title: Diffusion-weighted MR imaging of pancreatic cancer: A comparison of mono-exponential, bi-exponential and non-Gaussian kurtosis models.
abstract: OBJECTIVE
  To compare two Gaussian diffusion-weighted MRI (DWI) models including mono-exponential and bi-exponential, with the non-Gaussian kurtosis model in patients with pancreatic ductal adenocarcinoma.
  
  
  METHODS
  After written informed consent, 15 consecutive patients with pancreatic ductal adenocarcinoma underwent free-breathing DWI (1.5T, b-values: 0, 50, 150, 200, 300, 600 and 1000 s/mm2). Mean values of DWI-derived metrics ADC, D, D*, f, K and DKwere calculated from multiple regions of interest in all tumours and non-tumorous parenchyma and compared. Area under the curve was determined for all metrics.
  
  
  RESULTS
  Mean ADC and DKshowed significant differences between tumours and non-tumorous parenchyma (bothP< 0.001). Area under the curve for ADC, D, D*, f, K, and DKwere 0.77, 0.52, 0.53, 0.62, 0.42, and 0.84, respectively.
  
  
  CONCLUSIONS
  ADC and DKcould differentiate tumours from non-tumorous parenchyma with the latter showing a higher diagnostic accuracy. Correction for kurtosis effects has the potential to increase the diagnostic accuracy of DWI in patients with pancreatic ductal adenocarcinoma.
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kartalis
authors.affiliation: Laboratory of Computational Medicine, Institute of Computer Science, FORTH, Heraklion, Greece.
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Manikis
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Louiza
authors.initials: L
authors.lastname: Loizou
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Ersta Hospital, Stockholm, Sweden.
authors.forename: Nils
authors.initials: N
authors.lastname: Albiin
authors.affiliation: Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Frank G
authors.initials: FG
authors.lastname: Zöllner
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Marco
authors.initials: M
authors.lastname: Del Chiaro
authors.affiliation: Laboratory of Computational Medicine, Institute of Computer Science, FORTH, Heraklion, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Marias
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Laboratory of Computational Medicine, Institute of Computer Science, FORTH, Heraklion, Greece; Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanikolaou
keywords: Diffusion-weighted MRI; MRI; Pancreas; Pancreatic ductal carcinoma