Diffusion-weighted MR imaging: The importance of ADC and perfusion values in differential-diagnosis of pancreatic adenocarcinoma and mass forming pancreatitis

Abstract

Objective: Despite the increasing diagnostic accuracy of cross sectional imaging modalities, the correct differentiation between pancreatic adenocarcinoma and mass forming pancreatitis has been remained a challenge. The aim of the authors is based on their two and a half year experience the assessment of diffusion-weighted MR imaging in the diagnosis and discernment of pancreatic adenocarcinoma and mass forming pancreatitis. Materials and methods: Three b-values diffusion-weighted MR examinations were performed at 19 patients suffering from adenocarcinoma and 8 from pancreatitis. 12 healthy patients were examined as reference. ADC and perfusion values were calculated. Malignancy was verified by pathology in all cases. Inflammatory disease was diagnosed by the previous medical history, the changing of laboratory data, follow-up CT examinations and improvement of patients’ conditions. Results: Comparison the ADC and perfusion values significant differences were between the healthy and the inflamma- tory or tumor affected tissues. The highest values could be measured at normal pancreas, mass forming pancreatitis had diminished ADC and perfusion, and tumor’s values were the lowest. Conclusion: In agreement with literature data, the authors conclude that DWI MR is a promising differential-diagnostic imaging tool in distinction of circumscribed pancreatic lesions.