Comparative Evaluation of Multiphase CT and MRI in the Early Diagnosis of Pancreatic Cancer: Optimizing Imaging Approaches for Improved Clinical Outcomes

Abstract: Background: Pancreatic cancer remains one of the most fatal malignancies, where early identification is crucial for better patient prognosis. Advanced imaging methods such as multiphase computed tomography (CT) and magnetic resonance imaging (MRI) are fundamental in detecting and staging pancreatic tumours. However, their comparative effectiveness, especially for detecting small neoplasms and borderline resectable tumours, warrants further study. This research aims to assess and contrast the diagnostic accuracy of MRI and CT in identifying pancreatic abnormalities, determining vascular involvement, and evaluating tumour resectability to facilitate clinical decision-making. Material and Methods: A retrospective analysis was performed on 95 patients who had undergone both MRI and CT scans due to suspected pancreatic cancer. Diagnostic parameters such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were examined to compare lesion detection and characterization. Further analysis was conducted on small tumours (<2 cm) and cases with borderline resectability. Statistical evaluation included McNemar’s and chi-square tests. Findings MRI exhibited a greater sensitivity (92.6%) compared to CT (87.4%) in identifying pancreatic lesions, particularly for smaller tumors (<2 cm), where MRI had a significantly higher sensitivity (88.2% vs. 73.5%; p = 0.014). When assessing vascular involvement in borderline resectable tumours, MRI achieved an accuracy of 94.7%, whereas CT reached 89.5%. Although CT demonstrated a slightly superior specificity (85.3% vs. 82.1% for MRI), MRI provided enhanced lesion characterization due to better soft tissue contrast. Both imaging modalities encountered difficulties in identifying small hepatic and peritoneal metastases, although MRI performed marginally better in these instances. The findings of this study underscore MRI’s superior diagnostic efficiency over CT in detecting and characterizing pancreatic malignancies. MRI’s heightened sensitivity and detailed visualization of small lesions and vascular involvement establish it as a preferred imaging technique for presurgical assessments. These findings advocate for the incorporation of MRI into routine diagnostic protocols to enhance patient management and outcomes