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- Title
Accuracy of apparent diffusion coefficient in differentiating pancreatic neuroendocrine tumour from intrapancreatic accessory spleen.
- Authors
Pandey, Ankur; Pandey, Pallavi; Ghasabeh, Mounes Aliyari; Varzaneh, Farnaz Najmi; Khoshpouri, Pegah; Shao, Nannan; Pour, Manijeh Zargham; Fouladi, Daniel Fadaei; Hruban, Ralph H.; O’Broin-Lennon, Anne Marie; Kamel, Ihab R.; O'Broin-Lennon, Anne Marie
- Abstract
<bold>Objectives: </bold>To evaluate and compare the accuracy of absolute apparent diffusion coefficient (ADC) and normalised ADC (lesion-to-spleen ADC ratio) in differentiating pancreatic neuroendocrine tumour (NET) from intrapancreatic accessory spleen (IPAS).<bold>Methods: </bold>Study included 62 patients with the diagnosis of pancreatic NET (n=51) or IPAS (n=11). Two independent reviewers measured ADC on all lesions and spleen. Receiver operating characteristics (ROC) analysis to differentiate NET from IPAS was performed and compared for absolute and normalised ADC. Inter-reader reliability for the two methods was assessed.<bold>Results: </bold>Pancreatic NET had significantly higher absolute ADC (1.431x10-3 vs 0.967x10-3 mm2/s; P<0.0001) and normalised ADC (1.59 vs 1.09; P<0.0001) compared to IPAS. An ADC value of ≥1.206x10-3 mm2/s was 70.6% sensitive and 90.9% specific for the diagnosis of NET vs. IPAS. Lesion to spleen ADC ratio of ≥1.25 was 80.4% sensitive, and 81.8% specific while ratio of ≥1.29 was 74.5% sensitive and 100% specific in the differentiation. The area under the curve (AUCs) for two methods were similar (88.2% vs. 88.8%; P=0.899). Both methods demonstrated excellent inter-reader reliability with ICCs for absolute ADC and ADC ratio being 0.957 and 0.927, respectively.<bold>Conclusion: </bold>Both absolute and normalised ADC allow clinically relevant differentiation of pancreatic NET and IPAS.<bold>Key Points: </bold>• Imaging overlaps between IPASs and pancreatic-NETs lead to unnecessary procedures including pancreatectomy. • Uniquely low ADC of spleen allows differentiating IPASs from pancreatic NETs. • Both absolute-ADC and normalised-ADC (lesion-to-spleen ADC-ratio) demonstrate high accuracy in differentiating IPASs from NETs. • Both methods demonstrate excellent inter-reader reliability.
- Subjects
PANCREATIC tumors; NEUROENDOCRINE tumors; PANCREATECTOMY; SPLEEN; SURGICAL excision; DIFFERENTIAL diagnosis; MAGNETIC resonance imaging; RESEARCH evaluation; SPLEEN diseases; RETROSPECTIVE studies
- Publication
European Radiology, 2018, Vol 28, Issue 4, p1560
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-017-5122-3