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Intravoxel incoherent motion diffusion‐weighted imaging of the pancreas: Characterization of benign and malignant pancreatic pathologies
Author(s) -
Kim Bohyun,
Lee Seung Soo,
Sung Yu Sub,
Cheong Hyunhee,
Byun Jae Ho,
Kim Hyoung Jung,
Kim Jin Hee
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25334
Subject(s) - intravoxel incoherent motion , pancreas , diffusion mri , medicine , radiology , pancreatic cancer , diffusion , pathology , nuclear medicine , magnetic resonance imaging , physics , cancer , thermodynamics
Purpose To evaluate the diagnostic value of apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters in differentiating patients with either a normal pancreas (NP), pancreatic ductal adenocarcinoma (PDAC), neuroendocrine tumor (NET), solid pseudopapillary tumor (SPT), acute pancreatitis (AcP), vs. autoimmune pancreatitis (AIP). Materials and Methods In all, 84 pathologically confirmed pancreatic tumors (60 PDACs, 15 NETs, 9 SPTs), 20 pancreatitis (13 AcPs, 7 AIPs), and 30 NP subjects underwent IVIM diffusion‐weighted imaging using 10 b ‐values (0–900 sec/mm 2 ) at 1.5T. The ADC, pure molecular diffusion coefficient ( D slow ), perfusion fraction ( f ), and perfusion‐related diffusion coefficient ( D fast ) were calculated and compared using a Kruskal–Wallis test and post‐hoc Dunn procedure. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance. Results The f and D fast of the PDAC were significantly lower than that of the NP ( f = 0.10 vs. 0.24; D fast = 42.21 vs. 71.74 × 10 −3 mm 2 /sec; P < 0.05). In ROC analysis, f showed the best diagnostic performance (area‐under‐the‐curve, 0.919) among all parameters in differentiating PDAC from NP ( P ≤ 0.001). The f values of AcP (0.11) and AIP (0.13) and the D fast values of SPT (20.48 × 10 −3 mm 2 /sec) and AcP (24.49 × 10 −3 mm 2 /sec) were significantly lower compared with NP ( f = 0.24; D fast = 71.74 × 10 −3 mm 2 /sec; P < 0.05). For NET, the f (0.21) was significantly higher than that of PDAC (0.10, P < 0.01). Conclusion Perfusion‐related parameters f and D fast are more helpful in characterizing pancreatic diseases than ADC or D slow . The PDCA, SPT, AcP, and AIP were characterized by reduced f and D fast values compared with normal pancreas. The f value might help in differentiating between PDAC and NET. Level of Evidence: 3 J. Magn. Reson. Imaging 2017;45:260–269.