title: Assessment of dynamic contrast-enhanced magnetic resonance imaging in the differentiation of pancreatic ductal adenocarcinoma from other pancreatic solid lesions.
abstract: OBJECTIVE
  The purpose of this study was to investigate the diagnostic value of quantitative dynamic contrast-enhanced magnetic resonance imaging (QDCE-MRI) of pancreatic ductal adenocarcinoma (PDA) on a 3.0-T magnetic resonance.
  
  
  METHODS
  The study was approved by the local institutional review board, and all subjects provided written informed consent. Seventy-five patients with suspected pancreatic tumors underwent QDCE-MRI, in which 33 patients with cases of pancreatic solid lesions (23 patients with PDA, 3 patients with solid pseudopapillary tumor, 3 patients with neuroendocrine tumor, 2 patients with mass-forming pancreatitis, 2 patients with ampullary adenocarcinoma) proven through histopathologic diagnosis were included in this study. The parameters of QDCE-MRI were recorded and compared.
  
  
  RESULTS
  The parameters of QDCE-MRI of PDA tissue and non-cancer tissue did not show significant difference between 2-compartment model (2C) and 3-compartment model (3C). The contrast enhancement ratio of non-cancer tissue with dilatation of pancreatic duct was significantly higher than that of non-cancer tissue without dilatation of pancreatic duct, whereas the rate constant (Kep) of 2C was significantly lower. The maximun slope of signal intensity ascent (MxSIp), the volume transfer constant (Ktrans), and the Kep of PDA tissue were significantly lower than those of the non-cancer tissue, but the time of peaking of contrast agent (PeakT) was significantly longer. Receiver operating characteristic curves showed that the areas under the curve of differentiating PDA tissue from the non-cancer tissue were 0.82, 0.79, 0.91, 0.94, 0.88, and 0.89 for PeakT, MxSIp, Ktrans-2C, Kep-2C, Ktrans-3C, and Kep-3C, respectively. The PDA tissue showed lower MxSIp and Kep as well as longer PeakT than those of the non-PDA lesions. The receiver operating characteristic curves showed that the areas under the curve of differentiating the PDA from the non-PDA tumor were 0.73, 0.72, 0.79, and 0.72 for PeakT, MxSIp, Kep-2C, and Kep-3C, respectively
  
  
  CONCLUSIONS
  The parameters of QDCE-MRI are useful for the diagnosis of PDA.
authors.affiliation: From the *Department of Radiology, Fudan University Shanghai Cancer Center, †Department of Oncology, Shanghai Medical College, Fudan University, Shanghai; and ‡Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.
authors.forename: Kefu
authors.initials: K
authors.lastname: Liu
authors.forename: Ping
authors.initials: P
authors.lastname: Xie
authors.forename: Weijun
authors.initials: W
authors.lastname: Peng
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA