Predictive value of dynamic contrast enhanced magnetic resonance imaging and diffusion-weighted imaging in pancreatic cancer invasion and metastasis.

[OBJECTIVE] To explore the clinical value of parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in the diagnosis of pancreatic cancer and its invasiveness prediction.

[MATERIALS AND METHODS] A total of 122 participants, comprising 58 patients with pathologically confirmed pancreatic cancer (median age 60.50 years [interquartile range, 54.00-65.25 years]; 38 males), 34 pancreatitis patients (median age 55.50 years[interquartile range, 43.00-67.25 years]; 23 males), and 30 healthy volunteers (median age 52.00 years[interquartile range, 36.00-62.25 years]; 16 males), underwent DWI and DCE-MRI scans. The values of K (volume transfer constant), K (rate constant), V (extravascular extracellular volume fraction), V (plasma volume fraction), TTP (Time to Peak), MAX Conc (Maximum Concentration), AUC (Area Under the Curve), and MAXSlope (Maximum Slope) from DCE sequence as well as the values of ADC and eADC from DWI sequence were collected. We also collected data on tumor invasion and metastasis within the pancreatic cancer cohort and divided it into ten subgroups. We analyzed the differences in parameters between pancreatic cancer, pancreatitis, and normal groups, and differences in parameters within pathologic subgroups of the pancreatic cancer group to distinguish among the groups. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance.

[RESULTS] The most prominent parameter to differentiate pancreatic cancer from pancreatitis was TTP, with AUC of 0.897, sensitivity of 86.2% and specificity of 91.2%. K values were higher in the group with organ invasion than in the group without organ invasion (p = 0.007), higher in the group with nerve invasion than in the group without nerve invasion (p = 0.021), and lower in the group with implantation metastasis than in the group without implantation metastasis (p = 0.009) for pancreatic cancer.

[CONCLUSION] DCE-MRI and DWI parameters were of clinical value in the diagnosis of pancreatic cancer. DCE parameters, especially K, can be used to predict the occurrence of invasion or metastasis in pancreatic cancer.