Diffusion-weighted imaging in characterization of cystic pancreatic lesions

Value of apparent diffusion coefficient for predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas

“…ADC, apparent diffusion coefficient; ROC, receiver operating characteristics; AUC, area under the ROC curve; PPV, positive predictive value; NPV, negative predictive value; ADC, apparent diffusion coefficient; CI, confidence interval. (20,21), which may perhaps be another explanation for why there is less-restricted diffusion in benign IPMNs (16). Another interesting finding of the present study is that the sensitivity of ADC-min improved from 76.5% to 82.4% without any loss of specificity compared with the mean ADC, which resulted in a lower overestimation of malignancy of IPMN of the pancreas for ADC-min.…”

“…Sandrasegaran et al (16) Kang et al (13) also confirmed that a lower mean ADC value was a potential useful biomarker for the assessment of malignancy for IPMN. DWI can discriminate between tissues of different cellularity by analyzing the different motion of water molecules in the extracellular space (18).…”

“…DWI can provide qualitative and quantitative information reflecting changes at a cellular level and yields unique insights into tumor cellularity and the integrity of cell membranes (12). Recently, studies have suggested that quantitative measurement of the apparent diffusion coefficient (ADC) may have potential value for the characterization of cystic pancreatic lesions (13)(14)(15)(16). However, there is no consensus on the true value of ADC measurement appropriate for the evaluation of malignancy of IPMN.…”

Pancreatic Adenocarcinoma

“…In the work of Sandrasegaran et al, ADC values were found to be helpful in deciding the malignant potential of IPMT. However, ADC values were not useful for differentiating malignant from benign lesions, or for characterizing cystic pancreatic lesions [5].…”

Radiological Workup of Cystic Neoplasms of the Pancreas

“…The role of diffusion-weighted imaging (DWI) in the characterization of CPNs is still controversial and appears rather limited. Particularly, it remains difficult to differentiate neoplastic from non-neoplastic cysts at DWI because of the freedom of water diffusion encountered in both serous and mucinous fluid-filled cystic lesions [7,8]. MRI has superior sensitivity for detecting CPNs compared with MDCT and comes along with a reasonable accuracy in its characterization [5,9].…”