Early detection of pancreatic cancer using new MRI Techniques
Researchers from University of North Carolina Hospitals have found that pancreatic cancer could be detected at an early stage through a new magnetic resonance imaging technique (MRI).
The principal investigator of this study Dr. Richard C. Semelka who is also a radiologist and vice chairman for clinical research in the University of North Carolina at Chapel Hill School of Medicine's department of radiology, has stated that this is an important and major advancement since the detection pancreatic cancer at a very early stage is possible with MRI which is not possible with other modalities.
A recent issue of the American Journal of Roentgenology has published the results of the study by Semelka and colleagues. It is believed that this article is the first to be published in the medical literature describing how the suspected pancreatic cancer is evaluated by dynamic gadolinium enhanced, 3-D gradient-echo MRI images.
This MRI technology, which is also called 3D GRE, is less than 3 years old. It has been estimated by the American Cancer Society that in the year 2005 nearly 32,180 people will be diagnosed with pancreatic cancer nationwide and there would be nearly 31,800 who would die due to this disease. It has also been found that the fourth leading cause of cancer death is from pancreatic cancer.
In most of the patients pancreatic cancer is not detected until it reaches its advanced stage. However it is unfortunate that only between the third and fourth month of the development of the tumor it is possible to treat the pancreatic cancer successfully.
The ability of radiologists for the detection of pancreatic cancer was limited until recently because of the problems associated with the MRI and computed tomography techniques, which exists. As an example we can consider the difficulty in obtaining images of the pancreas that were required for the early detection of cancer due to the distortions in the MRI images which occurs due to the pulsing of blood through the aorta or by the breathing of the patient.
Semalka also said that though dynamic enhanced CT is useful for the evaluation of pancreatic cancer, it is difficult to detect tumors, which are smaller than two centimeters in size because the soft tissue resolution is limited.
The radiologists have been enabled by the development of 3D GRE to obtain higher quality images of the pancreas. The result of this is that it was believed by Semelka and colleagues at UNC hospitals that an excellent tool for the evaluation of the pancreas and for the detection of pancreatic cancer is the 3D GRE.
Between June 2002 and August 2003 two experienced radiologists, who had undergone training in body MRI techniques, reviewed all 3D GRE images from 57 patients referred by UNC hospitals. The review was done with the purpose to evaluate the usefulness of the 3D GRE. In order to prevent observer bias, the clinical histories of the patients and the original MRI interpretations were withheld from the reviewers.
Evidence of pancreatic cancer was found in 27 of the 57 patients. The review showed that 21 out of the 27 did indeed have pancreatic cancer. In addition to this, it was found by the reviewers that eight patients had tumors, which were smaller than 2 centimeters in size.
Semelka said that these patients had undergone high quality CT scans, which failed to detect these tumors. So, their tumors would not have been found without 3D GRE at such an early stage of development.
It was concluded by Semelka and his colleagues that pancreatic cancer could be identified using dynamic gadolinium enhanced 3D GRE images with a high degree of confidence and accuracy, which would make them very useful for detecting pancreatic cancer.