Skip to main content
Top
Published in: European Radiology 8/2009

01-08-2009 | Hepatobiliary-Pancreas

Diffusion-weighted magnetic resonance imaging of pancreas tumours

Authors: Nikolaos Kartalis, Terri L. Lindholm, Peter Aspelin, Johan Permert, Nils Albiin

Published in: European Radiology | Issue 8/2009

Login to get access

Abstract

The purpose of this study was to evaluate the accuracy of diffusion-weighted imaging (DWI) in diagnosis of pancreas cancer, to compare DWI with a conventional comprehensive MRI (MRI-c) and to analyse apparent diffusion coefficient (ADC) values of lesions. Thirty-six patients with pancreatic lesions (12 malignant and 24 benign) and 39 patients without lesions were included. MRI-c and DWI (free breathing, b values 0 and 500 s/mm2) were performed prospectively and consecutively in a 1.5-T system. The analysis was retrospectively performed blinded by two radiologists in consensus. The sensitivity, specificity, accuracy, and positive and negative predictive values of DWI and MRI-c were 92, 97, 96, 85, 98% and 100, 97, 97, 86, 100%, respectively. Mean ADC values of malignant lesions were significantly lower than those of benign lesions. DWI has a similar accuracy to MRI-c in diagnosis of pancreas cancer.
Literature
1.
go back to reference Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ (2008) Cancer statistics, 2008. CA Cancer J Clin 58(2):71–96PubMedCrossRef Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ (2008) Cancer statistics, 2008. CA Cancer J Clin 58(2):71–96PubMedCrossRef
2.
3.
go back to reference Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M (1986) MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurological disorders. Radiology 161(2):401–407PubMed Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M (1986) MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurological disorders. Radiology 161(2):401–407PubMed
4.
go back to reference Robertson RL, Glasier CM (2007) Diffusion-weighted imaging of the brain in infants and children. Pediatr Radiol 37(8):749–768PubMedCrossRef Robertson RL, Glasier CM (2007) Diffusion-weighted imaging of the brain in infants and children. Pediatr Radiol 37(8):749–768PubMedCrossRef
5.
go back to reference Eustace S, DiMasi M, Adams J, Ward R, Caruthers S, McAlindon T (2000) In vitro and in vivo spin echo diffusion imaging characteristics of synovial fluid: potential non-invasive differentiation of inflammatory and degenerative arthritis. Skeletal Radiol 29(6):320–323PubMedCrossRef Eustace S, DiMasi M, Adams J, Ward R, Caruthers S, McAlindon T (2000) In vitro and in vivo spin echo diffusion imaging characteristics of synovial fluid: potential non-invasive differentiation of inflammatory and degenerative arthritis. Skeletal Radiol 29(6):320–323PubMedCrossRef
6.
go back to reference Nonomura Y, Yasumoto M, Yoshimura R, Haraguchi K, Ito S, Akashi T, Ohashi I (2001) Relationship between bone marrow cellularity and apparent diffusion coefficient. J Magn Reson Imaging 13(5):757–760PubMedCrossRef Nonomura Y, Yasumoto M, Yoshimura R, Haraguchi K, Ito S, Akashi T, Ohashi I (2001) Relationship between bone marrow cellularity and apparent diffusion coefficient. J Magn Reson Imaging 13(5):757–760PubMedCrossRef
7.
go back to reference Morgan VA, Kyriazi S, Ashley SE, DeSouza NM (2007) Evaluation of the potential of diffusion-weighted imaging in prostate cancer detection. Acta Radiol 48(6):695–703PubMedCrossRef Morgan VA, Kyriazi S, Ashley SE, DeSouza NM (2007) Evaluation of the potential of diffusion-weighted imaging in prostate cancer detection. Acta Radiol 48(6):695–703PubMedCrossRef
