Correlation of MR features and histogram-derived parameters with aggressiveness and outcomes after resection in pancreat
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PANCREAS
Correlation of MR features and histogram‑derived parameters with aggressiveness and outcomes after resection in pancreatic ductal adenocarcinoma Riccardo De Robertis1 · Alessandro Beleù2 · Nicolò Cardobi1 · Isabella Frigerio3 · Silvia Ortolani4 · Stefano Gobbo4 · Bogdan Maris5 · Davide Melisi6 · Stefania Montemezzi1 · Mirko D’Onofrio2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate MR-derived histogram parameters in predicting aggressiveness and surgical outcomes in patients with PDAC, by correlating them to pathological features, recurrence-free survival (RFS), and overall survival (OS). Methods Pre-operative MR examinations of 103 patients with PDAC between July 2014 and September 2018 were retrospectively analyzed. Morphologic features and whole-tumor histogram-derived parameters were correlated to pathological features using Fisher’s exact or Mann–Whitney U tests and receiver operating characteristic (ROC) curves were constructed for significant parameters. Cox regression analysis and Kaplan–Meier curves were used to determine the association of clinical–pathological variables, morphological features, and histogram-derived parameters with RFS and OS. Results T1entropy, ADCentropy, T2kurtosis, and ADCuniformity had the highest area under the curve (AUC) for prediction of vascular infiltration, nodal metastases, microscopic vascular invasion, and peripancreatic fat invasion (.657, .742, .760, and .818, respectively). Poor tumor differentiation (P = 0.002, hazard ratio—HR = 4.08), nodal ratio (P = 0.034, HR 6.95), and ADCmaximum (P = 0.021, HR 1.01) were significant predictors of RFS. Poor tumor differentiation (P = 0.05, HR 2.82), ADCuniformity (P = 0.02, HR 3.32), and arterialentropy (P = 0.02, HR 6.84) were the only significant predictors of death; patients with higher a rterialentropy had significantly shorter OS than patients who did not meet this criterion (P = 0.02; median OS 24 vs 31 months). Conclusion Histogram-derived parameters may predict adverse pathological features in PDACs. High arterialentropy seems to be associated with short OS after surgery in patients with PDAC. Keywords Pancreatic carcinoma · Pancreas · Pancreatic neoplasms · Magnetic resonance imaging Abbreviations ADC Apparent diffusion coefficient AUC Area under the curve Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00261-020-02509-3) contains supplementary material, which is available to authorized users. * Riccardo De Robertis [email protected] 1
Department of Radiology, Ospedale Civile Maggiore - Azienda Ospedaliera Universitaria Integrata Verona, Piazzale A. Stefani 1, 37126 Verona, Italy
2
Department of Radiology, Ospedale G.B. Rossi - University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
3
Department of Pancreatic Surgery, Ospedale P. Pederzoli, Via Monte Baldo 24, 37019 Peschiera del Garda, Italy
FI Peripancreatic fat invasion IPMN Intraductal papillary mucinous ne
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