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European Radiology

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01-07-2016 | Hepatobiliary-Pancreas

IVIM DW-MRI of autoimmune pancreatitis: therapy monitoring and differentiation from pancreatic cancer

Authors: Miriam Klauß, Klaus Maier-Hein, Christine Tjaden, Thilo Hackert, Lars Grenacher, Bram Stieltjes

Published in: European Radiology | Issue 7/2016

Abstract

Objectives

To evaluate IVIM DW-MRI for changes in IVIM-derived parameters during steroid treatment of autoimmune pancreatitis (AIP) and for the differentiation from pancreatic cancer (PC).

Methods

Fifteen AIP-patients, 11 healthy patients and 20 PC-patients were examined with DWI-MRI using eight b-values (50, 100, 150, 200, 300, 400, 600, 800). 12 AIP-patients underwent follow-up examinations during treatment. IVIM-parameters and ADC₈₀₀-values were tested for significant differences and an ROC analysis was performed.

Results

The perfusion fraction f was significantly lower in patients with AIP at the time of diagnosis (10.5 ± 4.3 %) than in patients without AIP (20.7 ± 4.3 %). In AIP follow-up, f increased significantly to 17.1 ± 7.0 % in the first and 21.0 ± 4.1 % in the second follow up. In PC, the f-values were lower (8.2 ± 4.0 %, n.s.) compared to initial AIP and were significantly lower compared to first and second follow-up examination. In the ROC-analysis AUC-values for f were 0.63, 0.88 and 0.98 for differentiation of PC from initial, first and second follow up AIP-examination.

Conclusions

The found differences in f between AIP, AIP during steroid treatment and pancreatic cancer suggest that IVIM-diffusion MRI could serve as imaging biomarker during treatment in AIP-patients and as a helpful tool for differentiation between PC and AIP.

Key Points

• MRI is used for follow-up examinations during therapy in AIP-patients

• IVIM-DWI-MRI offers parameters which reflect perfusion and true diffusion

• IVIM-parameters are helpful for differentiation between AIP and pancreatic cancer

• IVIM-parameters could serve as an imaging biomarker during steroid treatment

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Title: IVIM DW-MRI of autoimmune pancreatitis: therapy monitoring and differentiation from pancreatic cancer
Authors: Miriam Klauß
Klaus Maier-Hein
Christine Tjaden
Thilo Hackert
Lars Grenacher
Bram Stieltjes
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4041-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

IVIM DW-MRI of autoimmune pancreatitis: therapy monitoring and differentiation from pancreatic cancer

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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