In:
Canadian Association of Radiologists Journal, SAGE Publications, Vol. 70, No. 4 ( 2019-11), p. 416-423
Abstract:
To evaluate whole-lesion 3D-histogram apparent diffusion coefficient (ADC) metrics for assessment of pancreatic malignancy. Methods Forty-two pancreatic malignancies (36 pancreatic adenocarcinoma [PDAC], 6 pancreatic neuroendocrine [PanNET] ) underwent abdominal magnetic resonance imaging (MRI) with diffusion-weighted imaging before endoscopic ultrasound biopsy or surgical resection. Two radiologists independently placed 3D volumes of interest to derive whole-lesion histogram ADC metrics. Mann-Whitney tests and receiver operating characteristic analyses were used to assess metrics’ diagnostic performance for lesion histology, T-stage, N-stage, and grade. Results Whole-lesion ADC histogram metrics lower in PDACs than PanNETs for both readers ( P ≤ .026) were mean ADC (area under the curve [AUC] = 0.787-0.792), mean of the bottom 10th percentile (mean 0-10 ) (AUC = 0.787-0.880), mean of the 10th-25th percentile (mean 10-25 ) (AUC = 0.884-0.917) and mean of the 25th-50th percentile (mean 25-50 ) (AUC = 0.829-0.829). For mean 10-25 (metric with highest AUC for identifying PDAC), for reader 1 a threshold 〉 0.94 × 10 −3 mm 2 /s achieved sensitivity 94% and specificity 83%, and for reader 2 a threshold 〉 0.82 achieved sensitivity 97% and specificity 67%. Metrics lower in nodal status ≥ N 1 than N 0 for both readers ( P ≤ .043) were mean 0-10 (AUC = 0.789-0.822) and mean 10-25 (AUC = 0.800-0.822). For mean 10-25 (metric with highest AUC for identifying N 0 ), for reader 1 a threshold 〈 1.17 achieved sensitivity 87% and specificity 67%, and for reader 2 a threshold 〈 1.04 achieved sensitivity 87% and specificity 83%. No metric was associated with T-stage ( P 〉 .195) or grade ( P 〉 .215). Conclusion Volumetric ADC histogram metrics may serve as non-invasive biomarkers of pancreatic malignancy. Mean 10-25 outperformed standard mean for lesion histology and nodal status, supporting the role of histogram analysis.
Type of Medium:
Online Resource
ISSN:
0846-5371
,
1488-2361
DOI:
10.1016/j.carj.2019.07.001
Language:
English
Publisher:
SAGE Publications
Publication Date:
2019
detail.hit.zdb_id:
2068691-2
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