8.
go back to reference Matsuki M, Inada Y, Tatsugami F, Tanikake M, Narabayashi I, Katsuoka Y (2007) Diffusion-weighted MR imaging for urinary bladder carcinoma: initial results. Eur Radiol 17(1):201–204PubMedCrossRef Matsuki M, Inada Y, Tatsugami F, Tanikake M, Narabayashi I, Katsuoka Y (2007) Diffusion-weighted MR imaging for urinary bladder carcinoma: initial results. Eur Radiol 17(1):201–204PubMedCrossRef
9.
go back to reference Tamai K, Koyama T, Saga T, Morisawa N, Fujimoto K, Mikami Y, Togashi K (2008) The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 18(4):723–730PubMedCrossRef Tamai K, Koyama T, Saga T, Morisawa N, Fujimoto K, Mikami Y, Togashi K (2008) The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 18(4):723–730PubMedCrossRef
10.
go back to reference Ichikawa T, Erturk SM, Motosugi U, Sou H, Iino H, Araki T, Fujii H (2006) High-b-value diffusion-weighted MRI in colorectal cancer. AJR Am J Roentgenol 187(1):181–184PubMedCrossRef Ichikawa T, Erturk SM, Motosugi U, Sou H, Iino H, Araki T, Fujii H (2006) High-b-value diffusion-weighted MRI in colorectal cancer. AJR Am J Roentgenol 187(1):181–184PubMedCrossRef
11.
go back to reference Bruegel M, Holzapfel K, Gaa J, Woertler K, Waldt S, Kiefer B, Stemmer A, Ganter C, Rummeny EJ (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18(3):477–485PubMedCrossRef Bruegel M, Holzapfel K, Gaa J, Woertler K, Waldt S, Kiefer B, Stemmer A, Ganter C, Rummeny EJ (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18(3):477–485PubMedCrossRef
12.
go back to reference Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18(3):486–492PubMedCrossRef Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18(3):486–492PubMedCrossRef
13.
go back to reference Ichikawa T, Erturk SM, Motosugi U, Sou H, Iino H, Araki T, Fujii H (2007) High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results. AJR Am J Roentgenol 188(2):409–414PubMedCrossRef Ichikawa T, Erturk SM, Motosugi U, Sou H, Iino H, Araki T, Fujii H (2007) High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results. AJR Am J Roentgenol 188(2):409–414PubMedCrossRef
14.
go back to reference Matsuki M, Inada Y, Nakai G, Tatsugami F, Tanikake M, Narabayashi I, Masuda D, Arisaka Y, Takaori K, Tanigawa N (2007) Diffusion-weighted MR imaging of pancreatic carcinoma. Abdom Imaging 32(4):481–483PubMedCrossRef Matsuki M, Inada Y, Nakai G, Tatsugami F, Tanikake M, Narabayashi I, Masuda D, Arisaka Y, Takaori K, Tanigawa N (2007) Diffusion-weighted MR imaging of pancreatic carcinoma. Abdom Imaging 32(4):481–483PubMedCrossRef
15.
go back to reference Takeuchi M, Matsuzaki K, Kubo H, Nishitani H (2008) High-b-value diffusion-weighted magnetic resonance imaging of pancreatic cancer and mass-forming chronic pancreatitis: preliminary results. Acta Radiol 49(4):383–386PubMedCrossRef Takeuchi M, Matsuzaki K, Kubo H, Nishitani H (2008) High-b-value diffusion-weighted magnetic resonance imaging of pancreatic cancer and mass-forming chronic pancreatitis: preliminary results. Acta Radiol 49(4):383–386PubMedCrossRef
16.
go back to reference Birchard KR, Semelka RC, Hyslop WB, Brown A, Armao D, Firat Z, Vaidean G (2005) Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. AJR Am J Roentgenol 185(3):700–703PubMed Birchard KR, Semelka RC, Hyslop WB, Brown A, Armao D, Firat Z, Vaidean G (2005) Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. AJR Am J Roentgenol 185(3):700–703PubMed
