Incremental value of secretin-enhanced magnetic resonance cholangiopancreatography in detecting ductal communication in a population with high prevalence of small pancreatic cysts

Neda Rastegar, Luciana G. Matteoni-Athayde, John Eng, Naoki Takahashi, Eric P. Tamm, Koenraad J. Mortele, Sapna Syngal, Daniel Margolis, Anne Marie Lennon, Christopher L. Wolfgang, Elliot K. Fishman, Ralph H. Hruban, Michael Goggins, Marcia I. Canto, Ihab R. Kamel

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We investigated the incremental diagnostic yield of S-MRCP in a population with high prevalence of small pancreatic cysts. Methods: Standard MRCP protocol was performed with and without secretin using 1.5 T units in subjects undergoing pancreatic screening because of a strong family history of pancreatic cancer as part of the multicenter Cancer of the Pancreas Screening-3 trial (CAPS 3). All studies were reviewed prospectively by two independent readers who recorded the presence and number of pancreatic cysts, the presence of visualized ductal communication before and after secretin, and the degree of confidence in the diagnoses. Result: Of 202 individuals enrolled (mean age 56 years, 46% males), 93 (46%) had pancreatic cysts detected by MRCP, and 64 of the 93 had pre-and post-secretin MRCP images available for comparison. Data from the 128 readings show that 6 (6/128 = 4.7%) had ductal communication visualized only on the secretin studies compared to pre-secretin studies (odds ratio 1.28, p = 0.04). In addition, there was a statistically significant increase in confidence in reporting ductal communication after secretin compared to before secretin (p < 0.0005). Conclusion: At 1.5 T MRI, the use of secretin can improve the visualization of ductal communication of cystic pancreatic lesions.

Original languageEnglish (US)
Pages (from-to)575-580
Number of pages6
JournalEuropean Journal of Radiology
Volume84
Issue number4
DOIs
StatePublished - 2015

Keywords

  • Cyst
  • Magnetic resonance imaging
  • Neoplasm
  • Pancreas
  • Screening
  • Secretin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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