Pilot study of rapid MR pancreas screening for patients with BRCA mutation
Abstract
Purpose
To develop and optimize a rapid magnetic resonance imaging (MRI) screening protocol for pancreatic cancer to be performed in conjunction with breast MRI screening in breast cancer susceptibility gene (BRCA)–positive individuals.
Methods
An IRB-approved prospective study was conducted. The rapid screening pancreatic MR protocol was designed to be less than 10 min to be performed after a standard breast MRI protocol. Protocol consisted of coronal NT T2 SSFSE, axial NT T2 SSFSE and axial NT rFOV FOCUS DWI, and axial T1. Images were acquired with the patient in the same prone position of breast MRI using the built-in body coil. Image quality was qualitatively assessed by two radiologists with 12 and 13 years of MRI experience, respectively. The imaging protocol was modified until an endpoint of five consecutive patients with high-quality diagnostic images were achieved. Signal-to-noise ratio and contrast-to-noise ratio were assessed.
Results
The rapid pancreas MR protocol was successfully completed in all patients. Diagnostic image quality was achieved for all patients. Excellent image quality was achieved for low b values; however, image quality at higher b values was more variable. In one patient, a pancreatic neuroendocrine tumor was found and the patient was treated surgically. In four patients, small pancreatic cystic lesions were detected. In one subject, a hepatic mass was identified and confirmed as adenoma by liver MRI.
Conclusion
Rapid MR protocol for pancreatic cancer screening is feasible and has the potential to play a role in screening BRCA patients undergoing breast MRI.
Key Point
• Develop and optimize a rapid magnetic resonance imaging (MRI) screening protocol for pancreatic cancer to be performed in conjunction with breast MRI screening in BRCA mutation positive individuals.
Keywords
Early detection of cancer Pancreatic neoplasm Breast cancer Magnetic resonance imaging ScreeningAbbreviations
- ADC
Apparent diffusion coefficient
- ANOVA
Analysis of variance
- BRCA
Breast-related cancer antigens
- CI
Confidence interval
- CNR
Contrast-to-noise ratio
- EUS
Endoscopic ultrasound
- FNA
Fine needle biopsy
- FOCUS DWI
Field-of-view optimized and constrained undistorted single-shot diffusion-weighted imaging
- FSPGR
Fast spoiled gradient echo
- ICC
Intra-class correlation coefficient
- IPMN
Intraductal papillary mucinous neoplasms
- MRCP
Magnetic resonance cholangiopancreatography
- MRI
Magnetic resonance imaging
- NEX
Number of excitations
- NT
Navigator-triggered
- PDAC
Pancreatic ductal adenocarcinoma
- pNET
Pancreatic neuroendocrine tumor
- RC
Repeatability coefficient
- ROI
Regions-of-interest
- SNR
Signal-to-noise ratio
- SSFSE
Single-shot fast spin echo
Notes
Acknowledgements
The authors would like to thank Laura Tang, Department of Pathology, Memorial Sloan Kettering Cancer Center, for her assistance in the histopathological analysis.
Funding
- This work was supported by the National Institutes of Health (Grant P30 CA008748).
- Supported in part by a grant from the Lustgarten Foundation for Pancreas Cancer Research (DK).
- Work from Giuseppe Corrias was partially supported by a scholarship awarded by ISSNAF Imaging Science Chapter.
The funding sources had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Compliance with ethical standards
Guarantor
The scientific guarantor of this publication is Lorenzo Mannelli.
Conflict of interest
The authors of this manuscript declare relationships with the following companies:
Maggie Fung, PhD works for GE Healthcare, Global MR Applications and Workflow, New York, NY, United States.
Statistics and biometry
Marinela Capanu, PhD, and Junting Zheng, MS, kindly provided statistical advice for this manuscript.
Marinela Capanu, PhD, and Junting Zheng, MS, are of the authors and have significant statistical expertise.
Informed consent
Only if the study is on human subjects:
Written informed consent was obtained from all subjects (patients) in this study.
Ethical approval
Institutional Review Board approval was obtained.
Methodology
• prospective
• observational
• performed at one institution
Supplementary material
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