Prognostic relevance of apparent diffusion coefficient obtained by diffusion-weighted MRI in pancreatic cancer

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Abstract

Background:

Diffusion-weighted magnetic resonance imaging (DW-MRI) is utilized as a method of oncologic imaging for predicting treatment outcomes. This study explored the role of DW-MRI in the treatment of patients with resected pancreatic cancer by comparing apparent diffusion coefficient (ADC) values with clinicopathological findings and survival rates.

Materials and Methods:

Records of 54 patients in whom DW-MRI at 1.5T was performed (b values: 0 and 1000 mm2/s) before macroscopically curative resection were analyzed. ADC values were then calculated and compared with clinicopathological factors including age, gender, serum carcinoembryonic antigen levels, serum carbohydrate antigen 19–9 levels, lymph node metastasis, primary tumoral location, size, differentiation, resectability, and pT stage. A survival analysis of clinicopathological factors and ADC values was performed using the Kaplan–Meier method, and the results were evaluated with the log-rank test. Prognostic significance was assessed using the Cox proportional hazard model.

Results:

Significant associations were found between tumor differentiation and ADC values (P = 0.001). In a univariate analysis of overall survival, tumor differentiation (P = 0.037) and ADC values (P = 0.002) were identified as significant prognostic factors. However, age, gender, carcinoembryonic antigen levels, carbohydrate antigen 19–9 levels, lymph node metastasis, primary tumoral location, size, resectability, and pT stage were not associated with overall survival. In a multivariate analysis of overall survival, only ADC values were identified as significant prognostic factors (hazard ratio 2.293, 95% confidence interval 1.147–4.585, P = 0.019).

Conclusion:

ADC values were found to be associated with prognosis in patients with resected pancreatic cancer. J. MAGN. RESON. IMAGING 2015;42:1532–1537.

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