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Erschienen in: European Radiology 7/2018

05.02.2018 | Magnetic Resonance

Intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic and non-metastatic lymph nodes in pancreatic ductal adenocarcinoma

verfasst von: Dailin Rong, Yize Mao, Wanming Hu, Shuhang Xu, Jun Wang, Haoqiang He, Shengping Li, Rong Zhang

Erschienen in: European Radiology | Ausgabe 7/2018

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Abstract

Objectives

To evaluate the diagnostic potential of intravoxel incoherent motion (IVIM) DWI for differentiating metastatic and non-metastatic lymph node stations (LNS) in pancreatic ductal adenocarcinoma (PDAC).

Methods

59 LNS histologically diagnosed following surgical resection from 15 patients were included. IVIM DWI with 12 b values was added to the standard MRI protocol. Evaluation of parameters was performed pre-operatively and included the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Diagnostic performance of ADC, D, D* and f for differentiating between metastatic and non-metastatic LNS was evaluated using ROC analysis.

Results

Metastatic LNS had significantly lower D, D*, f and ADC values than the non-metastatic LNS (p< 0.01). The best diagnostic performance was found in D, with an area under the ROC curve of 0.979, while the area under the ROC curve values of D*, f and ADC were 0.867, 0.855 and 0.940, respectively. The optimal cut-off values for distinguishing metastatic and non-metastatic lymph nodes were D = 1.180 × 10−3 mm2/s; D* = 14.750 × 10−3 mm2/s, f = 20.65 %, and ADC = 1.390 × 10−3 mm2/s.

Conclusion

IVIM DWI is useful for differentiating between metastatic and non-metastatic LNS in PDAC.

Key Points

IVIM DWI is feasible for diagnosing LN metastasis in PDAC.
Metastatic LNS has lower D, D*, f, ADC values than non-metastatic LNS.
D-value from IVIM model has best diagnostic performance, followed by ADC value.
D* has the lowest AUC value.
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Metadaten
Titel
Intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic and non-metastatic lymph nodes in pancreatic ductal adenocarcinoma
verfasst von
Dailin Rong
Yize Mao
Wanming Hu
Shuhang Xu
Jun Wang
Haoqiang He
Shengping Li
Rong Zhang
Publikationsdatum
05.02.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 7/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5259-0

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