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Abuzeid HM, Yassin A, Kamel OF, Sabry KA. Role of diffusion-weighted MR imaging in diagnosis of acute pancreatitis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the diagnosis of acute pancreatitis is assessed in this study by measuring the apparent diffusion coefficient (ADC) values in acute pancreatitis and comparing them with a control group. The aim of this study is to compare those two groups thus supporting the diagnosis of this disease.
Sixteen patients with acute pancreatitis and 16 control participants underwent diffusion-weighted imaging with b values of 0, 200, and 800. ADC maps were generated from the DW-MRI and ADC values, which were calculated for the pancreas, and the results of the two groups of patients were compared.
Results
The mean pancreatic ADC value in the acute pancreatitis group (1.15 10(−3) mm(2)/s ± 0.28) was significantly lower than in the normal group (1.6 10−3 mm(2)/s ± 0.2). A threshold ADC value of 1.38 10−3 mm(2)/s yielded 81.25%, specificity of 93.75%, positive predictive value of 92.9%, negative predictive value of 83.3%, and accuracy of 91.8%. Pancreatic ADC values were significantly lower in patients with acute pancreatitis than in the control group.
Conclusion
Diffusion-weighted magnetic resonance imaging could be an important supportive tool in the diagnosis of acute pancreatitis.
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Tokunaga K, Arizono S, Shimizu H, Fujimoto K, Kurata M, Minamiguchi S, Isoda H, Togashi K. Optimizing b-values for accurate depiction of pancreatic cancer with tumor-associated pancreatitis on computed diffusion-weighted imaging. Clin Imaging 2020; 61:20-26. [PMID: 31954347 DOI: 10.1016/j.clinimag.2020.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/05/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine the optimal b-value for accurate depiction of pancreatic cancer (PC) in patients with active tumor-associated pancreatitis (TAP), using computed diffusion-weighted imaging (cDWI) with a range of b-values up to 3000 s/mm2. METHODS The study protocol was approved by the institutional review board. We retrospectively analyzed 34 consecutive PC cases with active TAP who underwent pancreatectomy without preoperative therapy. Four cDWI datasets with b-values of 1500-3000 s/mm2 (cDWI1500-cDWI3000) were generated from the original DWI datasets with b-values of 0 and 1000 s/mm2 obtained using a 3-T scanner. Two board-certified radiologists evaluated images qualitatively (tumor conspicuity and total image quality), and another two board-certified radiologists placed regions of interest for quantitative evaluations (apparent diffusion coefficient [ADC] values of both lesions, contrast ratio [CR] of PC to active TAP, and volume ratio [VR] of PC to surgical specimen). RESULTS As the b-value increased, tumor conspicuity improved significantly in cDWI2000 and cDWI2500 (P = 0.0121 and 0.0015, respectively), although total image quality decreased in all cDWIs compared with DWI1000 (P < 0.0001). Significantly lower ADC values were seen in PC (P < 0.0001). All cDWI groups showed positive correlation between the tumor conspicuity and ADC difference between PC and TAP. CR increased with the b-value, while VR decreased. Significant equivalence of VR to the surgical specimen was seen on cDWI2000 (P = 0.0031). CONCLUSION Accurate depiction of PC was optimal with cDWI2000 in the presence of active TAP.
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Affiliation(s)
- Koji Tokunaga
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Shigeki Arizono
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Hironori Shimizu
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Koji Fujimoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Mariyo Kurata
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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