Tumor size on abdominal MRI versus pathologic specimen in resected pancreatic adenocarcinoma: Implications for radiation treatment planning

William A. Hall, John L. Mikell, Pardeep Kumar Mittal, Lauren Colbert, Roshan S. Prabhu, David A. Kooby, Dana Nickleach, Krisztina Hanley, Juan M. Sarmiento, Arif N. Ali, Jerome C. Landry

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: We assessed the accuracy of abdominal magnetic resonance imaging (MRI) for determining tumor size by comparing the preoperative contrast-enhanced T1-weighted gradient echo (3-dimensional [3D] volumetric interpolated breath-hold [VIBE]) MRI tumor size with pathologic specimen size. Methods and Materials: The records of 92 patients who had both preoperative contrast-enhanced 3D VIBE MRI images and detailed pathologic specimen measurements were available for review. Primary tumor size from the MRI was independently measured by a single diagnostic radiologist (P.M.) who was blinded to the pathology reports. Pathologic tumor measurements from gross specimens were obtained from the pathology reports. The maximum dimensions of tumor measured in any plane on the MRI and the gross specimen were compared. The median difference between the pathology sample and the MRI measurements was calculated. A paired t test was conducted to test for differences between the MRI and pathology measurements. The Pearson correlation coefficient was used to measure the association of disparity between the MRI and pathology sizes with the pathology size. Disparities relative to pathology size were also examined and tested for significance using a 1-sample t test. Results: The median patient age was 64.5 years. The primary site was pancreatic head in 81 patients, body in 4, and tail in 7. Three patients were American Joint Commission on Cancer stage IA, 7 stage IB, 21 stage IIA, 58 stage IIB, and 3 stage III. The 3D VIBE MRI underestimated tumor size by a median difference of 4 mm (range, -34-22 mm). The median largest tumor dimensions on MRI and pathology specimen were 2.65 cm (range, 1.5-9.5 cm) and 3.2 cm (range, 1.3-10 cm), respectively. Conclusions: Contrast-enhanced 3D VIBE MRI underestimates tumor size by 4 mm when compared with pathologic specimen. Advanced abdominal MRI sequences warrant further investigation for radiation therapy planning in pancreatic adenocarcinoma before routine integration into the treatment planning process.

Original languageEnglish (US)
Pages (from-to)102-107
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume86
Issue number1
DOIs
StatePublished - May 1 2013
Externally publishedYes

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magnetic resonance
planning
Adenocarcinoma
tumors
Magnetic Resonance Imaging
pathology
Radiation
radiation
Pathology
Neoplasms
Therapeutics
correlation coefficients
radiation therapy
echoes
Radiotherapy
Joints
cancer
gradients

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Tumor size on abdominal MRI versus pathologic specimen in resected pancreatic adenocarcinoma : Implications for radiation treatment planning. / Hall, William A.; Mikell, John L.; Mittal, Pardeep Kumar; Colbert, Lauren; Prabhu, Roshan S.; Kooby, David A.; Nickleach, Dana; Hanley, Krisztina; Sarmiento, Juan M.; Ali, Arif N.; Landry, Jerome C.

In: International Journal of Radiation Oncology Biology Physics, Vol. 86, No. 1, 01.05.2013, p. 102-107.

Research output: Contribution to journalArticle

Hall, William A. ; Mikell, John L. ; Mittal, Pardeep Kumar ; Colbert, Lauren ; Prabhu, Roshan S. ; Kooby, David A. ; Nickleach, Dana ; Hanley, Krisztina ; Sarmiento, Juan M. ; Ali, Arif N. ; Landry, Jerome C. / Tumor size on abdominal MRI versus pathologic specimen in resected pancreatic adenocarcinoma : Implications for radiation treatment planning. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 86, No. 1. pp. 102-107.
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abstract = "Purpose: We assessed the accuracy of abdominal magnetic resonance imaging (MRI) for determining tumor size by comparing the preoperative contrast-enhanced T1-weighted gradient echo (3-dimensional [3D] volumetric interpolated breath-hold [VIBE]) MRI tumor size with pathologic specimen size. Methods and Materials: The records of 92 patients who had both preoperative contrast-enhanced 3D VIBE MRI images and detailed pathologic specimen measurements were available for review. Primary tumor size from the MRI was independently measured by a single diagnostic radiologist (P.M.) who was blinded to the pathology reports. Pathologic tumor measurements from gross specimens were obtained from the pathology reports. The maximum dimensions of tumor measured in any plane on the MRI and the gross specimen were compared. The median difference between the pathology sample and the MRI measurements was calculated. A paired t test was conducted to test for differences between the MRI and pathology measurements. The Pearson correlation coefficient was used to measure the association of disparity between the MRI and pathology sizes with the pathology size. Disparities relative to pathology size were also examined and tested for significance using a 1-sample t test. Results: The median patient age was 64.5 years. The primary site was pancreatic head in 81 patients, body in 4, and tail in 7. Three patients were American Joint Commission on Cancer stage IA, 7 stage IB, 21 stage IIA, 58 stage IIB, and 3 stage III. The 3D VIBE MRI underestimated tumor size by a median difference of 4 mm (range, -34-22 mm). The median largest tumor dimensions on MRI and pathology specimen were 2.65 cm (range, 1.5-9.5 cm) and 3.2 cm (range, 1.3-10 cm), respectively. Conclusions: Contrast-enhanced 3D VIBE MRI underestimates tumor size by 4 mm when compared with pathologic specimen. Advanced abdominal MRI sequences warrant further investigation for radiation therapy planning in pancreatic adenocarcinoma before routine integration into the treatment planning process.",
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AU - Mikell, John L.

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AU - Colbert, Lauren

AU - Prabhu, Roshan S.

AU - Kooby, David A.

AU - Nickleach, Dana

AU - Hanley, Krisztina

AU - Sarmiento, Juan M.

AU - Ali, Arif N.

AU - Landry, Jerome C.

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