title: Histogram Analysis of Apparent Diffusion Coefficient in Differentiating Pancreatic Adenocarcinoma and Neuroendocrine Tumor.
abstract: The aim of this study was to investigate whether histogram analysis in diffusion-weighted (DW) magnetic resonance imaging (MRI) can help differentiate pancreatic adenocarcinomas from neuroendocrine tumors.Sixty-four patients with histologically confirmed 53 pancreatic adenocarcinomas or 19 neuroendocrine tumors underwent DW MRI. We evaluated the pixel distribution histogram parameters (mean, skewness, kurtosis, and entropy) of the apparent diffusion coefficient (ADC) values derived from b-values of 0 and 200 (ADC200), 0 and 400 (ADC400), or 0 and 800 (ADC800) s/mm(2). Histogram parameters were compared between pancreatic adenocarcinomas and neuroendocrine tumors, and the diagnostic performance was evaluated by using receiver operating characteristic (ROC) analysis.The mean ADC200 and ADC400 were significantly higher in neuroendocrine tumors than in pancreatic adenocarcinomas (P = 0.001 and P = 0.019, respectively). Pancreatic adenocarcinomas showed significantly higher skewness and kurtosis on ADC400 (P = 0.007 and P = 0.001, respectively) and ADC800 (P = 0.001 and P = 0.001, respectively). With all b-value combinations, the entropy of ADC values was significantly higher in pancreatic adenocarcinomas (P < 0.001 for ADC200; P = 0.001 for ADC400; P < 0.001 for ADC800), and showed the highest area under the ROC curve for diagnosing adenocarcinomas (0.77 for ADC200, 0.76 for ADC400, and 0.78 for ADC800).ADC histogram analysis of DW MRI can help differentiate pancreatic adenocarcinomas from neuroendocrine tumors.
authors.affiliation: From the Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima City, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Shindo
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Fukukura
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Umanodan
authors.forename: Koji
authors.initials: K
authors.lastname: Takumi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Hakamada
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakajo
authors.forename: Aya
authors.initials: A
authors.lastname: Umanodan
authors.forename: Junichi
authors.initials: J
authors.lastname: Ideue
authors.forename: Kiyohisa
authors.initials: K
authors.lastname: Kamimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D019277:Entropy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies
references.citation: AJR Am J Roentgenol. 2008 Oct;191(4):1115-21
references.pmid: 18806153
references.citation: J Magn Reson Imaging. 2011 Jan;33(1):136-42
references.pmid: 21182131
references.citation: Magn Reson Imaging. 2013 May;31(4):524-8
references.pmid: 23200681
references.citation: JOP. 2011 Jul 08;12(4):316-21
references.pmid: 21737886
references.citation: Radiology. 2012 Jun;263(3):732-40
references.pmid: 22623694
references.citation: Radiology. 2015 Jan;274(1):45-63
references.pmid: 25531479
references.citation: AJR Am J Roentgenol. 2012 Aug;199(2):301-8
references.pmid: 22826390
references.citation: AJR Am J Roentgenol. 2002 Sep;179(3):725-30
references.pmid: 12185053
references.citation: J Magn Reson Imaging. 2008 Oct;28(4):928-36
references.pmid: 18821618
references.citation: AJR Am J Roentgenol. 2013 Feb;200(2):314-20
references.pmid: 23345352
references.citation: Br J Radiol. 2009 Jan;82(973):28-34
references.pmid: 19095814
references.citation: Eur Radiol. 2012 Feb;22(2):447-57
references.pmid: 21918916
references.citation: Radiology. 2011 Dec;261(3):882-90
references.pmid: 21969667
references.citation: Acad Radiol. 2012 Oct;19(10):1233-40
references.pmid: 22818788
references.citation: Acta Radiol. 2014 Dec;55(10):1270-7
references.pmid: 24316663
references.citation: AJR Am J Roentgenol. 2007 Feb;188(2):409-14
references.pmid: 17242249
references.citation: Radiology. 2014 Feb;270(2):444-53
references.pmid: 24126370
references.citation: Eur J Radiol. 2010 Apr;74(1):214-20
references.pmid: 19264435
references.citation: Ann Oncol. 2005 Nov;16(11):1806-10
references.pmid: 16085691
references.citation: Cancer. 1950 Jan;3(1):32-5
references.pmid: 15405679
references.citation: Arch Gynecol Obstet. 2014 Aug;290(2):341-8
references.pmid: 24687746
references.citation: Radiology. 2013 Feb;266(2):531-8
references.pmid: 23151830
references.citation: Ann Oncol. 2008 Oct;19(10):1727-33
references.pmid: 18515795
references.citation: Acad Radiol. 2014 Aug;21(8):1027-34
references.pmid: 24833566
references.citation: Pancreas. 2004 Apr;28(3):219-30
references.pmid: 15084961
references.citation: Eur Radiol. 2004 Mar;14(3):425-30
references.pmid: 14618363
references.citation: Invest Radiol. 2011 Jan;46(1):57-63
references.pmid: 21139505
references.citation: Magn Reson Imaging. 2010 Dec;28(10):1447-55
references.pmid: 20864287
references.citation: Invest Radiol. 2014 Feb;49(2):93-100
references.pmid: 24089021
references.citation: Radiology. 2011 Oct;261(1):182-92
references.pmid: 21828186
references.citation: J Magn Reson Imaging. 2000 Feb;11(2):141-8
references.pmid: 10713946
references.citation: Radiology. 2009 Jul;252(1):182-9
references.pmid: 19561256
references.citation: CA Cancer J Clin. 2015 Mar;65(2):87-108
references.pmid: 25651787
references.citation: Lancet. 2004 Mar 27;363(9414):1049-57
references.pmid: 15051286