IVIM DW-MRI of autoimmune pancreatitis: therapy monitoring and differentiation from pancreatic cancer
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To evaluate IVIM DW-MRI for changes in IVIM-derived parameters during steroid treatment of autoimmune pancreatitis (AIP) and for the differentiation from pancreatic cancer (PC).
Fifteen AIP-patients, 11 healthy patients and 20 PC-patients were examined with DWI-MRI using eight b-values (50, 100, 150, 200, 300, 400, 600, 800). 12 AIP-patients underwent follow-up examinations during treatment. IVIM-parameters and ADC800-values were tested for significant differences and an ROC analysis was performed.
The perfusion fraction f was significantly lower in patients with AIP at the time of diagnosis (10.5 ± 4.3 %) than in patients without AIP (20.7 ± 4.3 %). In AIP follow-up, f increased significantly to 17.1 ± 7.0 % in the first and 21.0 ± 4.1 % in the second follow up. In PC, the f-values were lower (8.2 ± 4.0 %, n.s.) compared to initial AIP and were significantly lower compared to first and second follow-up examination. In the ROC-analysis AUC-values for f were 0.63, 0.88 and 0.98 for differentiation of PC from initial, first and second follow up AIP-examination.
The found differences in f between AIP, AIP during steroid treatment and pancreatic cancer suggest that IVIM-diffusion MRI could serve as imaging biomarker during treatment in AIP-patients and as a helpful tool for differentiation between PC and AIP.
• MRI is used for follow-up examinations during therapy in AIP-patients
• IVIM-DWI-MRI offers parameters which reflect perfusion and true diffusion
• IVIM-parameters are helpful for differentiation between AIP and pancreatic cancer
• IVIM-parameters could serve as an imaging biomarker during steroid treatment
KeywordsPancreatitis Pancreatic carcinoma Diffusion Magnetic Resonance Imaging Diffusion-weighted MRI
Intravoxel incoherent motion
The scientific guarantor of this publication is Miriam Klauss. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by the German Research Foundation (DFG) Grant SFB/TRR 125 “Cognition guided surgery” (MK, KM-H, LG and BS). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.
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