Document Detail


Evaluation of the longitudinal tumor extent of bile duct cancer: value of adding gadolinium-enhanced dynamic imaging to unenhanced images and magnetic resonance cholangiography.
MedLine Citation:
PMID:  17538298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the added value of gadolinium-enhanced dynamic magnetic resonance (MR) images compared with unenhanced and MR cholangiography (MRC) images, to evaluate the longitudinal extension of bile duct cancer. MATERIALS AND METHOD: Thirty-three patients with hilar cholangiocarcinoma or common duct cancer who had undergone MRC, unenhanced, and gadolinium-enhanced dynamic MR images and surgery were included in this study. Two experienced radiologists independently reviewed 2 image sets in 2 steps, that is, the MRC set (unenhanced and MRC) and the combined image set (MRC set with dynamic images). At each step, the readers determined the tumor status according to the Bismuth-Corlette classification. The readers assigned their confidence levels on a 5-point scale regarding whether the tumor involved the secondary confluence of the bile duct and the intrapancreatic common bile duct. The radiologists' diagnostic confidence of the 2 image sets was analyzed using receiver operating characteristic analysis. RESULTS: Receiver operating characteristic analysis showed higher areas under the curve values when the combined image set was interpreted (0.990 +/- 0.017 for reader 1 and 0.951 +/- 0.027 for reader 2) than when the MRC set was interpreted (0.982 +/- 0.017 for reader 1 and 0.902 +/- 0.038 for reader 2); however, the difference was not statistically significant for either reader (P > 0.05). In addition, regarding evaluation of the tumor status according to the Bismuth-Corlette classification, the overall accuracy was higher for the combined image set than for the MRC set alone, but the difference was not significant (P > 0.05). When dynamic images were added to the MRC images, interobserver agreement improved from 0.72 to 0.84. CONCLUSIONS: The addition of contrast-enhanced dynamic images to unenhanced and MRC images did not significantly improve the diagnostic accuracy for assessment of the longitudinal extent of bile duct cancer.
Authors:
Hyuk Jung Kim; Jeong Min Lee; Se Hyung Kim; Joon Koo Han; Jae Young Lee; Jin Young Choi; Ki Hyun Kim; Ji Yang Kim; Min Woo Lee; Su Jin Kim; Byung Ihn Choi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  31     ISSN:  0363-8715     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    2007 May-Jun
Date Detail:
Created Date:  2007-05-31     Completed Date:  2007-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-74     Citation Subset:  IM    
Affiliation:
Department of Radiology, Seoul Medical Center, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms / pathology*
Cholangiocarcinoma / pathology*
Cholangiopancreatography, Magnetic Resonance*
Contrast Media
Female
Humans
Image Processing, Computer-Assisted
Male
Meglumine / analogs & derivatives
Middle Aged
Organometallic Compounds
ROC Curve
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 113662-23-0/gadobenic acid; 6284-40-8/Meglumine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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