The usefulness of perfusion-weighted magnetic resonance imaging in advanced pancreatic cancer.
OBJECTIVE
Perfusion-weighted magnetic resonance imaging (MRI) can detect the changes of signal intensity in tumors. We evaluated the prognostic value of perfusion-weighted MRI in patients with advanced pancreatic cancer (PC).


METHODS
Perfusion-weighted MRI was performed before treatment on 27 consecutive patients with advanced PC. The American Joint Committee on Cancer (AJCC) stages of patients were as follows (8, stage III; 19, stage IV). Imaging acquisition was continually repeated with echo planar sequence every 2 seconds for 2 minutes after a bolus injection of gadolinium. We made a time intensity curve of PC and calculated the signal ratio (SR) on perfusion-weighted imaging. We assessed the relation between SR and clinical factors including tumor stage, lymph node metastasis, liver metastasis, and so on. Patients were divided into low and high SR group and compared SR with the overall survival.


RESULTS
All cases showed transient decreases signal intensity (SR, 6.9-55.7%). These patients were classified into 2 groups at cutoff median SR of 22.0% The high SR group significantly correlated with the higher stage (P=0.03) and the presence of lymph node metastasis (P=0.04). The high SR group had significantly shorter overall survival (P=0.04).


CONCLUSIONS
Perfusion-weighted MRI may predict the survival in advanced PC patients.
Ueno
Makoto
M
Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center Hospital, Yokohama, Japan. uenom@kcch.jp
Niwa
Tetsu
T
Ohkawa
Shinichi
S
Amano
Ayumi
A
Masaki
Takahiro
T
Miyakawa
Kaoru
K
Yoshida
Tetsuo
T
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D005641:Tegafur / Q000627:therapeutic use; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine