Diffusion-weighted MRI boosts detection of locally recurrent pancreatic cancer

Jessica Kania | | Health Imaging | Magnetic Resonance Imaging
Photo and caption courtesy of American Journal of Roentgenology (AJR), American Roentgen Ray Society (ARRS). Used with permission.
A. Axial contrast-enhanced CT image shows 1.7 cm lesion (arrow) with ill-defined margin at left side of superior mesenteric artery. B. On axial T2-weighted image, mass is hyperintense to paravertebral muscle (arrow). C. On arterial phase post-contrast T1-weighted image, mass shows mild enhancement (arrow) compared to unenhanced image; enhancement pattern classified as early. D. On DWI with b-value of 800 mm2/s, mass is hyperintense (arrow) to paravertebral muscle. E. On ADC map, mass is visually hypointense (arrow) to paravertebral muscle. Findings indicate presence of qualitative diffusion restriction; lesion ADC value was 0.96 × 10−3 mm2/s. F. Axial image from CT performed 6 months after MRI shows increase in lesion’s greatest axial diameter by more than 5 mm (arrow), indicating soft tissue abnormality represents locally recurrent tumor. Photo and caption courtesy of American Journal of Roentgenology (AJR), American Roentgen Ray Society (ARRS). Used with permission.

Source

American Journal of Roentgenology (AJR), American Roentgen Ray Society (ARRS)

For pancreatic cancer patients who have undergone pancreatic ductal adenocarcinoma (PDAC) resection, traditional MRI images alone can present difficulties in distinguishing recurrent tumors from post-surgical fibrosis. A new study published in American Journal of Roentgenology (AJR) found that adding diffusion-weighted MRI (DWI) to traditional MRI may help make that differentiation.[1]

“The findings indicate a potential role for MRI with DWI in surveillance protocols after PDAC resection,” corresponding author Tae Wook Kang, MD, of Samsung Medical Center in Seoul, South Korea, said in a statement about the study’s findings.

To make that determination, Kang and coauthors performed a retrospective study examining 66 patients who had PDAC resection between January 2009 and March 2016, and for whom a postoperative surveillance CT revealed a soft tissue lesion at the operative site or at the site of peripancreatic vessels. Those patients were then referred for MRI with DWI for additional evaluation. 

Two observers independently reviewed the conventional MRI images versus the MRI with DWI images, using CT at least six months after MRI as a reference standard.The MRI with DWI images showed higher sensitivity, without difference in specificity, in detecting local recurrence after PDAC resection, the study concluded.

Based on those results, using MRI with DWI may be able to play an important role in helping providers identify recurrent pancreatic cancer at an earlier stage. 

“MRI with DWI as a problem-solving tool during post-operative surveillance after PDAC resection could facilitate earlier detection of recurrences,” the study’s authors added, “guiding prognostic assessment and treatment decisions.”

View the full statement here.

 

Reference:

1. Shin, Nari; Kang, Tae Wook;  Min, Ji Hye; et al. Utility of Diffusion-Weighted MRI for Detection of Locally Recurrent Pancreatic Cancer After Surgical Resection. American Journal of Roentgenology. May 25, 2022. DOI: 10.2214/AJR.22.27739

 

Related Pancreatic Cancer Content: 

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MR imaging-guided SABR extends the lives of patients with inoperable pancreatic cancer

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Jessica Kania

Jessica Kania is a digital editor who has worked across the Innovate Healthcare brands, including Radiology Business, Health Imaging, AI in Healthcare and Cardiovascular Business. She also has vast experience working on custom content projects focused on technology innovation, clinical excellence, operational efficiency and improving financial performance in healthcare.  

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