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Differentiation of intrapancreatic accessory spleen from pancreatic neuroendocrine tumor using MRI R2

Authors
 Jun Gu Kang  ;  Jae Hyon Park  ;  Mi-Suk Park  ;  Kyunghwa Han  ;  Hee Seung Lee  ;  Hyun Kyung Yang 
Citation
 ABDOMINAL RADIOLOGY, Vol.50(8) : 3674-3684, 2025-08 
Journal Title
ABDOMINAL RADIOLOGY
ISSN
 2366-004X 
Issue Date
2025-08
MeSH
1
Keywords
Adult ; Aged ; Choristoma* / diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging* / methods ; Male ; Middle Aged ; Neuroendocrine Tumors* / diagnostic imaging ; Pancreatic Diseases* / diagnostic imaging ; Pancreatic Neoplasms* / diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Spleen* / abnormalities ; Spleen* / diagnostic imaging
Abstract
Accessory spleen ; Magnetic resonance imaging (MRI) ; Pancreas ; Pancreatic neuroendocrine tumor ; Spleen
Article Number
 10.1007/s00261-024-04758-y. 
DOI
Purpose: To evaluate the performance of R2* in distinguishing intrapancreatic accessory spleens (IPASs) from pancreatic neuroendocrine tumors (PNETs). Methods: Two radiologists (R1 and R2) retrospectively reviewed the MRIs of 20 IPAS and 20 PNET patients. IPASs were diagnosed with uptake on 99mTc labeled heat-damaged red blood cell scintigraphy or characteristic findings on CT/MRI and ≥ 12 month-long-stability. PNETs were histopathologically diagnosed with resection. Using McNemar test, sensitivities and specificities of the diagnostic criterion based on R2* mass-to-spleen ratio (MSR) were compared with those of the other criteria using contrast-enhanced (CE) MRI and apparent diffusion coefficient (ADC) MSR. Results: The study included 40 patients (median age, 54; interquartile range, 43-65; 24 men, 16 women). IPASs exhibited spleen-isointensity on T2WI, late arterial and portal phases, and diffusion-weighted images more frequently than PNETs (p <.05). ADC MSRs were lower (p <.001) and R2* MSRs were higher (p <.001) in IPASs compared to PNETs. For R1, sensitivity and specificity were 45.0% and 100.0% for criterion 1 (spleen-isointensity on CE-MRI); 45.0% and 85.0% for criterion 2 (ADC MSR ≤ 1.08); 90.0% and 95.0% for criterion 3 (0.9 ≤ R2* MSR ≤ 1.7). For R2, 75.0% and 100.0%; 45.0% and 90.0%; 90.0% and 100.0%. Criterion 3 showed higher sensitivity than criterion 1 for R1 (p =.004), and criterion 2 for R1 and R2 (p =.012). There was no difference in specificity. Conclusion: For differentiating IPAS from PNET, R2* showed higher sensitivity than, and similar specificity to CE-MRI and ADC.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Yang, Hyun Kyung(양현경) ORCID logo https://orcid.org/0000-0003-3576-9146
Han, Kyung Hwa(한경화)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/207485
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