Diffusion-weighted magnetic resonance imaging of pancreas tumours

Kartalis, Nikolaos; Lindholm, Terri L.; Aspelin, Peter; Permert, Johan; Albiin, Nils

doi:10.1007/s00330-009-1384-8

Cited by 162 publications

(134 citation statements)

References 29 publications

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“…Bu olgulardan birisi psödokistik lezyonu olan, diğeri ise pankreas başına komşu küçük bir lenf nodu olan olgu idi. [36] Psödokistik lezyondaki yanlış negatif sonuç çıkmasına neden olarak, yüksek viskoziteli enflamatuvar içerik gösterilmiştir. Çalışmamızda sekiz psödokistik lezyonun hiçbirinde düşük ADC değerleri ve diffüzyon kısıtlılığı saptanmamıştır.…”

Section: Discussionunclassified

“…Dolayısıyla yanlış pozitif psö-dokistik lezyonlar yüksek vizkositeli enflamasyon içeriği nedeniyle difüzyon kısıtlılığına neden olabilirler. [36] Psödokistler en yüksek ADC değerlerine sahipken, malign kitlelerin ADC değerleri düşüktür. Psödokistle-rin ortalama ADC değeri 2.43±0.6x10 -3 mm²/s'dir.…”

Section: Discussionunclassified

“…Çalışmamız-dan farklı olarak Kartalis ve ark.nın yaptığı çalışmada malign kitlelerinden bir tanesinde difüzyon kısıtlılığı saptanmamış, bu durumun olgunun adenokarsinomundan dolayın radyo/kemoterapi almasından kaynaklandığını ifade edilmiştir. [36] Ayrıca Kartalis ve ark., pankreatik kitlelerin tanısında, kantitatif analizin tek başına yeterli olmadığı, doğru tanının konulmasında kalitatif analizin de göz önünde bulundurulması gerektiğini vurgulamışlardır. [36] Malign lezyonlar içerisinde en yüksek ADC değeri orta derece diferansiye adenokarsinomda (1.48x10 -3 mm 2 /s) saptanmıştı.…”

Section: Discussionunclassified

“…[36] Ayrıca Kartalis ve ark., pankreatik kitlelerin tanısında, kantitatif analizin tek başına yeterli olmadığı, doğru tanının konulmasında kalitatif analizin de göz önünde bulundurulması gerektiğini vurgulamışlardır. [36] Malign lezyonlar içerisinde en yüksek ADC değeri orta derece diferansiye adenokarsinomda (1.48x10 -3 mm 2 /s) saptanmıştı. Çalışmamızda malign lezyonlardaki diferansiasyon derecesi ve ADC değerleri arasındaki ilişki değerlendirilmese de kötü diferansiye adenokarsinomlu olgularda ADC değerlerinin düşük olması dikkat çekicidir.…”

Section: Discussionunclassified

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The Role of Diffusion Weighted MR for Differentiation Between Benign and Malign Pancreatic Masses

Yağtu¹,

Turan²,

Turan³

2014

J Kartal TR

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Mehmet YAĞTU, Eren TURAN, Çiğdem ÖZTÜRK TURAN ÖzetAmaç: Bu çalışmada pankreas kitlelerinin, difüzyon ağırlıklı MR görüntüleme ile görünür difüzyon katsayısı (ADC) değerlerinin ölçülmesinin tanıya ve kitlelerin benign malign ayrımına katkısının değerlendirilmesi amaçlandı. Gereç ve Yöntem:Pankreas kitlesi olan 31 olgunun 31 adet kitlesine difüzyon ağırlıklı MR sekansı uygulandı. Aksiyal planda, single shot eko-planar spin eko sekansı ile her üç yönde (x, y, z), üç farklı b değerinde (b=0, b=500 ve b=1000 s/mm²) difüzyon duyarlı gradiyentler uygulanarak difüzyon ağırlıklı görüntüler ve b=500 değeri için ADC haritaları elde edildi. Verilerin istatistiksel olarak değerlendirmesi yapılırken gruplar arasındaki değişkenler için Mann-Whitney U testi kullanıldı. Bulgular:Otuz bir pankreas kitlesinin 17 tanesi benign, 14 tanesi malign özellikteydi. Benign kitlelerin sekizi psödokist, sekizi indetermine, biri kitleyi taklit eden pankreatit oluşturuyor-du. Malign kitleler ise sekizi adenokarsinom, üçü intraduktal papiller musinöz neoplazi, üçü orijini bilinmeyen malign hüc-relerden oluşmaktaydı. ADC ölçümleri sonucunda en yüksek değerler psödokistler aitti. B=500 s/mm² değerinde benign kitlelerin ortalama ADC değeri, 2.12±0.56x10 -3 mm 2 /s, malign kitlelerin ortalama 1.25±0.14x10 -3 mm 2 /s olarak ölçüldü.Sonuç: Benign lezyonların ortalama ADC değeri malign lezyonların ortalama ADC değeri ile karşılaştırıldığında; ADC ölçümlerinin pankreas kitlelerinin malign benign ayrımında anlamlı olduğu bulundu (p<0.05).Anahtar sözcükler: Görünür difüzyon katsayısı; manyetik rezonans görüntüleme; pankreas. (x, y, z) Summary Background: In this study, we aimed to evaluate the value of diffusion weighted MR imaging with the use of apparent diffusion coefficient (ADC) measurements on diagnosis and differentiation of benign and malignant pancreatic masses. Methods: Diffusion weighted MR sequence was performed to 31 masses of 31 cases. In axial plan single shoot echo-planar spin echo sequence for 3 plans

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Section: Discussionunclassified

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The Role of Diffusion Weighted MR for Differentiation Between Benign and Malign Pancreatic Masses

Yağtu¹,

Turan²,

Turan³

2014

J Kartal TR

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“…Although the sensitivity and accuracy of MDCT and MRI in diagnosis of pancreatic cancer have been improved significantly, it is still difficult to diagnosis at an early stage (Bronstein et al 2004;Kartalis et al 2009). The sensitivities and specificities were reported as 73%-94% and 95% for CT (DelMaschio et al 1991;Koito et al 1997), 85% and 96% for MRI (Ichikawa et al 2001).…”

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Combined Imaging with Multi-Detector Row Computed Tomography and Diffusion-Weighted Imaging in the Detection of Pancreatic Cancer

Yasui¹,

Sato²

2011

Tohoku J. Exp. Med.

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Pancreatic cancer is one of the most aggressive malignant tumor types. Its prognosis is extremely poor without early detection, and an accurate diagnosis with imaging techniques is vital for any chance of long-term survival after treatment. Despite the great technical advances that have been made with various kinds of imaging equipment, detection of pancreatic cancer is unsatisfactory, and new modalities are required. Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) has high sensitivity and specificity for the detection of pancreatic cancer; however, it does not provide anatomic information. Quite often, the necessary spatial correlation of a high-intensity area with anatomic structures is constrained. If it becomes possible to combine the imaging technique of DWI with multi-detector row computed tomography (MDCT), such as is done with positron emission tomography (PET) and computed tomography (CT), it is expected that the early diagnostic capability will improve. The objective of this study was to introduce combined imaging with DWI and CT into clinical practice to improve the diagnosis of pancreatic cancer. In the current report, we demonstrate a clinical attempt to combine DWI on MRI with the anatomical accuracy of MDCT for two patients of pancreatic adenocarcinoma. Analysis of these two patients revealed that the combined images corresponded precisely to the operative findings. Thus, the combined imaging with DWI and MDCT is useful for the detection of the pancreatic cancer.

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CMR2009: 3.05: Diffusion‐weighted MR imaging of pancreas using manganese oral contrast agent

Yuki

Narumi

Fujita

et al. 2009

Contrast Media & Molecular

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Conclusions: Considering the signal enhancement of normal liver parenchyma and the improved liver-lesion contrast, our initial results suggest that the optimal time point for liver MR imaging is between 2 and 6 h after oral intake of CMC-001. Rationale and Objectives: The limited sensitivity of MRI is the major drawback to the thorough involvement of this modality in Molecular Imaging applications. Some years ago the use of Gd-loaded apoferritin was reported (1) with a relaxivity of ca 600-800 mM À1 s À1. The attainable relaxation enhancement of Gd-loaded apoferritin is limited by the number of Gd-HPDO3A (<10) that it is possible to entrap in the inner cavity. It has been reported that metal ions, as well as iron, can be stored in high number inside the apoferritin cavity. Among them it has been shown that manganese ions enter the protein to yield wellcharacterized nanosized crystals of b-MnOOH (2). However, to improve T 1 -relaxation enhancement capabilities it is necessary to solubilize the metal ion payload inside the inner cavity. The dissolution of b-MnOOH occurs via the reduction of Mn(III) to Mn(II) operated with aminopolycarboxilic acids that also act as coordination ligands for sequestering weakly coordinated manganese ions on the outer surface of the protein.Methods: Iron-free horse spleen apoferritin was reconstituted in the presence of MnCl 2 solution at pH¼9 under air. After a 1 week reaction time, the samples were treated with aminopolycarboxilic acids (NTA, TETA), which resulted the elimination of bound Mn ions from the external surface of the protein and the reduction of the internally loaded Mn(III) to Mn(II). Results: The reductive treatment has allowed generation of an apoferritin-based nanocarrier (Mn-Apo) containing up to 300-400 Mn(II) aqua ions encapsulated in the inner cavity. This yielded the remarkable relaxivity value (per apoferritin) of ca 4000-7000 mM À1 s À1. Mn-Apo formed by endogeneously occuring molecules and ions displays a high biocompatibility. It targets hepatocytes with high efficiency and is able to discriminate healthy cells from hepatocarcinoma ones, on the basis of the different expression of ferritin receptors. Mn-apo was injected into C57BL/6 mice at a dose of 0.01 mmol kg À1 of Mn, and a very high signal intensity (SI) enhancement of the liver in the MRI images was detected 30 min and 1 h after the administration. Complete elimination of the probe occurred 24 h after the decreased liver SI. Conclusion: Mn-loaded apoferritin is a very efficient probe specific for liver imaging. In particular, it could be useful in the diagnosis of a variety of liver diseases involving differences in the hepatic iron storing capabilities. Purpose: The purpose of this study was to evaluate visual appearance of diffusion-weighted imaging (DWI) using oral manganese contrast agent. Material and Methods: Preliminary study included imaging evaluation of pancreas head with DWI with or without the oral manganese-based contrast agent (Bothdel: 36 mg manganese chloride tetrahydrate, Kyowa Kirin,...

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Diffusion-weighted magnetic resonance imaging of pancreas tumours

Cited by 162 publications

References 29 publications

The Role of Diffusion Weighted MR for Differentiation Between Benign and Malign Pancreatic Masses

The Role of Diffusion Weighted MR for Differentiation Between Benign and Malign Pancreatic Masses

Combined Imaging with Multi-Detector Row Computed Tomography and Diffusion-Weighted Imaging in the Detection of Pancreatic Cancer

CMR2009: 3.05: Diffusion‐weighted MR imaging of pancreas using manganese oral contrast agent

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