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Pancreatic Adenocarcinoma: Variability of Diffusion-weighted MR Imaging Findings.
MedLine Citation:
PMID:  22535563     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose:To compare the apparent diffusion coefficients (ADCs) of pancreatic adenocarcinomas that appear hyperintense with clearly defined borders (clear hyperintense) with those that do not show clear hyperintense borders on diffusion-weighted magnetic resonance (MR) images.Materials and Methods:Institutional review board approval was obtained and informed consent was waived. Eighty patients with histologically confirmed pancreatic adenocarcinoma (mean tumor size, 32 mm) underwent fat-suppressed single-shot echo-planar 3.0-T diffusion-weighted MR imaging with diffusion gradients (b = 1000 sec/mm(2)). ADC values of the pancreatic adenocarcinomas (n = 80) and proximal (n = 51) and distal (n = 70) pancreas were compared by using the Friedman test, followed by the Wilcoxon signed-rank test, and the difference in serum amylase levels between pancreatic adenocarcinomas with and without clear hyperintensity was evaluated by using the x(2) test.Results:In 38 of 80 patients, pancreatic adenocarcinomas showed clear hyperintensity relative to the surrounding pancreas; 26 were hyperintense with unclear distal borders; 12, isointense; and four, hypointense. In all patients, the mean ADC (± standard deviation) of the tumors (1.16 × 10(-3) mm(2)/sec ± 0.22) was significantly lower than those of the proximal pancreas (1.33 × 10(-3) mm(2)/sec ± 0.16, P < .001) and the distal pancreatic parenchyma (1.24 × 10(-3) mm(2)/sec ± 0.23, P = .004). No significant difference in ADC was seen between the pancreatic adenocarcinomas without clear hyperintensity and the distal pancreas. The frequency of serum amylase levels greater than 120 U/L (2.00 μkat/L) was significantly higher than in those with clear hyperintense pancreatic adenocarcinomas (P < .001).Conclusion:Diffusion-weighted MR imaging was not useful for delineating 47% of pancreatic adenocarcinomas, because of hyperintensity of the pancreatic parenchyma distal to the cancer.© RSNA, 2012.
Authors:
Yoshihiko Fukukura; Koji Takumi; Kiyohisa Kamimura; Toshikazu Shindo; Yuichi Kumagae; Akihiro Tateyama; Masayuki Nakajo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-24
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
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