Magnetic resonance imaging versus endoscopic ultrasonography for the detection of pancreatic tumours in multiple endocrine neoplasia type 1.
Fiche publication
Date publication
mars 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr CADIOT Guillaume
Tous les auteurs :
Barbe C, Murat A, Dupas B, Ruszniewski P, Tabarin A, Vullierme MP, Penfornis A, Rohmer V, Baudin E, Le Rhun M, Gaye D, Marcus C, Cadiot G
Lien Pubmed
Résumé
OBJECTIVE: In multiple endocrine neoplasia type 1, the main risk factor for metastases is pancreatic tumour size. We and others recommend limiting surgery to non-functioning pancreatic tumors >/=20 mm or growing, based on their size measured with endoscopic ultrasonography. Because endoscopic ultrasonography is invasive, we compared endoscopic ultrasonography (EUS) to non-invasive magnetic resonance imaging (MRI) for the detection of pancreatic tumours >/=10 mm in multiple endocrine neoplasia type 1 patients. METHODS: A prospective study was performed in nine participating centres; 90 patients with multiple endocrine neoplasia type 1 underwent EUS and MRI with gadolinium infusion. Gastroenterologists and radiologists were blinded to the results, magnetic resonance images were reviewed centrally. RESULTS: EUS detected 86 tumours >/=10 mm, and 48 (53.3%) patients had at least one tumour >/=10 mm. MRI detected 67 tumours >/=10 mm, and 46 (51.1%) patients had at least one tumour >/=10 mm. EUS and MRI agreement was moderate for detection of tumours >/=10 mm (Kappa coefficient=0.49), and for selection of patients with tumours >/=10 mm (Kappa coefficient=0.55). EUS and MRI missed 11/24 and 4/24 lesions >/=20 mm, respectively. EUS failed to identify 9/57 (15.7%) patients with pancreatic tumours >/=10 mm, and MRI failed to identify 11/57 (19.3%) patients with pancreatic tumours >/=10 mm. CONCLUSIONS: EUS and MRI are complementary and should be performed at initial evaluation in multiple endocrine neoplasia type 1 patients. Whether follow-up should be based on either technique or both, requires further evaluation.
Référence
Dig Liver Dis. 2012 Mar;44(3):228-34