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RACS ASC 2024

Screening MRI vs CT for the detection of liver metastases in pancreatic adenocarcinoma

Poster

Poster

Disciplines

HPB Surgery

Presentation Description

Institution: Griffith University - Queensland, Australia

Purpose Pancreatic adenocarcinoma is an aggressive malignancy that is often diagnosed at an advanced stage. Surgical resection is associated with high morbidity, necessitating careful selection of surgical candidates. The detection of liver metastases is critical as it is a contraindication to surgical resection. Routine staging of pancreatic adenocarcinoma includes computed tomography (CT) scanning. Magnetic resonance imaging (MRI) is proposed to be a more sensitive investigation, which may prevent inappropriate surgery. This study aims to review whether MRI is superior to CT in the detection of liver metastases in pancreatic adenocarcinoma. Methodology A literature review was performed through a search of PubMed with combinations of the following keywords: "mri”, “ct”, “pancreatic adenocarcinoma” and “liver metastases”. Results Sixteen studies were included, Overall, studies indicated MRI was more sensitive than CT in detecting liver metastases, with average sensitivity of 84% compared to 68.1%. Specificity was similar, with average being 91.8% for MRI and 89.9% for CT. Conclusion MRI has superior sensitivity to CT in detecting liver metastases in pancreatic adenocarcinoma. This has important implications in the appropriate selection of candidates for surgical resection. In addition to CT imaging, MRI of the liver should be considered in the routine staging of individuals with potentially resectable pancreatic adenocarcinoma, as this may prevent the morbidity and costs associated with unnecessary surgery.

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