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Are the thickness and ADC values reliable to evaluate pancreas in children? A retrospective MRI study
Ercan Ayaz1,2, Ozlem Ozkale Yavuz3,4, H Nursun Ozcan3
1Pediatric Radiology Division, Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey. ercan.ayaz1@gmail.com.
Insights
Pancreatic thickness measurements in children show good reliability for the head but less for other sections. Apparent diffusion coefficient (ADC) values vary by MRI scanner, necessitating consistent machine use for follow-up comparisons.
Area of Science:
- Pediatric Radiology
- Medical Imaging Physics
Background:
- Establishing normative data for pancreatic dimensions and diffusion characteristics in children is crucial for accurate diagnosis.
- Variability in MRI scanner technology can impact quantitative measurements like apparent diffusion coefficient (ADC).
Purpose of the Study:
- To define normal pancreatic thickness and ADC values in children across multiple anatomical locations.
- To assess the inter-rater and intra-rater reliability of these measurements.
- To investigate the influence of age, height, weight, and MRI vendor on pancreatic measurements.
Main Methods:
- Retrospective analysis of 190 pediatric MRI examinations using two 1.5 Tesla scanners (MAGNETOM Symphony and Signa HDxt).
- Two reviewers measured pancreatic thickness and ADC values at four locations (head, neck, body, tail).
- Patients were stratified into age groups for analysis.
Main Results:
- Pancreatic thickness correlated significantly with patient age, height, and weight (p < 0.01).
- Excellent inter-rater agreement was found for pancreatic head thickness (ICC: 0.837), with good agreement for other segments.
- Significant differences in mean ADC values were observed between MRI vendors and age groups (p < 0.05), with higher values on the Signa HDxt.
Conclusions:
- Pancreatic head thickness measurements demonstrate higher reliability compared to other segments.
- Pancreatic body and tail measurements exhibit lower reliability, potentially due to inter-study discrepancies.
- Consistent use of the same MRI machine is essential for serial ADC comparisons in pediatric patients due to vendor-specific variations.
Purpose:
To define the pancreatic thickness on the transverse plane and apparent diffusion coefficient (ADC) values at multiple anatomical locations in the normal pancreas of children and to evaluate inter-rater and intra-rater reliability.
Methods:
Two reviewers measured the thickness and ADC values of the pancreas at four locations obtained from two different 1,5 Tesla MRI scanners [MAGNETOM Symphony (Siemens Medical Systems, Erlangen, Germany) and Signa HDxt(GE Healthcare, Milwaukee, WI, USA)]. Measurements were made based on 190 retrospective MRI examinations. Patients were distributed among ten age groups for thickness measurements and three age groups for ADC measurements between 0 and 18 years.
Results:
The thickness measurements from each segment of the pancreas were significantly correlated with patient age, height and weight (p < 0.01). Inter-rater agreement was excellent for pancreatic head (intraclass correlation coefficient (ICC): 0.837) and good for pancreatic neck, body and tail (ICC: 0.646, 0.632 and 0.678, respectively). We also defined the mean ADC values for three age groups. There was significant difference in the mean ADC value of the head and body by both the vendor and age group (p < 0.05). The mean ADC values and mean ranks of the Signa HDxt were significantly higher and the frequencies were lower than those of the MAGNETOM Symphony at all locations (p < 0.001).
Conclusion:
The thickness of the pancreatic head is more reliable than that at other locations. Pancreatic body and tail measurements are not as reliable as head or neck measurements due to discrepancies between published studies and low interobserver agreement. ADC values of the normal pancreas can be significantly different among vendors; therefore, ADC comparison on follow-up should be performed using same MRI machine.
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