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Diffusion-weighted MR imaging in pancreatic ductal adenocarcinoma: prediction of next-generation sequencing-based tumor cellularity and prognosis after surgical resection

  • Pancreas
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To identify features on preoperative MR imaging with diffusion-weighted imaging (DWI) for predicting next-generation sequencing (NGS)-based tumor cellularity and patient outcome after surgical resection of pancreatic ductal adenocarcinoma (PDAC).

Methods

This retrospective study included 105 patients with surgically resected PDAC who underwent preoperative MR imaging with DWI. Tumor cellularity was measured using molecular techniques and bioinformatics methods. Clinico-pathologic findings including tumor T stage for predicting disease-free survival (DFS) and overall survival (OS) were identified using Cox proportional hazards model. Important MR imaging findings including apparent diffusion coefficient (ADC) value of PDAC and modified ADC value (the ratio of the ADC value of PDAC to the ADC value of the spleen) for predicting higher tumor cellularity (≥ 30%) and poor prognosis were also identified.

Results

The median DFS and OS were 12.0 months [95% confidence interval (CI), 8.0–17.0] and 22.0 months (95% CI, 18.0–29.0), respectively. Higher T stage (T3/4) [hazard ratio (HR), 7.720, (95% CI 1.072, 55.612); p = 0.048] and higher tumor cellularity [HR, 1.599 (95% CI, 1.003–2.548); p = 0.048] were significantly associated with worse DFS. Among MR imaging features, the modified ADC value was significantly associated with tumor cellularity [odds ratio, 0.068 (95% CI, 0.012–0.372); p = 0.002], and PDAC with lower modified ADC value [≤ 1.40 (cutoff value)] showed significantly shorter median DFS than PDAC with higher modified ADC value [8 months (95% CI, 4–12) vs. 16 months (95% CI, 10–29); HR, 1.713 (95% CI, 1.073–2.735), log-rank p = 0.024].

Conclusion

Higher NGS-based tumor cellularity may be a negative prognostic factor in pancreatic cancer after resection, and modified ADC value derived from DWI could be helpful in predicting tumor cellularity and patient surgical outcome with regard to recurrence.

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Data availability

We declared that materials described in the manuscript, including all relevant raw data, will be freely available to any scientist wishing to use them for non-commercial purposes, without breaching participant confidentiality.

Code availability

All softwares used during the study appear in the submitted article; No code was generated or used during the study.

Abbreviations

ADC:

Apparent diffusion coefficient

DFS:

Disease-free survival

DWI:

Diffusion-weighted imaging

NGS:

Next-generation sequencing

OS:

Overall survival

PDAC:

Pancreatic ductal adenocarcinoma

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Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Sun Kyung Jeon & Jung Hoon Kim

  2. Department of Surgery and Cancer Research Institute, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 03080, Korea

    Jin-Young Jang, Wooil Kwon, Hongbeom Kim & Youngmin Han

  3. Department of Biological Sciences, College of Natural Sciences, Ajou University, Suwon, 16499, Republic of Korea

    Daeun Kim & Daechan Park

  4. Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Jung Hoon Kim

Authors
  1. Sun Kyung Jeon
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  4. Hongbeom Kim
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Contributions

Conception and design: JHK and JJ; Data acquisition: SKJ, WK, HK, and YH; Data analysis and interpretation: SKJ, DK, and DP; Drafting of the manuscript: SKJ and JHK; Critical revision of the manuscript: JHK.

Corresponding author

Correspondence to Jung Hoon Kim.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

This study was approved by Institutional Review Board of Seoul National University Hospital (IRB; No 2005-212-1127) and written informed consent was waived. This study was in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was waived by Institutional Review Board of Seoul National University Hospital due to retrospective design of the study.

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Jeon, S.K., Jang, JY., Kwon, W. et al. Diffusion-weighted MR imaging in pancreatic ductal adenocarcinoma: prediction of next-generation sequencing-based tumor cellularity and prognosis after surgical resection. Abdom Radiol 46, 4787–4799 (2021). https://doi.org/10.1007/s00261-021-03177-7

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  • DOI: https://doi.org/10.1007/s00261-021-03177-7

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