[Prospective study to compare high-resolution computed tomography and magnetic resonance imaging in the detection of pancreatic neoplasms: use of intravenous and oral MR contrast media]. / Prospektive Studie zum Vergleich der hochauflösenden Computertomographie und Magnetresonanztomographie in der Detektion von Pankreasneoplasien: Verwendung intravenöser und oraler MR-Kontrastmittel.

PURPOSE: To compare thin-section hydro-CT and MRI in the detection of pancreatic neoplasms. Evaluation of an oral, superparamagnetic contrast agent (OMP) for pancreatic MRI. MATERIAL AND METHODS: 45 patients with suspected pancreatic neoplasms were examined with consecutive thin-section helical CT (Hydro-CT, 3/6/3, 130 ml Ultravist, Schering) and MRI (1.0 T, breath-holding, T1w-GRE, T1w-GRE fat-sat, T2w-TSE). The MRI protocol included precontrast studies, studies after oral administration of OMP (Abdoscan, Nycomed Amersham) and studies after administration of OMP and Gadodiamide i.v. (Omniscan, Nycomed Amersham). All images were assessed by two independent radiologists in a blinded fashion. Radiologic diagnosis was correlated with histology or clinical follow-up (> or = 3 month). RESULTS: 39 patients could be included in analysis. In 13 cases a pancreatic neoplasm was proven by histology. Thin-section hydro-CT and MRI showed no statistically significant differences for the detection of pancreatic neoplasia. The sensitivity of helical hydro-CT was superior compared to MRI (88.5% vs. 65.44/73.1%/76.9%). The specificity of MRI was superior compared to helical hydro-CT (86.5% vs. 94.2%/90.4%/88.5%). CONCLUSION: Thin-section hydro-CT and MRI show similar results for the detection of pancreatic neoplasms. Compared to thin-section helical CT, MRI still has the drawbacks of much more time consumption and, still, lower spatial resolution. The use of an oral, superparamagnetic contrast agent added no advantage for pancreatic MRI.

[Clinical value of native and contrast enhanced MRI in staging prostatic carcinoma before planned radical prostatectomy]. / Klinischer Stellenwert der nativen und KM-unterstützten MRT im Staging des Prostatakarzinoms vor geplanter radikaler Prostatektomie.

PURPOSE: To assess the clinical value of MRI with and without contrast agent in the staging of prostatic carcinoma. Relevance for surgical management. METHODS: 60 patients with carcinoma proven by biopsy or suspected prostatic carcinoma were evaluated with MRI. The examinations were performed in a 1.5 T (Philips ACS-NT Gyroscan) imager with multiplanar orientations before and after intravenous application of 0.1 mmol/kg/bw Gadodiamide (Omniscan-Nycomed/Amersham). The gold standard was histology after radical prostatectomy and in case of non-operability the consensual final staging. RESULTS: Compared to histology MRI revealed a sensitivity of 75% and a specificity of 82% in the differentiation of locally advanced carcinoma (T 3/4). Including the non-surgical cases MRI showed a sensitivity of 82.5% and a specificity of 86%. Interindividual analysis showed no difference in diagnostic accuracy between the non-enhanced and the contrast-enhanced techniques. In 23% of cases (n = 14) MRI induced changes in patient management. CONCLUSIONS: MRI is an accurate procedure in the local staging of prostatic carcinoma. In combination with clinical findings, PSA, and grading scores MRI has a significant influence on treatment selection. Contrast agent administration does not seem to increase the diagnostic accuracy significantly.