17.
go back to reference Fletcher JG, Wiersema MJ, Farrell MA, Fidler JL, Burgart LJ, Koyama T, Johnson CD, Stephens DH, Ward EM, Harmsen WS (2003) Pancreatic malignancy: value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CT. Radiology 229(1):81–90PubMedCrossRef Fletcher JG, Wiersema MJ, Farrell MA, Fidler JL, Burgart LJ, Koyama T, Johnson CD, Stephens DH, Ward EM, Harmsen WS (2003) Pancreatic malignancy: value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CT. Radiology 229(1):81–90PubMedCrossRef
18.
go back to reference Farma JM, Santillan AA, Melis M, Walters J, Belinc D, Chen DT, Eikman EA, Malafa M (2008) PET/CT fusion scan enhances CT staging in patients with pancreatic neoplasms. Ann Surg Oncol 15(9):2465–2471PubMedCrossRef Farma JM, Santillan AA, Melis M, Walters J, Belinc D, Chen DT, Eikman EA, Malafa M (2008) PET/CT fusion scan enhances CT staging in patients with pancreatic neoplasms. Ann Surg Oncol 15(9):2465–2471PubMedCrossRef
19.
go back to reference Agarwal B, Abu-Hamda E, Molke KL, Correa AM, Ho L (2004) Endoscopic ultrasound-guided fine needle aspiration and multidetector spiral CT in the diagnosis of pancreatic cancer. Am J Gastroenterol 99(5):844–850PubMedCrossRef Agarwal B, Abu-Hamda E, Molke KL, Correa AM, Ho L (2004) Endoscopic ultrasound-guided fine needle aspiration and multidetector spiral CT in the diagnosis of pancreatic cancer. Am J Gastroenterol 99(5):844–850PubMedCrossRef
20.
go back to reference Schick V, Franzius C, Beyna T, Oei ML, Schnekenburger J, Weckesser M, Domschke W, Schober O, Heindel W, Pohle T, Juergens KU (2008) Diagnostic impact of (18)F-FDG PET-CT evaluating solid pancreatic lesions versus endosonography, endoscopic retrograde cholangio-pancreatography with intraductal ultrasonography and abdominal ultrasound. Eur J Nucl Med Mol Imaging 35(10):1775–1785PubMedCrossRef Schick V, Franzius C, Beyna T, Oei ML, Schnekenburger J, Weckesser M, Domschke W, Schober O, Heindel W, Pohle T, Juergens KU (2008) Diagnostic impact of (18)F-FDG PET-CT evaluating solid pancreatic lesions versus endosonography, endoscopic retrograde cholangio-pancreatography with intraductal ultrasonography and abdominal ultrasound. Eur J Nucl Med Mol Imaging 35(10):1775–1785PubMedCrossRef
21.
go back to reference Noguchi K, Watanabe N, Nagayoshi T, Kanazawa T, Toyoshima S, Shimizu M, Seto H (1999) Role of diffusion-weighted echo-planar MRI in distinguishing between brain abscess and tumour: a preliminary report. Neuroradiology 41(3):171–174PubMedCrossRef Noguchi K, Watanabe N, Nagayoshi T, Kanazawa T, Toyoshima S, Shimizu M, Seto H (1999) Role of diffusion-weighted echo-planar MRI in distinguishing between brain abscess and tumour: a preliminary report. Neuroradiology 41(3):171–174PubMedCrossRef
22.
go back to reference Mishra AM, Gupta RK, Saksena S, Prasad KN, Pandey CM, Rathore D, Purwar A, Rathore RK, Husain N, Jha DK, Jaggi RS, Husain M (2005) Biological correlates of diffusivity in brain abscess. Magn Reson Med 54(4):878–885PubMedCrossRef Mishra AM, Gupta RK, Saksena S, Prasad KN, Pandey CM, Rathore D, Purwar A, Rathore RK, Husain N, Jha DK, Jaggi RS, Husain M (2005) Biological correlates of diffusivity in brain abscess. Magn Reson Med 54(4):878–885PubMedCrossRef
23.
