title: Pancreatic adenocarcinoma: a pilot study of quantitative perfusion and diffusion-weighted breath-hold magnetic resonance imaging.
abstract: OBJECTIVE
  To confirm the feasibility of breath-hold DCE-MRI and DWI at 3T to obtain the intra-abdominal quantitative physiologic parameters, K(trans), k ep, and ADC, in patients with untreated pancreatic ductal adenocarcinomas.
  
  
  METHODS
  Diffusion-weighted single-shot echo-planar imaging (DW-SS-EPI) and dynamic contrast-enhanced (DCE) MRI were used for 16 patients with newly diagnosed biopsy-proven pancreatic ductal adenocarcinomas. K(trans), k ep, and apparent diffusion coefficient (ADC) values of pancreatic tumors, non-tumor adjacent pancreatic parenchyma (NAP), liver metastases, and normal liver tissues were quantitated and statistically compared.
  
  
  RESULTS
  Fourteen patients were able to adequately hold their breath for DCE-MRI, and 15 patients for DW-SS-EPI. Four patients had liver metastases within the 6 cm of Z axis coverage centered on the pancreatic primary tumors. K(trans) values (10(-3) min(-1)) of primary pancreatic tumors, NAP, liver metastases, and normal liver tissues were 7.3 ± 4.2 (mean ± SD), 25.8 ± 14.9, 8.1 ± 5.9, and 45.1 ± 15.6, respectively, k ep values (10(-2) min(-1)) were 3.0 ± 0.9, 7.4 ± 3.1, 5.2 ± 2.0, and 12.1 ± 2.8, respectively, and ADC values (10(-3) mm(2)/s) were 1.3 ± 0.2, 1.6 ± 0.3, 1.1 ± 0.1, and 1.3 ± 0.1, respectively. K(trans), k ep, and ADC values of primary pancreatic tumors were significantly lower than those of NAP (p < 0.05), while K(trans) and k ep values of liver metastases were significantly lower than those of normal liver tissues (p < 0.05).
  
  
  CONCLUSIONS
  3T breath-hold quantitative physiologic MRI is a feasible technique that can be applied to a majority of patients with pancreatic adenocarcinomas.
authors.affiliation: Departments of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294-0019, USA, Hyunki@uab.edu.
authors.forename: Hyunki
authors.initials: H
authors.lastname: Kim
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Arnoletti
authors.forename: John
authors.initials: J
authors.lastname: Christein
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Heslin
authors.forename: James A
authors.initials: JA
authors.lastname: Posey
authors.forename: Amol
authors.initials: A
authors.lastname: Pednekar
authors.forename: T
authors.initials: T
authors.lastname: Mark Beasley
authors.forename: Desiree E
authors.initials: DE
authors.lastname: Morgan
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000704:Analysis of Variance; D062485:Breath Holding; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010865:Pilot Projects; D015203:Reproducibility of Results