraclass Correlation Coefficient (ICC), and Cohen's kappa (κ) statistics to compare CT and MRI findings.
Main Results:
- MRI detected more pancreatic cystic lesions than CT, but a good overall agreement (ICC = 0.81) was observed.
- Very good agreement was found for lesion diameter (ICC = 0.98), location (κ = 0.90), MPD dilatation (κ = 1), septa presence (κ = 0.86), and MPD communication (κ = 0.87).
- Moderate agreement was noted for enhanced components (κ = 0.44), and fair agreement for calcifications (κ = 0.87).
Conclusions:
- Multi-detector CT (MDCT) reconstructed with MBIR is nearly equivalent to MRI with MRCP for evaluating worrisome features and high-risk stigmata in pancreatic cystic lesions.
- Low-kV CT-MBIR provides detailed morphological features beneficial for lesion characterization.
- CT can serve as a valuable first-line imaging technique for identifying concerning features in pancreatic cystic lesions, complementing MRI's role.
Keywords:
Magnetic resonance cholangiopancreatographyMultidetector computed tomographyPancreatic intraductal neoplasmsPancreatic neoplasmsMore Related Videos
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