title: [Diffusion-weighted imaging of the pancreas].
abstract: Diffusion-weighted imaging (DWI) has increasingly gained in importance over the last 10 years especially in cancer imaging for differentiation of malignant and benign lesions. Through development of fast magnetic resonance imaging (MRI) sequences DWI is not only applicable in neuroradiology but also in abdominal imaging. As a diagnostic tool of the pancreas DWI enables a differentiation between normal tissue, cancer and chronic pancreatitis. The ADC values (apparent diffusion coefficient, the so-called effective diffusion coefficient) reported in the literature for healthy pancreatic tissue are in the range from 1.49 to 1.9×10(-3) mm(2)/s, for pancreatic cancer in the range from 1.24 to 1.46×10(-3) mm(2)/s and for autoimmune pancreatitis an average ADC value of 1.012×10(-3) mm(2)/s. There are controversial data in the literature concerning the differentiation between chronic pancreatitis and pancreatic cancer. Using DWI-derived IVIM (intravoxel incoherent motion) the parameter f (perfusion fraction) seems to be advantageous but it is important to use several b values. In the literature the mean f value in chronic pancreatitis is around 16%, in pancreatic cancer 8% and in healthy pancreatic tissue around 25%. So far, DWI has not been helpful for differentiating cystic lesions of the pancreas. There are many references with other tumor entities and in animal models which indicate that there is a possible benefit of DWI in monitoring therapy of pancreatic cancer but so far no original work has been published.
authors.affiliation: Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Im Neuenheimer Feld 280, Heidelberg, Germany. k.gruenberg@dkfz.de
authors.forename: K
authors.initials: K
authors.lastname: Grünberg
authors.forename: L
authors.initials: L
authors.lastname: Grenacher
authors.forename: M
authors.initials: M
authors.lastname: Klauss
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018450:Disease Progression; D005240:Feasibility Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D010179:Pancreas / Q000473:pathology; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity; D016896:Treatment Outcome