Riviere Deniece M, Maas Marnix C, Brosens Lodewijk A A, Stommel Martijn W J, van Laarhoven Cornelis J H M, Hermans John J
Department of Medical Imaging, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
Department of Pathology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
Diagnostics (Basel). 2024 Mar 7;14(6):573. doi: 10.3390/diagnostics14060573.
This study evaluated the relationship between apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and tumor grades based on WHO, Adsay, and Kalimuthu classifications, using whole-mount pancreatectomy specimens. If glandular formation plays a key role in the degree of diffusion restriction, diffusion-weighted imaging could facilitate non-invasive grading of PDAC. A freehand region of interest (ROI) was drawn along tumor borders on the preoperative ADC map in each tumor-containing slice. Resection specimens were retrospectively graded according to WHO, Adsay, and Kalimuthu classifications and correlated with overall survival and the 10th percentile of whole-volume ADC values. Findings from 40 patients (23 male, median age 67) showed no correlation between ADC p10 values and WHO differentiation ( = 0.050), Adsay grade ( = 0.955), or Kalimuthu patterns ( = 0.117). There was no association between ADC p10 and overall survival ( = 0.082) and other clinicopathological variables. Survival was significantly lower for poor tumor differentiation ( = 0.046) and non-glandular Kalimuthu patterns ( = 0.016) and there was a trend towards inferior survival for Adsay G3 ( = 0.090) after correction for age, tumor location, and stage. Preoperative ADC measurements for determining PDAC aggressiveness had limited clinical utility, as there was no correlation with histological parameters or overall survival in resectable PDAC.
本研究使用全胰切除术标本，评估了胰腺导管腺癌（PDAC）的表观扩散系数（ADC）值与基于世界卫生组织（WHO）、阿德赛（Adsay）和卡里穆图（Kalimuthu）分类的肿瘤分级之间的关系。如果腺泡形成在扩散受限程度中起关键作用，那么扩散加权成像可能有助于对PDAC进行非侵入性分级。在每个含肿瘤切片的术前ADC图上，沿着肿瘤边界徒手绘制感兴趣区（ROI）。根据WHO、Adsay和Kalimuthu分类对切除标本进行回顾性分级，并将其与总生存期以及全容积ADC值的第10百分位数相关联。40例患者（23例男性，中位年龄67岁）的研究结果显示，ADC p10值与WHO分级（P = 0.050）、Adsay分级（P = 0.955）或Kalimuthu模式（P = 0.117）之间无相关性。ADC p10与总生存期（P = 0.082）及其他临床病理变量之间无关联。在对年龄、肿瘤位置和分期进行校正后，肿瘤分化差（P = 0.046）和非腺泡型Kalimuthu模式（P = 0.016）患者的生存期显著较低，Adsay G3级患者的生存期有降低趋势（P = 0.090）。术前ADC测量对于确定PDAC的侵袭性临床效用有限，因为其与可切除PDAC的组织学参数或总生存期无相关性。
