title: Prediction of pancreatic anastomotic failure after pancreatic head resection using preoperative diffusion-weighted MR imaging.
abstract: OBJECTIVE
  To determine whether the preoperative pancreatic apparent diffusion coefficient (ADC) can be used to predict the development of postoperative pancreatic anastomotic failure (PAF).
  
  
  METHODS
  We retrospectively examined the cases of 79 patients who underwent pancreatic head resection between January 2010 and October 2013. The patients underwent 1.5-T MR imaging including diffusion-weighted imaging before surgery. The main pancreatic duct diameter (MPD), the pancreatic parenchymal thickness (PT), and the ADC of the pancreatic remnant parenchyma were measured. Two radiologists blinded to the patients' outcomes performed the measurements. The imaging parameters were compared between the patients who developed PAF and those who did not. The cut-off ADC for the development of PAF was calculated with a receiver operating characteristic analysis.
  
  
  RESULTS
  The imaging parameters were highly correlated between the two observers. The MPD and PT did not differ significantly among the patients. The mean pancreatic ADCs were significantly higher in the patients with PAF than in those without PAF. An ADC higher than 1.50 × 10(-3) mm(2)/s (Az = 0.719, observer-1) or 1.35 × 10(-3) mm(2)/s (Az = 0.752, observer-2) was optimal for predicting the development of postoperative PAF.
  
  
  CONCLUSIONS
  Measuring the preoperative non-tumorous pancreatic ADC may be useful for the prediction of a postoperative PAF.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Graduate School of Medicine, N15 W7 Kita-ku, Sapporo, Hokkaido, 060-8638, Japan, nm-00@fg7.so-net.ne.jp.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Miyamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yabusaki
authors.forename: Keita
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Yasuka
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Rie
authors.initials: R
authors.lastname: Mimura
authors.forename: Fumi
authors.initials: F
authors.lastname: Kato
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.forename: Bunya
authors.initials: B
authors.lastname: Takahashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soyama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Abo
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sakuhara
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: Toru
authors.initials: T
authors.lastname: Nakamura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuchikawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010179:Pancreas / Q000473:pathology* / Q000601:surgery*; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity