Assessment of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Differentiation of Pancreatic Ductal Adenocarcinoma From Other Pancreatic Solid Lesions

Purpose: The purpose of this study was to investigate the diagnostic value of quantitative dynamic contrast-enhanced magnetic resonance imaging (QDCE-MRI) of pancreatic ductal adenocarcinoma (PDA) on a 3.0-T magnetic resonance. Materials and Methods: The study was approved by the local institutional review board, and all subjects provided written informed consent. Seventy-five patients with suspected pancreatic tumors underwent QDCE-MRI, in which 33 patientswith cases of pancreatic solid lesions (23 patients with PDA, 3 patients with solid pseudopapillary tumor, 3 patients with neuroendocrine tumor, 2 patients with mass-forming pancreatitis, 2 patients with ampullary adenocarcinoma) proven through histopathologic diagnosis were included in this study. The parameters of QDCE-MRI were recorded and compared. Results: The parameters of QDCE-MRI of PDA tissue and non-cancer tissue did not show significant difference between 2-compartment model (2C) and 3-compartment model (3C). The contrast enhancement ratio of non-cancer tissue with dilatation of pancreatic duct was significantly higher than that of non-cancer tissue without dilatation of pancreatic duct, whereas the rate constant (Kep) of 2C was significantly lower. The maximun slope of signal intensity ascent (MxSIp), the volume transfer constant (Ktrans), and the Kep of PDA tissue were significantly lower than those of the non-cancer tissue, but the time of peaking of contrast agent (PeakT) was significantly longer. Receiver operating characteristic curves showed that the areas under the curve of differentiating PDA tissue from the non-cancer tissue were 0.82, 0.79, 0.91, 0.94, 0.88, and 0.89 for PeakT, MxSIp, Ktrans-2C, Kep-2C, Ktrans-3C, and Kep-3C, respectively. The PDA tissue showed lower MxSIp and Kep as well as longer PeakT than those of the non-PDA lesions. The receiver operating characteristic curves showed that the areas under the curve of differentiating the PDA from the non-PDA tumor were 0.73, 0.72, 0.79, and 0.72 for PeakT, MxSIp, Kep-2C, and Kep-3C, respectively Conclusions: The parameters of QDCE-MRI are useful for the diagnosis of PDA.