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Published on: April 18, 2015
Diffusion-weighted MR imaging of the pancreas: optimizing b-value for visualization of pancreatic adenocarcinoma
Yoshihiko Fukukura1, Toshikazu Shindo2, Hiroto Hakamada2
1Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan. fukukura@m.kufm.kagoshima-u.ac.jp.
Objectives:
To determine the optimal b-value of 3.0-T diffusion-weighted imaging (DWI) for visualizing pancreatic adenocarcinomas
Methods:
Fifty-five patients with histologically confirmed pancreatic adenocarcinoma underwent DWI with different b-values (b = 500, 1000, 1500, and 2000 s/mm(2)) at 3.0 T. For each b-value, we retrospectively evaluated DWI findings of pancreatic adenocarcinomas (clear hyperintensity relative to the surrounding pancreas, hyperintensity with an unclear distal border, and isointensity) and image quality, and measured tumour-to-pancreas signal intensity (SI) ratios. DWI findings, image quality, and tumour-to-pancreas SI ratios were compared between the four b-values.
Results:
There was a significantly higher incidence of tumours showing clear hyperintensity on DWI with b-value of 1500 s/mm(2) than on that with b-value of 1000 s/mm(2) (P < 0.001), and on DWI with b-value of 1000 s/mm(2) than on that with b-value of 500 s/mm(2) (P < 0.001). The tumour-to-distal pancreas SI ratio was higher with b-value of 1500 s/mm(2) than with b-value of 1000 s/mm(2) (P < 0.001), and with b-value of 1000 s/mm(2) than with b-value of 500 s/mm(2) (P < 0.001). A lower image quality was obtained at increasing b-values (P < 0.001); the lowest scores were observed with b-value of 2000 s/mm(2).
Conclusions:
The use of b = 1500 s/mm(2) for 3.0-T DWI can improve the delineation of pancreatic adenocarcinomas.
Key Points:
• Diffusion-weighted imaging (DWI) has been used for diagnosing pancreatic adenocarcinoma • The techniques for DWI, including the choice of b-values, vary considerably • DWI often fails to delineate pancreatic adenocarcinomas because of hyperintense pancreas • DWI with a higher b-value can improve the tumour delineation • The lowest image quality was obtained on DWI with b-value = 2000 s/mm (2).
