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  • IVIM  (1)
  • carcinoma  (1)
  • 1
    Keywords: carcinoma ; DIFFERENTIATION ; TUMORS ; GRADE ; COEFFICIENT ; VALUES ; WEIGHTED MRI
    Abstract: INTRODUCTION: Stroma reaction leading to fibrosis is the most characteristic histopathological feature of both pancreatic carcinoma and chronic pancreatitis with increased fibrosis compared with healthy pancreatic tissue and further increased fibrosis during radiochemotherapy. Recent studies using intravoxel incoherent motion-derived parameters did not show differences for structural diffusion constant D between these 2 diseases. The aim of this study was to verify the hypothesis that D correlates with the histopathological grade of fibrosis in pancreatic lesions. MATERIALS AND METHODS: We included 15 patients with histopathologically proven pancreatic carcinoma and 9 patients with histopathologically proven focal chronic pancreatitis. Diffusion-weighted magnetic resonance imaging was performed using 10 b values between 25 and 800 s/mm(2) before surgery. We calculated the apparent diffusion coefficient and the intravoxel incoherent motion-derived parameters D and f within tumors and focal chronic pancreatitis. The resected tissue was evaluated with regard to the grade of fibrosis. RESULTS: Fourteen patients were found to have moderate fibrosis and 10 patients had severe fibrosis. The difference between the D values for the moderate and severe fibrosis was significant with mean (SD) D value of 1.02 x 10(-)(3) (0.48 x 10(-)(3) mm/s) and mean (SD) D of 1.22 x 10(-)(3) (0.76 x 10(-)(3)) mm(2)/s. There were no significant differences for the f and ADC values. CONCLUSIONS: Contrary to our hypothesis, D rises from moderate to severe fibrosis. It seems that cellular complexes surrounded by fibrosis provide more structural limitations than does fibrosis alone. Our data suggest that D is not intuitively related to the degree of fibrosis. Compared with healthy tissue, D is reduced in moderate fibrosis but increases when severe fibrosis is present.
    Type of Publication: Journal article published
    PubMed ID: 23296083
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  • 2
    Keywords: CANCER ; PERFUSION ; DIFFERENTIATION ; adenocarcinoma ; QUANTITATIVE-ANALYSIS ; DIFFUSION ; CIRRHOSIS ; pancreas ; PHASE HELICAL CT ; APPARENT-DIFFUSION-COEFFICIENT ; DUAL-PHASE ; DWI ; IVIM
    Abstract: Purpose: To determine which of the quantitative parameters obtained from intravoxel incoherent motion diffusion weighted imaging (DWI) is the most significant for the differentiation between pancreatic carcinoma and mass-forming chronic pancreatitis. Materials and Methods: Twenty-nine patients with pancreatic masses were included, 9 proved to have a mass-forming pancreatitis and 20 had a pancreatic carcinoma. The patients were studied using intravoxel incoherent motion DWI with 11 b-values and the apparent diffusion coefficient (ADC), the true diffusion constant (D) and the perfusion fraction (f) were calculated. The diagnostic strength of the parameters was evaluated using receiver operating characteristic analysis. Results: The ADC in chronic pancreatitis was higher than in pancreatic carcinoma with significant differences at b = 50, 75, 100, 150, 200, 300 s/mm(2) (ADC(50) = 3.17 +/- 0.67 vs. 2.55 +/- 1.09, ADC(75) = 2.46 +/- 0.4 vs. 1.93 +/- 0.52, ADC(100) = 2.28 +/- 0.48 vs. 1.73 +/- 0.45, ADC(150) = 1.97 +/- 0.26 vs. 1.63 +/- 0.40, ADC(200) = 1.98 +/- 0.24 vs. 1.53 +/- 0.28, and ADC(300) = 1.76 +/- 0.19 vs. 1.46 +/- 0.31 x 10(-3) mm(2)/s). No significant differences were found at b = 25, 400, 600, and 800 s/mm(2) (ADC(25) = 4.69 +/- 0.65 vs. 4.04 +/- 1.35, ADC(400) = 1.57 +/- 0.21 vs. 1.37 +/- 0.30, ADC(600) = 1.38 +/- 0.18 vs. 1.24 +/- 0.25, and ADC(800) = 1.27 +/- 0.10 vs. 1.18 +/- 0.19 x 10(-3) mm(2)/s) nor using ADC(tot) (1.42 +/- 0.23 vs. 1.28 +/- 0.12 x 10(-3) mm(2)/s). The perfusion fraction f was significantly higher in pancreatitis compared with pancreatic carcinoma (16.3% +/- 5.30% vs. 8.2% +/- 4.00%, P = 0.0001). There was no significant difference between groups for D (1.07 +/- 0.224 x 10(-3) mm(2)/s for chronic pancreatitis and 1.09 +/- 0.3 x 10(-3) mm(2)/s for pancreatic carcinoma, P = 0.66). For f, the highest area under the curve (0.894) and combined sensitivity (80%) and specificity (89.9%) were found. Conclusions: There were significant differences in ADC(50-300) between chronic pancreatitis and pancreatic carcinoma. Because D is not significantly different between groups, differences in ADC can be attributed mainly to differences in perfusion. The perfusion fraction f proved to be the superior DWI-derived parameter for differentiation of mass-forming pancreatitis and pancreatic carcinoma
    Type of Publication: Journal article published
    PubMed ID: 21139505
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