Added value of apparent diffusion coefficient in distinguishing between serous and mucin-producing pancreatic cystic neoplasms

Pallavi Pandey, Ankur Pandey, Nannan Shao, Farnaz Najmi Varzaneh, Mounes Aliyari Ghasabeh, Manijeh Zharghampour, Pegah Khoshpouri, Daniel Fouladi, John Eng, Anne Marie O'Broin-Lennon, Marcia Canto, Ralph H Hruban, Ihab R Kamel

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate the added value of diffusion-weighted imaging (DWI) on MRI in differentiating serous from mucin-producing pancreatic cystic neoplasms (PCNs). Methods: One hundred seventeen patients with PCN measuring ≥ 10 mm were included. Three readers independently evaluated MRI with and without the use of apparent diffusion coefficient (ADC). Logistic regression was used to analyze whether confidence scores were different with the use of different image sets. Diagnostic performance with and without ADC was compared. Results: DWI/ADC improved confidence in 44.8%, 73.6%, and 78.2% of patients by the three readers in distinguishing serous from mucin-producing PCNs. The use of ADC increased the probability of a higher confidence in the differentiation as compared to morphological imaging for all three readers (p < 0.001). Odds ratio for increase in the diagnostic confidence with the use of ADC for the three readers with decreasing years of experience were 5.8, 6.8, and 12.7. The diagnostic accuracy of morphological MRI with ADC was higher than that without ADC for two of three readers with lesser experience (87.2% vs. 80.8%; 91.5% vs. 80.8%). Conclusion: DWI may have added value as a complementary tool to conventional morphological MRI in differentiating between serous and mucin-producing PCNs with possibly greater value for readers with less experience in reading abdominal MRI. Key Points: • Optimal management of PCNs requires differentiation of serous from mucin-producing PCNs. • ADC measurements allow increased confidence in differentiating serous from mucin-producing PCNs. • ADC measurements increase the accuracy in diagnosing serous versus mucin-producing PCNs.

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StatePublished - Jan 1 2019

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Mucins
Pancreatic Neoplasms
Reading
Logistic Models
Odds Ratio

Keywords

  • Cysts
  • Diffusion MRI
  • Magnetic resonance imaging
  • Mucin
  • Pancreas

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Added value of apparent diffusion coefficient in distinguishing between serous and mucin-producing pancreatic cystic neoplasms. / Pandey, Pallavi; Pandey, Ankur; Shao, Nannan; Varzaneh, Farnaz Najmi; Ghasabeh, Mounes Aliyari; Zharghampour, Manijeh; Khoshpouri, Pegah; Fouladi, Daniel; Eng, John; O'Broin-Lennon, Anne Marie; Canto, Marcia; Hruban, Ralph H; Kamel, Ihab R.

In: European Radiology, 01.01.2019.

Research output: Contribution to journalArticle

Pandey, Pallavi ; Pandey, Ankur ; Shao, Nannan ; Varzaneh, Farnaz Najmi ; Ghasabeh, Mounes Aliyari ; Zharghampour, Manijeh ; Khoshpouri, Pegah ; Fouladi, Daniel ; Eng, John ; O'Broin-Lennon, Anne Marie ; Canto, Marcia ; Hruban, Ralph H ; Kamel, Ihab R. / Added value of apparent diffusion coefficient in distinguishing between serous and mucin-producing pancreatic cystic neoplasms. In: European Radiology. 2019.
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abstract = "Objectives: To evaluate the added value of diffusion-weighted imaging (DWI) on MRI in differentiating serous from mucin-producing pancreatic cystic neoplasms (PCNs). Methods: One hundred seventeen patients with PCN measuring ≥ 10 mm were included. Three readers independently evaluated MRI with and without the use of apparent diffusion coefficient (ADC). Logistic regression was used to analyze whether confidence scores were different with the use of different image sets. Diagnostic performance with and without ADC was compared. Results: DWI/ADC improved confidence in 44.8{\%}, 73.6{\%}, and 78.2{\%} of patients by the three readers in distinguishing serous from mucin-producing PCNs. The use of ADC increased the probability of a higher confidence in the differentiation as compared to morphological imaging for all three readers (p < 0.001). Odds ratio for increase in the diagnostic confidence with the use of ADC for the three readers with decreasing years of experience were 5.8, 6.8, and 12.7. The diagnostic accuracy of morphological MRI with ADC was higher than that without ADC for two of three readers with lesser experience (87.2{\%} vs. 80.8{\%}; 91.5{\%} vs. 80.8{\%}). Conclusion: DWI may have added value as a complementary tool to conventional morphological MRI in differentiating between serous and mucin-producing PCNs with possibly greater value for readers with less experience in reading abdominal MRI. Key Points: • Optimal management of PCNs requires differentiation of serous from mucin-producing PCNs. • ADC measurements allow increased confidence in differentiating serous from mucin-producing PCNs. • ADC measurements increase the accuracy in diagnosing serous versus mucin-producing PCNs.",
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author = "Pallavi Pandey and Ankur Pandey and Nannan Shao and Varzaneh, {Farnaz Najmi} and Ghasabeh, {Mounes Aliyari} and Manijeh Zharghampour and Pegah Khoshpouri and Daniel Fouladi and John Eng and O'Broin-Lennon, {Anne Marie} and Marcia Canto and Hruban, {Ralph H} and Kamel, {Ihab R}",
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AU - Pandey, Pallavi

