MR imaging of pancreatic lesions - Comparison of manganese-DPDP and gadolinium chelate

RATIONALE AND OBJECTIVES. TO compare manganese-DPDP-enhanced and gadolinium-DTPA-enhanced MR imaging in patients suspected of having pancreatic cancer. METHODS. Fifteen patients who underwent MR imaging for suspected pancreatic cancer and received gadolinium-DTPA took part in a clinical phase III trial in which the efficacy of manganese-DPDP for detection of pancreatic cancer was evaluated. T1-weighted gradient-echo (GRE) images with and without fat suppression were used. Signal-to-noise ratio and contrast-to-noise ratio were calculated before and after the administration of each contrast agent. Image quality Was assessed using a four-step score; delineation of the normal pancreas was assessed by two readers in consensus. RESULTS. In terms of pancreatic signal-to-noise ratio, only gadolinium-DTPA-enhanced fat-suppressed and non-fat-suppressed GRE imaging showed a significant (P < 0.001) increase (72% and 61%, respectively). In the patients with a focal pancreatic lesion (n = 14), a significant increase in contrast-to-noise ratio was found only in manganese-DPDP-enhanced GRE imaging without (106%) and with (82%) fat saturation. Qualitative image analysis demonstrated a significant improvement of manganese-DPDP-enhanced fat-suppressed MR images in delineating the pancreatic parenchyma (P < 0.01) as well as pancreatic tumors (P < 0.01). CONCLUSIONS. T1-weighted manganese-DPDP-enhanced GRE imaging with fat saturation should be regarded as the most suitable combination for detecting a pancreatic lesion.