The role of MRI diffusion and morphological parameters in diagnostic of local recurrence of posteoperative pancreatic adenocarcinoma proven by PET/CT
Abstract
Pancreatic adenocarcinoma is one of the most common malignant diseases today with a high mortality rate. The disease is asymptomatic for a long period or causes non-specific symptoms as nausea, pain and symptomatically icterus. It is why it is most often discovered in the later stages. The only available curative method is a radical surgical intervention, which involves the Whipple procedure for tumors localized in the area of the head of the pancreas or distal pancreatectomy in case the tumor is localized in the region of the body or tail.
Given the fact that most tumors are discovered in an advanced form of the disease, a small number of patients are candidates for surgical intervention and even after the same, and the five-year survival rate is relatively low. For this reason, early detection of local recurrence is of great importance. In daily work so far, PET-CT has proven to be the method of choice for early detection of local recurrence. More and more studies show the importance of MR and diffusion sequences in diagnosing recurrence of pancreatic cancer.
References
1. Siegel R, Ma J, Zou Z et al (2014) CA: A Cancer Journal for Clinicians [Internet] 64(1):9–29. Available from: http://doi.wiley.com/10.3322/caac.21208
2. Mortel KJ, Lemmerling M, de Hemptinne B (2000) Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features. European Radiology 10(1):123–8.
3. Kolbeinsson H, Hoppe A, Bayat A, et al (2021) Recurrence patterns and postrecurrence survival after curative intent resection for pancreatic ductal adenocarcinoma. Surgery 169(3):649-654. doi:10.1016/j.surg.2020.06.042
4. Djuric-Stefanovic, A., Saponjski, D., Mijovic, K (2023) The Cuff sign. Abdom Radiol 48, 1862–1864 https://doi.org/10.1007/s00261-023-03816-1
5. Balaj C, Ayav A, Oliver A et al (2016) CT imaging of early local recurrence of pancreatic adenocarcinoma following pancreaticoduodenectomy. Abdominal Radiology41(2):273–82.
6. Yao X-Z, Yun H, Zeng M-S et al (2013) Evaluation of ADC measurements among solid pancreatic masses by respiratory-triggered diffusion-weighted MR imaging with inversion-recovery fat-suppression technique at 3.0T. Magnetic Resonance Imaging 31(4):524–8.
7. Barral M, Taouli B, Guiu B et al (2015) Diffusion-weighted MR Imaging of the Pancreas: Current Status and Recommendations. Radiology 274(1):45–63.
8. Lucignani G, Paganelli G, Bombardieri E (2004) The use of standardized uptake values for assessing FDG uptake with PET in oncology: a clinical perspective. Nucl Med Commun (7):651–6.
9. Sakane M, Tatsumi M, Kim T et al (2015) Correlation between apparent diffusion coefficients on diffusion-weighted MRI and standardized uptake value on FDG-PET/CT in pancreatic adenocarcinoma. Acta Radiol 56(9):1034-1041.
10. Huang WC, Sheng J, Chen SY, Lu JP (2011) Differentiation between pancreatic carcinoma and mass-forming chronic pancreatitis: usefulness of high b value diffusion-weighted imaging. J Dig Dis 12(5):401-408