AU - Pandey, Ankur

AU - Shao, Nannan

AU - Varzaneh, Farnaz Najmi

AU - Ghasabeh, Mounes Aliyari

AU - Zharghampour, Manijeh

AU - Khoshpouri, Pegah

AU - Fouladi, Daniel

AU - Eng, John

AU - O'Broin-Lennon, Anne Marie

AU - Canto, Marcia

AU - Hruban, Ralph H

AU - Kamel, Ihab R

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: To evaluate the added value of diffusion-weighted imaging (DWI) on MRI in differentiating serous from mucin-producing pancreatic cystic neoplasms (PCNs). Methods: One hundred seventeen patients with PCN measuring ≥ 10 mm were included. Three readers independently evaluated MRI with and without the use of apparent diffusion coefficient (ADC). Logistic regression was used to analyze whether confidence scores were different with the use of different image sets. Diagnostic performance with and without ADC was compared. Results: DWI/ADC improved confidence in 44.8%, 73.6%, and 78.2% of patients by the three readers in distinguishing serous from mucin-producing PCNs. The use of ADC increased the probability of a higher confidence in the differentiation as compared to morphological imaging for all three readers (p < 0.001). Odds ratio for increase in the diagnostic confidence with the use of ADC for the three readers with decreasing years of experience were 5.8, 6.8, and 12.7. The diagnostic accuracy of morphological MRI with ADC was higher than that without ADC for two of three readers with lesser experience (87.2% vs. 80.8%; 91.5% vs. 80.8%). Conclusion: DWI may have added value as a complementary tool to conventional morphological MRI in differentiating between serous and mucin-producing PCNs with possibly greater value for readers with less experience in reading abdominal MRI. Key Points: • Optimal management of PCNs requires differentiation of serous from mucin-producing PCNs. • ADC measurements allow increased confidence in differentiating serous from mucin-producing PCNs. • ADC measurements increase the accuracy in diagnosing serous versus mucin-producing PCNs.

AB - Objectives: To evaluate the added value of diffusion-weighted imaging (DWI) on MRI in differentiating serous from mucin-producing pancreatic cystic neoplasms (PCNs). Methods: One hundred seventeen patients with PCN measuring ≥ 10 mm were included. Three readers independently evaluated MRI with and without the use of apparent diffusion coefficient (ADC). Logistic regression was used to analyze whether confidence scores were different with the use of different image sets. Diagnostic performance with and without ADC was compared. Results: DWI/ADC improved confidence in 44.8%, 73.6%, and 78.2% of patients by the three readers in distinguishing serous from mucin-producing PCNs. The use of ADC increased the probability of a higher confidence in the differentiation as compared to morphological imaging for all three readers (p < 0.001). Odds ratio for increase in the diagnostic confidence with the use of ADC for the three readers with decreasing years of experience were 5.8, 6.8, and 12.7. The diagnostic accuracy of morphological MRI with ADC was higher than that without ADC for two of three readers with lesser experience (87.2% vs. 80.8%; 91.5% vs. 80.8%). Conclusion: DWI may have added value as a complementary tool to conventional morphological MRI in differentiating between serous and mucin-producing PCNs with possibly greater value for readers with less experience in reading abdominal MRI. Key Points: • Optimal management of PCNs requires differentiation of serous from mucin-producing PCNs. • ADC measurements allow increased confidence in differentiating serous from mucin-producing PCNs. • ADC measurements increase the accuracy in diagnosing serous versus mucin-producing PCNs.

KW - Cysts

KW - Diffusion MRI

KW - Magnetic resonance imaging

KW - Mucin

KW - Pancreas

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