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Quantitative analysis of diffusion-weighted magnetic resonance imaging of the pancreas: Usefulness in characterizing solid pancreatic masses

✍ Scribed by Seung Soo Lee; Jae Ho Byun; Beom Jin Park; Seong Ho Park; Namkug Kim; Bumwoo Park; Jeong Kon Kim; Moon-Gyu Lee


Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
678 KB
Volume
28
Category
Article
ISSN
1053-1807

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✦ Synopsis


Abstract

Purpose

To evaluate whether measurement of apparent diffusion coefficient (ADC) and pure diffusion coefficient (D) can help to characterize solid pancreatic masses.

Materials and Methods

Diffusion‐weighted MR imaging was performed in both a patient group (n = 71; pancreatic cancer [n = 47], mass‐forming pancreatitis [n = 13], solid pseudopapillary neoplasm [n = 6], and neuroendocrine tumor [n = 5]) and a normal control group (n = 11) by applying three b‐factors of 0, 500, and 1000 sec/mm^2^. ADC~500~, ADC~1000~, D (ADC using b = 500 and 1000 sec/mm^2^), and perfusion fraction (f, 1‐ exp [‐500 sec/mm^2^ × (ADC~500~ – D)]) of normal pancreas, pancreatic cancer, and mass‐forming pancreatitis were compared using the Kruskal–Wallis test. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance and optimal cutoff value of these parameters in differentiating pancreatic cancer from mass‐forming pancreatitis.

Results

Normal pancreas had significantly higher mean ADC~500~, ADC~1000~, and f than either pancreatic cancer (P < 0.001, < 0.001, and 0.004, respectively) or mass‐forming pancreatitis (P < 0.001, < 0.001, and 0.002, respectively). ADC~500~, ADC~1000~, and D of mass‐forming pancreatitis were significantly lower than those of pancreatic cancer (P = 0.002, 0.004, and 0.014, respectively). Sensitivities and specificities in the diagnosis of pancreatic cancer were 72.3% and 76.9% for ADC~500~, 87.2% and 69.2% for ADC~1000~, 87.2% and 61.5% for D, and 42.6% and 92.3% for f, respectively.

Conclusion

Measurement of ADC and D may be helpful in differentiating pancreatic cancers from mass‐forming pancreatitis. J. Magn. Reson. Imaging 2008;28:928–936. © 2008 Wiley‐Liss, Inc.