Publications exploring the use of DWI for evaluation of pancreatic disease are limited in number and scope. However, the value of DWI in various pancreatic conditions continues to be explored and available results suggest that there will likely be a niche for this technique in the clinic. Available studies have shown that the measured ADC values of the normal pancreatic glandular parenchyma on DWI vary considerably and are determined by factors such as age, the anatomic portion of the gland, and magnet field strength. Normal pancreas has significantly higher mean ADC than pancreatic cancer or mass-forming pancreatitis. Furthermore, proper use of DWI may aid in the differentiation of focal pancreatitis from ductal adenocarcinoma. Besides, in patients with known pancreatic cancer, the benefits of DWI include improved characterization of enlarged lymph nodes, detection of peritoneal carcinomatosis, and detection of distant (such as hepatic) metastases. It is also possible that ADC measurements can be used as a quantitative tool for predicting and monitoring tumor response. There is some data that supports the use of DWI for characterizing and determining the significance of pancreatic cystic lesions. There is still very little published scientific data to support the use of DWI in the gallbladder and biliary tract, although cholangiocarcinoma exhibits diffusion restriction, which is helpful for separating the lesion from the surrounding hepatic parenchyma, and neoplastic and inflammatory diseases of the gallbladder can also be evaluated with MR.
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