Comparison of diffusion-weighted MR imaging and multidetector-row CT in the detection of liver metastases in patients operated for pancreatic cancer.
OBJECTIVE
The purpose of this study is to determine the value of diffusion-weighted MR imaging (DWI) in the detection of liver metastases in patients with pancreatic tumors when compared to multidetector-row CT (MDCT).


METHODS
DWI and MDCT were performed in 31 consecutive patients with newly diagnosed, potentially resectable pancreatic tumors. CT images were obtained in the arterial and the portal venous phase. For DWI, a respiratory-triggered single-shot echo-planar imaging sequence (b values: 0, 300, and 600 s/mm(2)) was acquired. Images were analyzed in consensus by two radiologists blinded to the clinical data. Imaging results were correlated with intraoperative surgical and ultrasound findings as well as with results of histopathologic analysis and imaging follow-up.


RESULTS
Sensitivity and specificity in detecting liver metastases were 53.3% and 77.8% for MDCT and 86.7% and 97.5% for DWI, respectively. In our study population DWI would have changed the therapeutic management in 4 out of 31 patients (12.9%) when compared to MDCT.


CONCLUSIONS
In the present pilot study, DWI performed significantly better than MDCT in the detection of liver metastases in patients with pancreatic tumors. Therefore, DWI may help to optimize therapeutic management in those patients in the future.
Holzapfel
Konstantin
K
Department of Radiology, Klinikum Rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. holzapfel@roe.med.tum.de
Reiser-Erkan
Carolin
C
Fingerle
Alexander A
AA
Erkan
Merd
M
Eiber
Matthias J
MJ
Rummeny
Ernst J
EJ
Friess
Helmut
H
Kleeff
Jörg
J
Gaa
Jochen
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007479:Iopamidol / Q000031:analogs & derivatives; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol