Differentiation of pancreatobiliary-type from intestinal-type periampullary carcinomas using 3.0T MRI

Bi, Lei; Yin, Dong; Jing, Changqing; Wu, Qingzhong; Xiu, Jianjun; Cai, Shun; Huang, Zhaoqin; Zhang, Jie; Han, Xue; Liu, Qingwei; Shou-chen, LV

doi:10.1002/jmri.25054

Cited by 10 publications

(5 citation statements)

References 41 publications

(92 reference statements)

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“…In the present study, the ADC values of the IPACs were higher than those of the PPACs, which corresponded to the ADC quantitative analysis by Bi et al[16]. In their study, the mean ADC could not help differentiate these two histological groups, but ADC min achieved a significant difference ( P = 0.047; sensitivity, 85.2%; specificity, 50%; AUC = 0.672).…”

Section: Discussionsupporting

confidence: 81%

“…A qualitative study found that the comprehensive evaluation of multiple CT features of the periampullary area could differentiate the histological subtypes, but required optimal duodenal distention and was highly dependent on the expertise of the radiologists[15]. An oval filling defect at the end of the bile duct on magnetic resonance cholangiopancreatography images tended to suggest IPAC but controversy still existed[16,17].…”

Section: Introductionmentioning

confidence: 99%

“…It calculates the apparent diffusion coefficient (ADC) to reflect random motion of water molecules, which could add information pertinent to tissue structure. Bi et al[16] found a combination of a progressive enhancement pattern and low minimum ADC value ( b 800 ) suggestive of PPAC, but the diagnostic performance of ADC min alone was not high enough. In addition, the use of gadolinium-based contrast agents is limited in patients with impaired renal function[18,19].…”

Section: Introductionmentioning

confidence: 99%

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Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma

Zou

et al. 2019

WJG

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BACKGROUNDFor periampullary adenocarcinoma, the histological subtype is a better prognostic predictor than the site of tumor origin. Intestinal-type periampullary adenocarcinoma (IPAC) is reported to have a better prognosis than the pan-creatobiliary-type periampullary adenocarcinoma (PPAC). However, the classification of histological subtypes is difficult to determine before surgery. Apparent diffusion coefficient (ADC) histogram analysis is a noninvasive, non-enhanced method with high reproducibility that could help differentiate the two subtypes.AIMTo investigate whether volumetric ADC histogram analysis is helpful for distinguishing IPAC from PPAC.METHODSBetween January 2015 and October 2018, 476 consecutive patients who were suspected of having a periampullary tumor and underwent magnetic resonance imaging (MRI) were reviewed in this retrospective study. Only patients who underwent MRI at 3.0 T with different diffusion-weighted images (b-values = 800 and 1000 s/mm2) and who were confirmed with a periampullary adenocarcinoma were further analyzed. Then, the mean, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values and ADCmin, ADCmax, kurtosis, skewness, and entropy were obtained from the volumetric histogram analysis. Comparisons were made by an independent Student's t-test or Mann-Whitney U test. Multiple-class receiver operating characteristic curve analysis was performed to determine and compare the diagnostic value of each significant parameter.RESULTSIn total, 40 patients with histopathologically confirmed IPAC (n = 17) or PPAC (n = 23) were enrolled. The mean, 5th, 25th, 50th, 75th, 90th, and 95th percentiles and ADCmax derived from ADC1000 were significantly lower in the PPAC group than in the IPAC group (P < 0.05). However, values derived from ADC800 showed no significant difference between the two groups. The 75th percentile of ADC1000 values achieved the highest area under the curve (AUC) for differentiating IPAC from PPAC (AUC = 0.781; sensitivity, 91%; specificity, 59%; cut-off value, 1.50 × 10-3 mm2/s).CONCLUSIONVolumetric ADC histogram analysis at a b-value of 1000 s/mm2 might be helpful for differentiating the histological subtypes of periampullary adenocarcinoma before surgery.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma

Zou

et al. 2019

WJG

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“…The sensitivity and specificity were found to be 91% and 59%, respectively, with a cut-off value of 1.50 x 10 -3 mm²/s. In their study, Bi et al [27] revealed that the average ADC was not able to differentiate these groups. However, they noticed that the ADCmin showed potential in terms of differentiating between the groups with a sensitivity of 85.2%, specificity of 50%, and an AUC of 0.672.…”

