Preliminary investigation of whole-pancreas 3D histogram ADC metrics for predicting progression of acute pancreatitis

Iranmahboob, Amir; Kierans, Andrea S.; Huang, Chenchan; Ream, Justin; Rosenkrantz, Andrew B.

doi:10.1016/j.clinimag.2016.12.007

Cited by 13 publications

(9 citation statements)

References 28 publications

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“…The use of diffusion-weighted images acquired from multiple MRI scanners, including 1.5 T and 3.0 T systems, and vendors may effect measurements due to variance in signal to noise or curve fitting techniques [35,36]. Nevertheless, our inclusion of multiple systems is consistent with previous studies and may improve the generalizability of our results [31,33]. The specific software utilized to extract texture metrics from image sets also introduces variance in reproducibility, as such programs have been shown to potentially provide different texture metrics from the same individual image [37].…”

Section: Discussionsupporting

confidence: 79%

“…The interobserver agreement was moderate for mean ADC, mean 0-10 , mean 10-25 , mean 25-50 , and kurtosis. The observed level of agreement was lower than reported in some earlier studies of whole volume ADC histogram analysis [31,32]. Future attention is needed into ways to improve consistency in the boundaries of reader defined VOIs that are required to achieve metric reproducibility, which may be especially problematic for smaller lesions.…”

Section: Discussioncontrasting

confidence: 55%

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Exploratory Study of Apparent Diffusion Coefficient Histogram Metrics in Assessing Pancreatic Malignancy

et al. 2019

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Purpose To evaluate whole-lesion 3D-histogram apparent diffusion coefficient (ADC) metrics for assessment of pancreatic malignancy. Methods Forty-two pancreatic malignancies (36 pancreatic adenocarcinoma [PDAC], 6 pancreatic neuroendocrine [PanNET]) underwent abdominal magnetic resonance imaging (MRI) with diffusion-weighted imaging before endoscopic ultrasound biopsy or surgical resection. Two radiologists independently placed 3D volumes of interest to derive whole-lesion histogram ADC metrics. Mann-Whitney tests and receiver operating characteristic analyses were used to assess metrics’ diagnostic performance for lesion histology, T-stage, N-stage, and grade. Results Whole-lesion ADC histogram metrics lower in PDACs than PanNETs for both readers ( P ≤ .026) were mean ADC (area under the curve [AUC] = 0.787-0.792), mean of the bottom 10th percentile (mean0-10) (AUC = 0.787-0.880), mean of the 10th-25th percentile (mean10-25) (AUC = 0.884-0.917) and mean of the 25th-50th percentile (mean25-50) (AUC = 0.829-0.829). For mean10-25 (metric with highest AUC for identifying PDAC), for reader 1 a threshold > 0.94 × 10−3 mm2/s achieved sensitivity 94% and specificity 83%, and for reader 2 a threshold > 0.82 achieved sensitivity 97% and specificity 67%. Metrics lower in nodal status ≥ N1 than N0 for both readers ( P ≤ .043) were mean0-10 (AUC = 0.789-0.822) and mean10-25 (AUC = 0.800-0.822). For mean10-25 (metric with highest AUC for identifying N0), for reader 1 a threshold <1.17 achieved sensitivity 87% and specificity 67%, and for reader 2 a threshold <1.04 achieved sensitivity 87% and specificity 83%. No metric was associated with T-stage ( P > .195) or grade ( P > .215). Conclusion Volumetric ADC histogram metrics may serve as non-invasive biomarkers of pancreatic malignancy. Mean10-25 outperformed standard mean for lesion histology and nodal status, supporting the role of histogram analysis.

