Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 28, Issue 4, Pages 928-936Publisher
JOHN WILEY & SONS INC
DOI: 10.1002/jmri.21508
Keywords
pancreas; MRI; diffusion-weighted imaging
Funding
- Korean Government (MOEHRD)
- Basic Research Promotion Fund [KRF-2006-E00406]
- National Research Foundation of Korea [R01-2006-000-10998-0] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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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 = 471], mass-forming pancreatitis [n = 13], solid pseudopapillary neoplasm [n = 6], and neuroendocrine tumor [In = 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/MM2), and perfusion fraction (f, 1 - exp [-500 see/mm(2) X (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.
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