Comparison of helical CT and MR imaging in detecting and staging small pancreatic adenocarcinoma

Background: To compare the value of helical computed tomography (CT) and various pulse sequences of magnetic resonance (MR) imaging in the detection and staging of small pancreatic adenocarcinoma. Methods: Small pancreatic adenocarcinomas (≤2 cm in diameter) in eight patients were evaluated with both helical CT and MR imaging. Five MR imaging pulse sequences that included fat-suppressed T1-weighted images and dynamic study using fast multiplanar spoiled gradient-recalled technique were compared for the tumor detectability. To evaluate the tumor vascularity, angiographic findings were also investigated. Results: Helical CT delineated the tumor in five cases, and MR imaging depicted the tumor in seven cases. MR imaging could detect the tumor of 0.8 cm in diameter clearly. Although helical CT and dynamic MR imaging missed the tumor of 2 cm with relative hypervascularity, fat- suppressed T1-weighted MR imaging demonstrated it precisely. As for the tumor staging, MR imaging was equal or slightly superior to helical CT. Conclusion: MR imaging is the first modality of choice to evaluate small pancreatic adenocarcinoma, and fat suppressed T1-weighted images and dynamic study must be performed.