Effective apparent diffusion coefficient parameters for differentiation between mass-forming autoimmune pancreatitis and
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PANCREAS
Effective apparent diffusion coefficient parameters for differentiation between mass‑forming autoimmune pancreatitis and pancreatic ductal adenocarcinoma Hainan Ren1 · Naoko Mori1 · Shin Hamada2 · Chiaki Takasawa1 · Shunji Mugikura1 · Atsushi Masamune2 · Kei Takase1 Received: 10 June 2020 / Revised: 14 September 2020 / Accepted: 27 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) parameters by region of interest (ROI) methods in differentiating mass-forming autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC). Methods The institutional review board approved this retrospective study and the requirement for informed consent was waived. Twenty-three patients with mass-forming AIP and 144 patients with PDAC underwent diffusion-weighted imaging with b-values of 0 s/mm2 and 800 s/mm2. The minimum, maximum, and mean ADC values obtained by placing ROIs within lesions and percentile ADC values (10th, 25th, 50th, 75th, and 90th) from entire-lesion histogram analysis were compared between the two groups by using Mann–Whitney U tests. The diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis. Results The minimum, maximum, and mean ADC values were significantly different between mass-forming AIP and PDAC groups. ROC curve analysis showed that the maximum ADC had the highest diagnostic performance (0.92), while the minimum ADC value had the lowest diagnostic performance (0.72). The AUC of minimum ADC was significantly lower than that of maximum or mean ADC (P < 0.0001, P < 0.0001). The AUC was lowest in 10th percentile ADC value and highest in 90th percentile value. The AUC increased along with the increase of percentile values. Conclusion Either the maximum or mean ADC value was effective in differentiating mass-forming AIP from the PDAC group, while the minimum ADC value might not be recommended. Keywords Mass-forming autoimmune pancreatitis · Pancreatic ductal adenocarcinoma · Apparent diffusion coefficient · Diffusion-weighted imaging · Magnetic resonance imaging Abbreviations AIP Autoimmune pancreatitis MRCP Magnetic resonance cholangiopancreatography PDAC Pancreatic ductal adenocarcinoma
ADC Apparent diffusion coefficient ROI Region of interest
* Naoko Mori [email protected]
Atsushi Masamune [email protected]
Hainan Ren [email protected]
Kei Takase [email protected]
Shin Hamada [email protected]
1
Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1‑1 Seiryo‑machi, Aoba‑ku, Sendai 980‑8574, Japan
2
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
Chiaki Takasawa [email protected] Shunji Mugikura [email protected]
13
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Introduction Autoimmune pancreatitis (AIP) is histologically characterized by an autoimmune inflammatory process in which dense T lymphocyte
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