Comparison of 3.0T and 1.5T MRCP for the evaluation of pancreatic cysts

Rationale: Distinction between the different types of pancreatic cysts is crucial, since some cysts are benign without need for follow-up, whereas others are premalignant and require either surgical resection or surveillance. A key feature of the most common premalignant cyst, the side branch-intraductal papillary mucinous neoplasm (SB-IPMN), is the presence of a connection between the cyst and the pancreatic duct (PD). Current imaging, mostly done with 1.5T MRI/MRCP, is often not capable of visualizing this connection. Recent, small studies have suggested that 3.0T MRI/MRCP can provide superior image quality with improved delineation of the PD, but prospective studies in patients with pancreatic cysts are lacking. We hypothesize that 3.0T MRI/MRCP might be more accurate in visualizing a connection between a pancreatic cyst and the PD than 1.5T MRI/MRCP.



Objective: Primary objective is to compare the diagnostic ability of 3.0T and 1.5T MRI/MRCP in visualizing PD communication of pancreatic cysts. Second objectives are to compare the presence of mural nodules and thickened cyst wall and the amount of artefacts.



Study design: Prospective consecutive cohort of 20 patients.



Study population: Consecutive adult patients of the multidisciplinary pancreatic cyst clinic who are under follow-up for at least one pancreatic cyst in which no clear or likely connection with the PD has been seen on previous 1.5T MRI/MRCP and without classic features of a serous/mucinous cystic neoplasm.



Intervention: 3.0T MRI/MRCP during routine follow up of pancreatic cysts



Main study parameters/endpoints: Primary endpoint is the number of patients in whom a connection between the pancreatic cyst and PD can be visualized with 3.0T, whereas 1.5T MRI/MRCP could not.

We hypothesize that 3.0T MRI/MRCP might be more accurate in visualizing a connection between a pancreatic cyst and the PD than 1.5T MRI/MRCP.

One 3.0T MRI/MRCP will be made during routine follow-up.

Patients who are planned to undergo surveillance with MRI/MRCP will undergo 3.0T MRI/MRCP with contrast (gadovist) instead of 1.5T MRI/MRCP with gadovist. Imaging features of 3.0T MRI/MRCP and previously made 1.5T MRI/MRCP will be compared.