New MRI aids early detection

A new magnetic resonance imaging (MRI) technique has proved quite successful for early detection of pancreatic cancer, report physicians at the University of North Carolina Hospitals, Chapel Hill. "The essence of this work is that very early detection of pancreatic cancer is possible with MRI that is not possible with other modalities," relates radiologist Richard C. Semelka, referring to dynamic gadolinium-enhanced, 3-D gradient-echo (3D GRE).

About 32,180 people nationwide will be diagnosed with pancreatic cancer in 2005 and another 31,800 will die from the disease, the American Cancer Society, Atlanta, estimates. It is the fourth leading cause of cancer death.

Pancreatic cancer is not detected in most patients until it has reached an advanced state. Successful treatment, however, occurs only between three and four months after a tumor begins developing. Until recently, the ability of radiologists to detect pancreatic cancer was limited by problems associated with existing MRI and computed tomography (CT) requirements.

For example, distortions in MRI images caused by the pulsing of blood through the aorta or by the patient's breathing make it difficult to obtain images of the pancreas that are good enough for early detection. While dynamic enhanced CT also is useful in evaluating pancreatic cancer, that technique has difficulty spotting tumors smaller than two centimeters because of limited soft-tissue resolution.

To evaluate the usefulness of 3D GRE, researchers reviewed all images from patients referred to UNC Hospitals for examination because of clinical suspicion of pancreatic cancer. They found signs in 27 of the 57 patients, with a level of confidence they rated as high or very high. A review of these patients' records showed that 21 of the 27 indeed were afflicted. In addition, the reviewers found tumors of less than two centimeters in eight patients.

"Most of these patients had recently had high-quality CT scans that failed to find these tumors," Semelka notes. "So, without 3D GRE, their tumors would not have been found at such an early stage in their development."

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