Characterization of focal pancreatic lesions using normalized apparent diffusion coefficient at 1.5-Tesla: Preliminary experience

• Published in: Diagnostic and interventional imaging 2013-06, Vol.94 (6), p.619-627
• Main Authors: Barral, M, Sebbag-Sfez, D, Hoeffel, C, Chaput, U, Dohan, A, Eveno, C, Boudiaf, M, Soyer, P
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnosis; Adult; Aged; Aged, 80 and over; Apparent diffusion coefficient; Cystadenoma, Mucinous - diagnosis; Cystadenoma, Serous - diagnosis; Diffusion Magnetic Resonance Imaging - methods; Diffusion-weighted MR imaging; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Lesion characterization; Male; Middle Aged; Neuroendocrine Tumors - diagnosis; Normalized ADC; Pancreas - pathology; Pancreas imaging; Pancreatic Neoplasms - diagnosis; Pancreatitis, Chronic - diagnosis; Radiology; Sensitivity and Specificity; Statistics, Nonparametric; Young Adult
• ISSN: 2211-5684; 2211-5684
• DOI: 10.1016/j.diii.2013.02.011

Abstract Purpose To compare the capabilities of apparent diffusion coefficient (ADC) and normalized ADC using the pancreatic parenchyma as reference organ in the characterization of focal pancreatic lesions. Patients and methods Thirty-six patients with focal pancreatic lesions (malignant, n = 18; benign tumors, n = 10; focal pancreatitis, n = 8) underwent diffusion-weighted MR imaging (DWI) at 1.5-Tesla using 3 b values ( b = 0, 400, 800 s/mm2 ). Lesion ADC and normalized lesion ADC (defined as the ratio of lesion ADC to apparently normal adjacent pancreas) were compared between lesion types using nonparametric tests. Results Significant differences in ADC values were found between malignant (1.150 × 10−3 mm2 /s) and benign tumors (2.493 × 10−3 mm2 /s) ( P = 0.004) and between benign tumors and mass-forming pancreatitis (1.160 × 10−3 mm2 /s) ( P = 0.0005) but not between malignant tumors and mass-forming pancreatitis ( P = 0.1092). Using normalized ADC, significant differences were found between malignant tumors (0.933 × 10−3 mm2 /s), benign tumors (1.807 × 10−3 mm2 /s) and mass-forming pancreatitis (0.839 × 10−3 mm2 /s) ( P < 0.0001). Conclusion Our preliminary results suggest that normalizing ADC of focal pancreatic lesions with ADC of apparently normal adjacent pancreatic parenchyma provides higher degrees of characterization of focal pancreatic lesions than the conventional ADC does.