多任务动态对比增强磁共振成像能够准确区分慢性胰腺炎和胰腺导管腺癌。

Multitasking dynamic contrast enhanced magnetic resonance imaging can accurately differentiate chronic pancreatitis from pancreatic ductal adenocarcinoma.

作者信息

Wang Nan, Gaddam Srinivas, Xie Yibin, Christodoulou Anthony G, Wu Chaowei, Ma Sen, Fan Zhaoyang, Wang Lixia, Lo Simon, Hendifar Andrew E, Pandol Stephen J, Li Debiao

机构信息

Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.

The Karsh Division of Gastroenterology and Hepatology, Cedars Sinai Medical Center, Los Angeles, CA, United States.

出版信息

Front Oncol. 2023 Jan 6;12:1007134. doi: 10.3389/fonc.2022.1007134. eCollection 2022.

DOI:10.3389/fonc.2022.1007134

PMID:36686811

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9853434/

Abstract

BACKGROUND AND AIMS

Accurate differentiation of chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) is an area of unmet clinical need. In this study, a novel Multitasking dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) technique was used to quantitatively evaluate the microcirculation properties of pancreas in CP and PDAC and differentiate between them.

METHODS

The Multitasking DCE technique was able to acquire one 3D image per second during the passage of MRI contrast agent, allowing the quantitative estimation of microcirculation properties of tissue, including blood flow F, plasma volume fraction v, transfer constant K, and extravascular extracellular volume fraction v. Receiver operating characteristic (ROC) analysis was performed to differentiate the CP pancreas, PDAC pancreas, normal control pancreas, PDAC tumor, PDAC upstream, and PDAC downstream. ROCs from quantitative analysis and conventional analysis were compared.

RESULTS

Fourteen PDAC patients, 8 CP patients and 20 healthy subjects were prospectively recruited. The combination of F, v, K, and v can differentiate CP versus PDAC pancreas with good AUC (AUC [95% CI] = 0.821 [0.654 - 0.988]), CP versus normal pancreas with excellent AUC (1.000 [1.000 - 1.000]), PDAC pancreas versus normal pancreas with excellent AUC (1.000 [1.000 - 1.000]), CP versus PDAC tumor with excellent AUC (1.000 [1.000 - 1.000]), CP versus PDAC downstream with excellent AUC (0.917 [0.795 - 1.000]), and CP versus PDAC upstream with fair AUC (0.722 [0.465 - 0.980]). This quantitative analysis outperformed conventional analysis in differentiation of each pair.

CONCLUSION

Multitasking DCE MRI is a promising clinical tool that is capable of unbiased quantitative differentiation between CP from PDAC.

摘要

背景与目的

准确区分慢性胰腺炎（CP）和胰腺导管腺癌（PDAC）是临床需求未得到满足的领域。在本研究中，一种新型多任务动态对比增强（DCE）磁共振成像（MRI）技术被用于定量评估CP和PDAC中胰腺的微循环特性并对它们进行鉴别。

方法

多任务DCE技术能够在MRI造影剂通过期间每秒获取一幅三维图像，从而能够对组织的微循环特性进行定量估计，包括血流量F、血浆容积分数v、转运常数K和血管外细胞外容积分数v。进行受试者操作特征（ROC）分析以区分CP胰腺、PDAC胰腺、正常对照胰腺、PDAC肿瘤、PDAC上游和PDAC下游。比较定量分析和传统分析的ROC曲线。

结果

前瞻性招募了14例PDAC患者、8例CP患者和20名健康受试者。F、v、K和v的组合能够很好地区分CP与PDAC胰腺，AUC良好（AUC [95% CI] = 0.821 [0.654 - 0.988]），CP与正常胰腺区分的AUC极佳（1.000 [1.000 - 1.000]），PDAC胰腺与正常胰腺区分的AUC极佳（1.000 [1.000 - 1.000]），CP与PDAC肿瘤区分的AUC极佳（1.000 [1.000 - 1.000]），CP与PDAC下游区分的AUC极佳（0.917 [0.795 - 1.000]），CP与PDAC上游区分的AUC中等（0.722 [0.465 - 0.980]）。在每一对的区分中，这种定量分析优于传统分析。