Diehl SJ, Lehmann KJ, Gaa J, McGill S, Hoffmann V, Georgi M. MR imaging of pancreatic lesions: Comparison of manganese-DPDP and gadolinium chelate. Invest Radiol 1999;34:589–595.
RATIONALE AND OBJECTIVES.
To compare manganese-DPDP–enhanced and gadolinium-DTPA–enhanced MR imaging in patients suspected of having pancreatic cancer.
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.
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).
T1-weighted manganese-DPDP–enhanced GRE imaging with fat saturation should be regarded as the most suitable combination for detecting a pancreatic lesion.