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Section: Discussionsupporting

confidence: 79%

Section: Discussioncontrasting

confidence: 55%

Exploratory Study of Apparent Diffusion Coefficient Histogram Metrics in Assessing Pancreatic Malignancy

et al. 2019

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“…Such investigations would further enable a determination of the utility of pancreatic MRI towards monitoring pancreatic pathology and potential treatment effect. Lastly, recent retrospective work has suggested that conventional metrics such as the mean ADCs of the pancreas may not be as sensitive towards monitoring pancreatic pathology or treatment response as other diffusion MRI measures [4,30,31]. Therefore, the variability and reproducibility of these novel approaches may be beneficial to consider.…”

Section: Prospective Assessment Of Variability and Reproducibility Ofmentioning

confidence: 99%

“…For longitudinal investigation of the diseased pancreas, where multiple imaging evaluations are needed within a short timeframe, MRI has the added value over CT given the lack of substantial radiation exposure or need for exogenous contrast agents that enable identification of pancreatic pathology. To date, MRI methods, mainly diffusion-weighted MRI (DW-MRI) and T2-MRI, have shown sensitivity for detecting pathology in acute or chronic pancreatitis [3][4][5][6][7], autoimmune pancreatitis [8][9][10] and pancreatic cancer [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Prospective Assessment of Variability and Reproducibility of Diffusion-Weighted MRI and T2-Mapping of the Pancreas in Healthy Volunteers

Upadhyay¹,

Dolgopolov²,

Narang³

et al. 2017

J Med Imaging Case Rep

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Purpose: To determine the test-retest reliability and variance of metrics obtained from pancreatic diffusion-weighted magnetic resonance imaging (DW-MRI) and T2-MRI (i.e., apparent diffusion coefficients (ADC) and T2relaxation times). Methods: A two scanning session, two observer test-retest study in healthy volunteers (N=10) at 1.5T was performed with DW-MRI and T2-mapping scans acquired. In addition to region-specific (head, neck, body and tail) ADC and T2-relaxation values, coefficients of variation (CVs) and Bland-Altman plots were calculated. Results: We observed mean ADC values (x 10-3 mm 2 /sec) of head: 1.50

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“…33 Histogram analysis of pancreatic parenchymal ADC maps have linked reduced skewness and higher kurtosis (Supplementary Material 1) with increased risk of future complications, although overall sensitivity was low (area under the curve = 0.784). 34 Parenchymal T 2 * measurements can increase in acute pancreatitis (the cause of this is uncertain, but may be secondary to increased perfusion), although these reduce in the presence of superadded haemorrhage. 35 Finally, DWI can also be useful in the evaluation of pancreatic/peripancreatic collections, as lower ADC values (as a result of cellular debris) can be indicative of superadded infection.…”

Section: Quantitative Pancreatic Mrimentioning

confidence: 99%

Quantitative pancreatic MRI: a pathology-based review

Chouhan

Firmin

Read

et al. 2019

The British Journal of Radiology

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MRI plays an important role in the clinical management of pancreatic disorders and interpretation is reliant on qualitative assessment of anatomy. Conventional sequences capturing pancreatic structure can however be adapted to yield quantitative measures which provide more diagnostic information, with a view to increasing diagnostic accuracy, improving patient stratification, providing robust non-invasive outcome measures for therapeutic trials and ultimately personalizing patient care. In this review, we evaluate the use of established techniques such as secretin-enhanced MR cholangiopancreatography, diffusion-weighted imaging, T 1, T 2* and fat fraction mapping, but also more experimental methods such as MR elastography and arterial spin labelling, and their application to the assessment of diffuse pancreatic disease (including chronic, acute and autoimmune pancreatitis/IgG4 disease, metabolic disease and iron deposition disorders) and cystic/solid focal pancreatic masses. Finally, we explore some of the broader challenges to their implementation and future directions in this promising area.

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Preliminary investigation of whole-pancreas 3D histogram ADC metrics for predicting progression of acute pancreatitis

Cited by 13 publications

References 28 publications

Exploratory Study of Apparent Diffusion Coefficient Histogram Metrics in Assessing Pancreatic Malignancy

Exploratory Study of Apparent Diffusion Coefficient Histogram Metrics in Assessing Pancreatic Malignancy

Prospective Assessment of Variability and Reproducibility of Diffusion-Weighted MRI and T2-Mapping of the Pancreas in Healthy Volunteers

Quantitative pancreatic MRI: a pathology-based review

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