The aim was to compare spiral CT and MRI enhanced with
mangafodipir trisodium (
Mn-DPDP) in the detection and staging of pancreatic lesions. 20 patients with suspected
pancreatic cancer were included in a phase III study. Triphasic spiral CT (4 ml s-1) and MRI (axial T1 weighted turbo spin echo with and without fat suppression, T1 weighted gradient echo and T2 weighted turbo spin echo at 1.5 T) were performed. All sequences were repeated following contrast medium using the same instrument settings as in the unenhanced sequences.
Mn-DPDP was administered by slow injection of 5 mumol kg-1
body weight. Imaging results were correlated with surgery, laparoscopy, biopsy and/or follow-up. Eight pancreatic
adenocarcinomas were present. Ten patients had
chronic pancreatitis, and two showed a stenosing
papillitis. CT detected eight malignant lesions and MRI detected seven. One
pancreatic cancer was not detected with MRI. CT and MRI excluded
malignancy in nine patients. MRI and CT returned three false positive results.
Mn-DPDP improved delineation of the lesion, resulting in a higher level of diagnostic confidence. Differentiation between pseudotumorous lesions in
chronic pancreatitis and
pancreatic carcinoma was difficult due to similar slight contrast enhancement. Owing to better delineation of the lesion and the higher confidence in diagnosis, MRI with
Mn-DPDP may have the potential to improve the detection rate and the staging accuracy of focal pancreatic lesions. These results need to be confirmed in a larger patient trial.