Abstract
Aim
The purpose of this study is to determine the value of diffusion-weighted MR imaging (DWI) in the detection of liver metastases in patients with pancreatic tumors when compared to multidetector-row CT (MDCT).
Methods
DWI and MDCT were performed in 31 consecutive patients with newly diagnosed, potentially resectable pancreatic tumors. CT images were obtained in the arterial and the portal venous phase. For DWI, a respiratory-triggered single-shot echo-planar imaging sequence (b values: 0, 300, and 600 s/mm2) was acquired. Images were analyzed in consensus by two radiologists blinded to the clinical data. Imaging results were correlated with intraoperative surgical and ultrasound findings as well as with results of histopathologic analysis and imaging follow-up.
Results
Sensitivity and specificity in detecting liver metastases were 53.3% and 77.8% for MDCT and 86.7% and 97.5% for DWI, respectively. In our study population DWI would have changed the therapeutic management in 4 out of 31 patients (12.9%) when compared to MDCT.
Conclusion
In the present pilot study, DWI performed significantly better than MDCT in the detection of liver metastases in patients with pancreatic tumors. Therefore, DWI may help to optimize therapeutic management in those patients in the future.
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References
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225–249
NCCN guidelines for treatment of pancreatic cancer 2006. http://www.nccn.org/professionals/physician_gls/PDF/pancreatic.pdf
Danet IM, Semelka RC, Nagase LL, et al. (2003) Liver metastases from pancreatic adenocarcinoma: MR imaging characteristics. J Magn Reson Imaging 18:181–188
Balci NC, Semelka RC (2001) Radiologic diagnosis and staging of pancreatic ductal adenocarcinoma. Eur J Radiol 38:105–112
Diehl SJ, Lehmann KJ, Sadick M, Lachmann R, Georgi M (1998) Pancreatic cancer: value of dual-phase helical CT in assessing resectability. Radiology 206:373–378
Holalkere NS, Sahani DV, Blake MA, et al. (2006) Characterization of small liver lesions: added role of MR after MDCT. J Comput Assist Tomogr 30:591–596
Mueller GC, Hussain HK, Carlos RC, Nghiem HV, Francis IR (2003) Effectiveness of MR imaging in characterizing small hepatic lesions: routine versus expert interpretation. AJR Am J Roentgenol 180:673–680
Gourtsoyianni S, Papanikolaou N, Yarmenitis S, et al. (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18:486–492
Bruegel M, Holzapfel K, Gaa J, et al. (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477–485
Nasu K, Kuroki Y, Nawano S, et al. (2006) Hepatic metastases: diffusion-weighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology 239:122–130
Coenegrachts K, Delanote J, Ter Beek L, et al. (2007) Improved focal liver lesion detection: comparison of single-shot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques. Br J Radiol 80:524–531
Bruegel M, Gaa J, Waldt S, et al. (2008) Diagnosis of hepatic metastasis: comparison of respiration-triggered diffusion-weighted echo-planar MRI and five t2-weighted turbo spin-echo sequences. AJR Am J Roentgenol 191:1421–1429
Holzapfel K, Bruegel M, Eiber M, Ganter C, Schuster T, Heinrich P, Rummeny EJ, Gaa J Characterization of small (≤10 mm) focal liver lesions: value of respiratory-triggered echo-planar diffusion-weighted MR imaging. Eur J Radiol. doi:10.1016/j.ejrad.2009.05.014
Semelka RC, Brown ED, Ascher SM, et al. (1994) Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 192:401–406
Bartolozzi C, Cioni D, Donati F, Lencioni R (2001) Focal liver lesions: MR imaging-pathologic correlation. Eur Radiol 11:1374–1388
Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics 19:431–451
Freeny PC, Traverso LW, Ryan JA (1993) Diagnosis and staging of pancreatic adenocarcinoma with dynamic computed tomography. Am J Surg 165:600–606
Warshaw AL, Fernández-del Castillo C (1992) Pancreatic carcinoma. N Engl J Med 326:455–465
Coenegrachts K, Orlent H, ter Beek L, et al. (2008) Improved focal liver lesion detection: comparison of single-shot spin-echo echo-planar and superparamagnetic iron oxide (SPIO)-enhanced MRI. J Magn Reson Imaging 27:117–124
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Konstantin Holzapfel and Carolin Reiser-Erkan contributed equally.
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Holzapfel, K., Reiser-Erkan, C., Fingerle, A.A. et al. Comparison of diffusion-weighted MR imaging and multidetector-row CT in the detection of liver metastases in patients operated for pancreatic cancer. Abdom Imaging 36, 179–184 (2011). https://doi.org/10.1007/s00261-010-9633-5
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DOI: https://doi.org/10.1007/s00261-010-9633-5