Evaluation of Perfusion Change According to Pancreatic Cancer and Pancreatic Duct Dilatation Using Free-Breathing Golden-Angle Radial Sparse Parallel (GRASP) Magnetic Resonance Imaging

Simple Summary Pancreas MRI is used to differentiate pancreas focal lesions by evaluating the enhancement pattern of the focal lesion compared with the adjacent pancreatic parenchyma. Morphologic changes in the pancreas are common as a result of pancreatic cancer and may cause changes in the blood supply (perfusion) to the pancreas. A dynamic contrast-enhanced MRI (DCE-MRI) technique that can obtain MRI images in very short intervals of time (about 2-5 s) was developed, even for the organs that continuously move as a result of breathing. In the present study, we confirm a perfusion change in the pancreas with pancreatic cancer using DCE-MRI, with a longer peak-enhancement time, longer delay time, and higher peak concentration. We also present the correlations between perfusion and morphological changes in the pancreas. DCE-MRI may be helpful to understand the microscopic changes in the pancreatic parenchyma when a disease occurs. Purpose: To evaluate perfusion changes in the pancreas with pancreatic cancer and pancreatic duct dilatation using dynamic contrast-enhanced MRI (DCE-MRI). Method: We evaluate the pancreas DCE-MRI of 75 patients. The qualitative analysis includes pancreas edge sharpness, motion artifacts, streak artifacts, noise, and overall image quality. The quantitative analysis includes measuring the pancreatic duct diameter and drawing six regions of interest (ROIs) in the three areas of the pancreas (head, body, and tail) and three vessels (aorta, celiac axis, and superior mesenteric artery) to measure the peak-enhancement time, delay time, and peak concentration. We evaluate the differences in three quantitative parameters among the ROIs and between patients with and without pancreatic cancer. The correlations between pancreatic duct diameter and delay time are also analyzed. Results: The pancreas DCE-MRI demonstrates good image quality, and respiratory motion artifacts show the highest score. The peak-enhancement time does not differ among the three vessels or among the three pancreas areas. The peak-enhancement time and concentrations in the pancreas body and tail and the delay time in the three pancreas areas are significantly longer (p < 0.05) in patients with pancreatic cancer than in those without pancreatic cancer. The delay time was significantly correlated with the pancreatic duct diameters in the head (p < 0.02) and body (p < 0.001). Conclusion: DCE-MRI can display the perfusion change in the pancreas with pancreatic cancer. A perfusion parameter in the pancreas is correlated with the pancreatic duct diameter reflecting a morphological change in the pancreas.

Automated summary

Pancreas MRI can differentiate focal lesions by evaluating the enhancement pattern and can be helpful in understanding microscopic changes in the pancreas. This study confirms perfusion changes in the pancreas with pancreatic cancer using dynamic contrast-enhanced MRI and identifies correlations between perfusion and morphological changes in the pancreas.