An MRI-driven practice: A new perspective on MRI for the evaluation of adenocarcinoma of the head of the pancreas

Objectives: The purpose of the study was to describe the MRI-driven management of masses at the head of the pancreas. Main outcome measures: The main outcome measure was tumor resectability. Methods: A retrospective review of prospective radiographic diagnoses was undertaken. Results: Between 2004 and 2008, we have treated 124 patients for a radiographic diagnosis of adenocarcinoma of the head of the pancreas. This diagnosis was correct in 96.0% of the time. MRI was 100% sensitive in determining resectability, 73.2-78.9% specific, and had an overall accuracy of 86.3-87.5%. MRI could detect venous and arterial involvement with 95% and 95.9% accuracy, respectively, and missed only six metastases. Conclusion: MRI is a useful tool in the preoperative imaging of pancreatic head lesions that is highly sensitive and very specific for resectable disease. Prospective trials of MRI in this setting are indicated.