Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Measuring Perfusion in Pancreatic Ductal Adenocarcinoma and Different Tumor Grade: A Preliminary Single Center Study

Abstract

Background: Dynamic contrast-enhanced magnetic resonance imaging is a noninvasive imaging modality that can supply information regarding the tumor anatomy and physiology. The aim of the study was to analyze DCE-MRI perfusion parameters in normal pancreatic parenchymal tissue and PDAC and to evaluate the efficacy of this diagnostic modality in determining the tumor grade. Methods: A single-center retrospective study was performed. A total of 28 patients with histologically proven PDAC underwent DCE-MRI; the control group enrolled 14 patients with normal pancreatic parenchymal tissue; the radiological findings were compared with histopathological data. The study patients were further grouped according to the differentiation grade (G value): well- and moderately differentiated and poorly differentiated PDAC. Results: The median values of Ktrans, kep and iAUC were calculated lower in PDAC compared with the normal pancreatic parenchymal tissue (p < 0.05). The mean value of Ve was higher in PDAC, compared with the normal pancreatic tissue (p < 0.05). Ktrans, kep and iAUC were lower in poorly differentiated PDAC, whereas Ve showed no differences between groups. Conclusions: Ve and iAUC DCE-MRI perfusion parameters are important as independent diagnostic criteria predicting the probability of PDAC; the Ktrans and iAUC DCE-MRI perfusion parameters may serve as effective independent prognosticators preoperatively identifying poorly differentiated PDAC.

Quantitative Magnetic Resonance Imaging for the Pancreas

“…146,149 The utility of DCE-MRI-derived estimation in predicting tumor aggressiveness was addressed in 2 studies. Zaborienė et al 145 a negative correlation between k ep and Ki67, which is associated with tumor cell proliferation. 152 Furthermore, DCE-MRI has been used to monitor or predict tumor response after chemotherapy and/or radiation therapy in patients with various types of cancer.…”

“…4). 31,[137][138][139][140][141][142][143][144][145][146][147][148][149][150] Currently, the use of DCE-MRI-derived estimation in chronic pancreatitis remains poorly investigated. Kim et al 146 demonstrated that chronic pancreatitis is associated with a significantly lower K trans and k ep than the healthy pancreas; however, there were no significant differences found in v e .…”

“…[142][143][144] Several studies have shown that PDAC has a lower K trans and k ep than the normal pancreas or chronic pancreatitis, while having a larger v e . 31,[145][146][147][148][149][150] Two studies examined the use of DCE-MRI in differentiating PDAC from NEN, showing a lower K trans in the former versus the latter. 146,149 The utility of DCE-MRI-derived estimation in predicting tumor aggressiveness was addressed in 2 studies.…”

“…Previous researchers have reported that the degree of fibrosis within PDACs is negatively correlated with K trans and positively correlated with v e 142–144 . Several studies have shown that PDAC has a lower K trans and k ep than the normal pancreas or chronic pancreatitis, while having a larger v e 31,145–150 . Two studies examined the use of DCE-MRI in differentiating PDAC from NEN, showing a lower K trans in the former versus the latter 146,149 …”

“…The utility of DCE-MRI–derived estimation in predicting tumor aggressiveness was addressed in 2 studies. Zaborienė et al 145 demonstrated that K trans and k ep values were significantly lower in poorly versus well-to-moderately differentiated PDACs. Liu et al 143 demonstrated a negative correlation between k ep and Ki67, which is associated with tumor cell proliferation 152 …”