go back to reference Tsushima Y, Takano A, Taketomi-Takahashi A, Endo K (2007) Body diffusion-weighted MR imaging using high b-value for malignant tumor screening: usefulness and necessity of referring to T2-weighted images and creating fusion images. Acad Radiol 14(6):643–650PubMedCrossRef Tsushima Y, Takano A, Taketomi-Takahashi A, Endo K (2007) Body diffusion-weighted MR imaging using high b-value for malignant tumor screening: usefulness and necessity of referring to T2-weighted images and creating fusion images. Acad Radiol 14(6):643–650PubMedCrossRef
24.
go back to reference Liapi E, Geschwind JF, Vossen JA, Buijs M, Georgiades CS, Bluemke DA, Kamel IR (2008) Functional MRI evaluation of tumor response in patients with neuroendocrine hepatic metastasis treated with transcatheter arterial chemoembolization. AJR Am J Roentgenol 190(1):67–73PubMedCrossRef Liapi E, Geschwind JF, Vossen JA, Buijs M, Georgiades CS, Bluemke DA, Kamel IR (2008) Functional MRI evaluation of tumor response in patients with neuroendocrine hepatic metastasis treated with transcatheter arterial chemoembolization. AJR Am J Roentgenol 190(1):67–73PubMedCrossRef
25.
go back to reference Kamel IR, Bluemke DA, Ramsey D, Abusedera M, Torbenson M, Eng J, Szarf G, Geschwind JF (2003) Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 181(3):708–710PubMed Kamel IR, Bluemke DA, Ramsey D, Abusedera M, Torbenson M, Eng J, Szarf G, Geschwind JF (2003) Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 181(3):708–710PubMed
26.
go back to reference Lee SS, Byun JH, Park BJ, Park SH, Kim N, Park B, Kim JK, Lee MG (2008) Quantitative analysis of diffusion-weighted magnetic resonance imaging of the pancreas: usefulness in characterizing solid pancreatic masses. J Magn Reson Imaging 28(4):928–936PubMedCrossRef Lee SS, Byun JH, Park BJ, Park SH, Kim N, Park B, Kim JK, Lee MG (2008) Quantitative analysis of diffusion-weighted magnetic resonance imaging of the pancreas: usefulness in characterizing solid pancreatic masses. J Magn Reson Imaging 28(4):928–936PubMedCrossRef
27.
go back to reference Yamada I, Aung W, Himeno Y, Nakagawa T, Shibuya H (1999) Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology 210(3):617–623PubMed Yamada I, Aung W, Himeno Y, Nakagawa T, Shibuya H (1999) Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology 210(3):617–623PubMed
28.
go back to reference Kim T, Murakami T, Takahashi S, Hori M, Tsuda K, Nakamura H (1999) Diffusion-weighted single-shot echoplanar MR imaging for liver disease. AJR Am J Roentgenol 173(2):393–398PubMed Kim T, Murakami T, Takahashi S, Hori M, Tsuda K, Nakamura H (1999) Diffusion-weighted single-shot echoplanar MR imaging for liver disease. AJR Am J Roentgenol 173(2):393–398PubMed
29.
go back to reference Rulyak SJ, Kimmey MB, Veenstra DL, Brentnall TA (2003) Cost-effectiveness of pancreatic cancer screening in familial pancreatic cancer kindreds. Gastrointest Endosc 57(1):23–29PubMedCrossRef Rulyak SJ, Kimmey MB, Veenstra DL, Brentnall TA (2003) Cost-effectiveness of pancreatic cancer screening in familial pancreatic cancer kindreds. Gastrointest Endosc 57(1):23–29PubMedCrossRef
Metadata
Title
Diffusion-weighted magnetic resonance imaging of pancreas tumours
Authors
Nikolaos Kartalis
Terri L. Lindholm
Peter Aspelin
Johan Permert
Nils Albiin
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
European Radiology / Issue 8/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1384-8

Other articles of this Issue 8/2009

European Radiology 8/2009 Go to the issue