The added value of intravoxel incoherent motion diffusion weighted imaging parameters in differentiating high‑grade pancreatic neuroendocrine neoplasms from pancreatic ductal adenocarcinoma

Ma,Wanling; Wei,Mengqi; Han,Zhiwei; Tang,Yongqiang; Pan,Qi; Zhang,Guangwen; Ren,Jing; Huan,Yi; Li,Na

doi:10.3892/ol.2019.10863

The added value of intravoxel incoherent motion diffusion weighted imaging parameters in differentiating high‑grade pancreatic neuroendocrine neoplasms from pancreatic ductal adenocarcinoma

Authors:
- Wanling Ma
- Mengqi Wei
- Zhiwei Han
- Yongqiang Tang
- Qi Pan
- Guangwen Zhang
- Jing Ren
- Yi Huan
- Na Li
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Affiliations: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China, Department of Radiology, Second Affiliated Hospital of Xi'an Medical Collage, Xi'an, Shaanxi 710038, P.R. China, Department of Radiology, Ninth Hospital of Xi'an City, Xi'an, Shaanxi 710068, P.R. China
Published online on: September 13, 2019 https://doi.org/10.3892/ol.2019.10863
Pages: 5448-5458
Copyright: © Ma et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate the potential significance of intravoxel incoherent motion (IVIM)‑diffusion weighted imaging (DWI) in differentiating high‑grade pancreatic neuroendocrine neoplasms (pNENs) from pancreatic ductal adenocarcinoma (PDAC). A total of 50 patients, including 37 patients with PDAC and 13 patients with high‑grade pNENs, underwent pancreatic multiple b‑values DWI with 15 b‑values including 0, 10, 20, 40, 60, 80, 100, 150, 200, 400, 800, 1,000, 1,200, 1,500 and 2,000 sec/mm2. Standard apparent diffusion coefficient (ADCstandard) and IVIM parameter [slow apparent diffusion coefficient (Dslow), fast apparent diffusion coefficient (Dfast), fraction of fast apparent diffusion coefficient (ƒ)] values of PDAC and pNENs were compared. P<0.05 was considered to indicate a statistically significant difference. Receiver operating characteristics analysis was performed in order to evaluate the diagnostic potential of IVIM parameters for differentiating high‑grade pNENs from PDAC. Dslow of pNENs was significantly lower compared with that of PDAC (0.460 vs. 0.579x10‑3 mm2/sec; P=0.001). Dfast of pNENs was significantly higher compared with that of PDAC (13.361 vs. 4.985x10‑3 mm2/sec; P<0.001). Area under the curve of Dslow, Dfast and combined Dslow and Dfast was 0.793, 0.863 and 0.885 respectively. The specificity and sensitivity of Dslow≤0.472x10‑3 mm2/sec were 97.3 and 53.9%, respectively, for differentiating high‑grade pNENs from PDAC. The specificity and sensitivity of Dfast >9.58x10‑3 mm2/sec were 91.9 and 69.2%, respectively, for differentiating high‑grade pNENs from PDAC. When Dslow and Dfast were combined, the specificity and sensitivity for differentiating high‑grade pNENs from PDAC were 76.9 and 100%, respectively. Taken together, these results indicated that the diffusion‑associated parameter Dslow and the perfusion‑associated parameter Dfast of IVIM‑DWI may differentiate high‑grade pNENs from PDAC with high diagnostic accuracy, and that IVIM‑DWI may be a valuable biomarker in differentiating pancreatic neoplasms.

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