November 12, 2014
Notes: Sah, Raghuwansh P
Dawra, Rajinder K
Saluja, Ashok K
R01 DK058694/DK/NIDDK NIH HHS/
R01 DK092145/DK/NIDDK NIH HHS/
R01 DK093047/DK/NIDDK NIH HHS/
Research Support, N.I.H., Extramural
Curr Opin Gastroenterol. 2013 Sep;29(5):523-30. doi: 10.1097/MOG.0b013e328363e399.
Author Address: Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Reference Type: Journal Article
Record Number: 4860Author: Sandrasegaran, K., Nutakki, K., Tahir, B., Dhanabal, A., Tann, M. and Cote, G. A.
Title: Use of diffusion-weighted MRI to differentiate chronic pancreatitis from pancreatic cancer
Journal: AJR Am J Roentgenol
Short Title: Use of diffusion-weighted MRI to differentiate chronic pancreatitis from pancreatic cancer
Alternate Journal: AJR. American journal of roentgenology
ISSN: 1546-3141 (Electronic)
Accession Number: 24147470
Aged, 80 and over
Contrast Media/diagnostic use
Diffusion Magnetic Resonance Imaging/*methods
Meglumine/analogs & derivatives/diagnostic use
Organometallic Compounds/diagnostic use
Abstract: OBJECTIVE: The purpose of this study was to compare diffusion-weighted MRI (DWI) and conventional (non-DWI) MRI sequences in differentiating mass-forming chronic pancreatitis from pancreatic cancer. MATERIALS AND METHODS: A retrospective cohort study included 36 patients who underwent pancreatic resection for pancreatic cancer (n = 13) and chronic pancreatitis (n = 23) after preoperative MRI with DWI. Two independent reviewers assessed the DW images for signal intensity and apparent diffusion coefficient (ADC) values. Four weeks later, they reviewed the other MR images for size of mass, double-duct sign, pancreatic duct cutoff, and perivascular soft-tissue cuffing. A score for conventional MRI was given with 1 meaning definitely benign and 5 meaning definitely malignant. Univariate and multivariate analyses and receiver operating characteristic (ROC) curve analysis were performed with surgical pathologic examination as the reference standard. RESULTS: The only finding that differentiated the two groups was the presence of a well-defined mass, favoring the diagnosis of cancer (p = 0.02, p < 0.01). There was no significant difference between the two groups in signal intensity on DW images (p = 0.82, p = 0.85) or ADC (p = 0.51, p = 0.76). Double-duct sign, pancreatic duct cutoff, and perivascular soft-tissue cuffing were not useful in differentiating the two groups. The areas under the ROC curve were 0.873 and 0.878 for the conventional MRI scores, compared with 0.602 and 0.552 for ADC measurements (p = 0.02, p = 0.008). CONCLUSION: The addition of DWI to conventional MRI does not facilitate differentiation of pancreatic cancer from chronic pancreatitis.