Importance of<i>b</i>value in diffusion weighted imaging for the diagnosis of pancreatic cancer

Jin-gang, Hao; Wang, Jia-Ping; Gu, Ya-Lv; Lu, Ming-Liang

doi:10.3748/wjg.v19.i39.6651

Cited by 8 publications

(5 citation statements)

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“…For example, Yoshikawa et al reported that pancreatic cancer had a higher ADC value than normal pancreas [ 34 ] while some studies showed no significant difference in ADC values between pancreatic tumor and normal pancreatic parenchyma [ 35 , 36 , 37 , 38 ]. However, an increased body of evidence have shown that ADC values of PDAC are much lower than those of normal pancreas [ 10 , 31 , 39 , 40 ]. Interestingly, in the present study we have demonstrated a significant increase in ADC in the advanced stages of PDAC tumor.…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Monitoring of Increased Fibrotic Tissue and Hyaluronan Deposition in the Tumor Microenvironment in the Advanced Stages of Pancreatic Ductal Adenocarcinoma

Vohra

Wang

Son

et al. 2022

Cancers

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Pancreatic ductal adenocarcinomas are characterized by a complex and robust tumor microenvironment (TME) consisting of fibrotic tissue, excessive levels of hyaluronan (HA), and immune cells. We utilized quantitative multi-parametric magnetic resonance imaging (mp-MRI) methods at 14 Tesla in a genetically engineered KPC (KrasLSL-G12D/+, Trp53LSL-R172H/+, Cre) mouse model to assess the complex TME in advanced stages of tumor development. The whole tumor, excluding cystic areas, was selected as the region of interest for data analysis and subsequent statistical analysis. Pearson correlation was used for statistical inference. There was a significant correlation between tumor volume and T2 (r = −0.66), magnetization transfer ratio (MTR) (r = 0.60), apparent diffusion coefficient (ADC) (r = 0.48), and Glycosaminoglycan-chemical exchange saturation transfer (GagCEST) (r = 0.51). A subset of mice was randomly selected for histological analysis. There were positive correlations between tumor volume and fibrosis (0.92), and HA (r = 0.76); GagCEST and HA (r = 0.81); and MTR and CD31 (r = 0.48). We found a negative correlation between ADC low-b (perfusion) and Ki67 (r = −0.82). Strong correlations between mp-MRI and histology results suggest that mp-MRI can be used as a non-invasive tool to monitor the tumor microenvironment.

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Section: Discussionmentioning

confidence: 99%

Non-Invasive Monitoring of Increased Fibrotic Tissue and Hyaluronan Deposition in the Tumor Microenvironment in the Advanced Stages of Pancreatic Ductal Adenocarcinoma

Vohra

Wang

Son

et al. 2022

Cancers

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“…We were unable to perform a meta-analysis in the subgroup of studies since 50% of the studies did not report any b-values. While a high intensity signal with poor anatomical delineation was associated with a high b-value of 1100 s/mm 2 , benign and malignant pancreatic tumors could be distinguished with a b-value of 700 s/mm 2 associated with ADCs; b-values of 50, 350, 400, 450, and 1100 s/mm 2 were associated with imprecise ADC values and could not differentiate between benign and malignant tumors (50). A b-value of 800 s/mm 2 can help to differentiate between pancreatic cancer, mass-forming focal pancreatitis, and a normal pancreas (51).…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted MRI versus FDG-PET/CT for diagnosing pancreatic cancer: an indirect comparison meta-analysis

et al. 2020

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Background Fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and diffusion-weighted magnetic resonance imaging (DWI or DW-MRI) are tools for the diagnosis of pancreatic cancer. However, comparison of their diagnostic performance remains unknown. Purpose To indirectly compare the diagnostic value of DWI and FDG-PET/CT in the detection of pancreatic cancer. Material and Methods A literature search of PubMed, Embase, and Cochrane Library electronic databases for articles published through May 2018 yielded 875 articles. For the meta-analysis, we included 26 studies evaluating the efficacy of DWI and FDG-PET/CT for determining pancreatic cancer with a total of 1377 patients. QUADAS (Quality Assessment of Diagnostic Accuracy Studies) was used to assess the study quality. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curves (AUC) with their 95% confidence intervals were calculated for each individual study. Results There were no significant differences between DWI and FDG-PET/CT for sensitivity, specificity, PLR, NLR, or DOR, while DWI AUC was higher than that of FDG-PET/CT for the detection of pancreatic cancer. Conclusion The diagnostic value of both DWI and FDG-PET/CT were comparable and, hence, both techniques seem to be equally useful tools for the diagnosis of pancreatic cancer.

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“…In general, cancers, including pancreatic cancer, tend to show higher signal intensity on DWI with a lower ADC value than normal tissues because cancer tissues have several factors restricting the water diffusion, such as higher cellularity, tissue disorganization, and extracellular space tortuosity [ 85 ]. In particular, in the DWI technique, the histology of different targets varies according to the b-values used, which reflect the strength and timing of the gradients used to generate these particular images [ 86 ]. DWI and ADCs with small b-values are generally not very useful in diagnosing malignant tumors since the proportion of diffusion is small and blood perfusion has a greater impact on the final imaging result [ 87 ].…”

Section: The Additional Value Of Diffusion-weighted Imaging: Can It R...mentioning

confidence: 99%

Towards a Simplified and Cost-Effective Diagnostic Algorithm for the Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Can We Save Contrast for Later?

Brandi,

Renzulli

2024

Cancers

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The increased detection of pancreatic cysts in recent years has triggered extensive diagnostic investigations to clarify their potential risk of malignancy, resulting in a large number of patients undergoing numerous imaging follow-up studies for many years. Therefore, there is a growing need for optimization of the current surveillance protocol to reduce both healthcare costs and waiting lists, while still maintaining appropriate sensibility and specificity. Imaging is an essential tool for evaluating patients with intraductal papillary mucinous neoplasms (IPMNs) since it can assess several predictors for malignancy and thus guide further management recommendations. Although contrast-enhanced magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) has been widely recommended by most international guidelines, recent results support the use of unenhanced abbreviated-MRI (A-MRI) protocols as a surveillance tool in patients with IPMN. In fact, A-MRI has shown high diagnostic performance in malignant detection, with high sensitivity and specificity as well as excellent interobserver agreement. The aim of this paper is, therefore, to discuss the current available evidence on whether the implementation of an abbreviated-MRI (A-MRI) protocol for cystic pancreatic lesion surveillance could improve healthcare economics and reduce waiting lists in clinical practice without significantly reducing diagnostic accuracy.

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Importance ofbvalue in diffusion weighted imaging for the diagnosis of pancreatic cancer

Abstract: Low b value images demonstrated superior anatomical details when compared to high b value images. Tumor tissue definition was high and contrast with the surrounding tissues was good. DWI was useful in diagnosing pancreatic cancer.

Cited by 8 publications

References 0 publications

Non-Invasive Monitoring of Increased Fibrotic Tissue and Hyaluronan Deposition in the Tumor Microenvironment in the Advanced Stages of Pancreatic Ductal Adenocarcinoma

Non-Invasive Monitoring of Increased Fibrotic Tissue and Hyaluronan Deposition in the Tumor Microenvironment in the Advanced Stages of Pancreatic Ductal Adenocarcinoma

Diffusion-weighted MRI versus FDG-PET/CT for diagnosing pancreatic cancer: an indirect comparison meta-analysis

Towards a Simplified and Cost-Effective Diagnostic Algorithm for the Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Can We Save Contrast for Later?

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