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British Journal of Radiology (2009) 82, 28-34
© 2009 British Institute of Radiology
doi: 10.1259/bjr/43911400
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Advanced pancreatic cancer: the use of the apparent diffusion coefficient to predict response to chemotherapy

T NIWA, MD 1 M UENO, MD 2 S OHKAWA, MD 2 T YOSHIDA, MD 1 T DOIUCHI, MD 1 K ITO, MD 1 and T INOUE, MD 3

Departments of 1 Radiology and, 2 Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Centre, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815 and 3 Department of Radiology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan


Figure 1
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  		Figure 1. Images from a 65-year-old man with advanced pancreatic cancer who showed early progression. Progression was noted on the 2-month follow-up CT. (a) Transverse T1 weighted fast-field echo image shows an irregularly shaped tumour at the pancreatic head (arrows). (b,c) Isotropic diffusion-weighted image (b) and the apparent diffusion coefficient (ADC) map (c) using the middle b-value (400 s mm–2) show an inhomogeneous high-signal mass (arrows). The ADC was 0.98x10–3 mm2 s–1. (d) Isotropic diffusion-weighted image and (e) ADC map with a high b-value (1000 s mm–2) show an inhomogeneous high-signal mass (arrows). The ADC was 0.84x10–3 mm2 s–1.

 

Figure 2
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  		Figure 2. Images from a 66-year-old man with relatively stable advanced pancreatic cancer. Progression was noted on the 8-month follow-up CT. (a) Transverse T1 weighted fast-field echo image shows an irregularly shaped tumour at the pancreatic head (arrows). (b) Isotropic diffusion-weighted image and (c) the apparent diffusion coefficient (ADC) map using the middle b-value (400 s mm–2) show an inhomogeneous high-signal mass (arrows). The ADC was 1.42x10–3 mm2 s–1. (d) Isotropic diffusion-weighted image and (e) the ADC map with a high b-value (1000 s mm–2 ) show an inhomogeneous high-signal mass (arrows). The ADC was 1.40x10–3 mm2 s–1.

 

Figure 3
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  		Figure 3. The graph shows the rates of local tumour progression in patients with advanced pancreatic cancer treated with chemotherapy. Patients with a lower apparent diffusion coefficient(ADC) using the high b-value (1000 s mm–2) had a significantly higher rate of progression than those with a higher ADC (p<0.01, log-rank test).

 




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