Section: Discussionmentioning

confidence: 90%

Volumetric apparent diffusion coefficient histogram analysis for determining the degree of differentiation of periampullary carcinomas

Nalbant,

Inci

2023

J Surg Med

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Background/Aim: The classification of periampullary adenocarcinomas into pancreatobiliary-type periampullary adenocarcinoma and intestinal-type periampullary adenocarcinoma (PPAC and IPAC, respectively) has gained significant acceptance in the medical community. A patient's prognosis is determined by the degree of differentiation of these tumor types. The objective of the present investigation was to assess the efficacy of volumetric apparent diffusion coefficient (ADC) histogram analysis in assessing the degree of differentiation for these two tumor types. Methods: This retrospective cohort research evaluated 54 PPAC (45 well-differentiated and nine poorly differentiated) and 15 IPAC (11 well-differentiated and four poorly differentiated) patients. Magnetic resonance imaging (1.5 T MRI) scans were used to evaluate the results. The features of the histogram for the ADC values were computed and incorporated several statistical measures, such as the mean, minimum, median, maximum, and percentiles in addition to the skewness, kurtosis, and variance. Results: In both PPAC and IPAC patients, the ADC values exhibited lower values in the poorly differentiated group when compared with the well-differentiated group. However, the changes between groups did not reach statistical significance. Among IPAC patients, the well-differentiated group had a larger kurtosis (P=0.048). In IPAC patients, the calculated value for the area under the curve (AUC) of kurtosis was determined to be 0.818. When the threshold was set at 0.123, the specificity and sensitivity were observed to be 90% and 75%, respectively. Conclusion: Our research indicates that the kurtosis of ADC is an effective indicator to determine the level of IPAC differentiation. Analysis of the histogram at increased b values can provide valuable insights to help determine the degree of differentiation of IPAC using a noninvasive technique.

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“…The novelty of our study arises from the fact that, to our knowledge, there are no other studies in the literature that performed volumetric histogram analysis in the paediatric HIE group. We evaluated only the ADC values derived from the b -value of 1000 mm 2 /s because no significant differences were found with low b -values in the studies carried out [ 26 , 27 ]. In our study, a retrospective analysis method with potential bias was used in patient selection.…”

Section: Discussionmentioning

confidence: 99%

Volumetric apparent diffusion coefficient (ADC) histogram analysis of the brain in paediatric patients with hypoxic ischaemic encephalopathy

Nalbant,

Erdil,

Akcay

et al. 2023

Pol J Radiol

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PurposeTo evaluate the whole brain, hippocampus, thalamus, and lentiform nucleus by volumetric apparent diffusion coefficient (ADC) histogram analysis in paediatric patients with hypoxic-ischaemic encephalopathy (HIE).Material and methodsThis retrospective study included 25 patients with HIE and 50 patients as the control group. Diffusion-weighted imaging was obtained at b-values of 1000 mm²/s. The histogram parameters of ADC values, including the mean, minimum, maximum, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, as well as skewness, kurtosis, and variance were determined. The interclass correlation coefficient (ICC) was used to assess the interobserver agreement.ResultsADCmin, ADCmean, and ADCmax, as well as the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values for the HIE group were all lower than those of the control group (p < 0.001) in the volumetric histogram analysis of the hippocampus, thalamus, and lentiform nucleus. In the whole-brain histogram analysis, ADC min, and the 50th and 75th percentiles of ADC values did not differ significantly, while other parameters were lower in the HIE group. The ROC curve revealed that the ADC histogram parameters of the hippocampus provided the most accurate results for the diagnosis of HIE. The area under the curve (AUC) of the 95th percentile of ADC values was the highest (AUC = 0.915; cut-off 1.262 × 10-3 mm²/s; sensitivity 88% and specificity 84%).ConclusionsVolumetric ADC histogram analysis of the whole brain, hippocampus, thalamus, and lentiform nucleus with b-values of 1000 mm²/s can serve as an imaging marker for determining HIE.

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Differentiation of pancreatobiliary-type from intestinal-type periampullary carcinomas using 3.0T MRI

Abstract: Progressive enhancement and low ADCmin values suggest a pancreatobiliary-type periampullary carcinoma.

Cited by 10 publications

References 41 publications

Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma

Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma

Volumetric apparent diffusion coefficient histogram analysis for determining the degree of differentiation of periampullary carcinomas

Volumetric apparent diffusion coefficient (ADC) histogram analysis of the brain in paediatric patients with hypoxic ischaemic encephalopathy

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