Introduction: Tumor grade, one of the most important risk factors for survival, is routinely determined after examining the biopsy material or a surgically removed specimen. The aim of the study was to analyze computed tomography (CT) perfusion parameters and diffusion-weighted imaging apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and to establish the diagnostic value of these modalities determining the tumor grade. Materials and Methods: A prospective clinical study included 56 subjects with PDAC. All the patients had a local perfusion assessment and ADC measurement of the tumor. For the prediction of poor tumor differentiation sensitivity, specificity, positive, and negative predictive values for each perfusion CT and ADC parameters based on cutoff values from ROC analysis were calculated. Results: Mean transit time (MTT) and ADC values were found to be independent prognosticators for the presence of G3 PDAC. MTT and ADC at the cutoff of 17.37 s and 1.15 × 10⁻³ mm²/s, respectively, appeared to be significant parameters discriminating against the differentiation grade of PDAC. If both values exceeded the defined cutoff point, the estimated probability for the presence of G3 PDAC was 89.29%. Conclusion: The MTT parameter, calculated with the deconvolution method, and the ADC value may serve as effective independent prognosticators identifying poorly differentiated PDAC.
Dig Surg

中文翻译：

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动态灌注计算机断层扫描和表观扩散系数作为低分化胰腺癌的潜在标志物

简介：肿瘤分级是生存的最重要危险因素之一，通常在检查活检材料或手术切除标本后确定。本研究的目的是分析胰腺导管腺癌 (PDAC) 的计算机断层扫描 (CT) 灌注参数和弥散加权成像表观弥散系数 (ADC) 值，并确定这些方式确定肿瘤分级的诊断价值。材料和方法：一项前瞻性临床研究包括 56 名 PDAC 受试者。所有患者都进行了肿瘤的局部灌注评估和 ADC 测量。为了预测差的肿瘤分化敏感性、特异性、阳性和阴性预测值，每个灌注 CT 和 ADC 参数基于 ROC 分析的截止值进行计算。结果：发现平均传输时间 (MTT) 和 ADC 值是 G3 PDAC 存在的独立预测因素。分别在 17.37 s 和 1.15 × 10 ^-3 mm ² /s的截止时间处的 MTT 和 ADC似乎是区分 PDAC 分化等级的重要参数。如果两个值都超过了定义的截止点，则 G3 PDAC 存在的估计概率为 89.29%。结论：使用解卷积方法计算的 MTT 参数和 ADC 值可作为识别低分化 PDAC 的有效独立预后因素。
挖掘手术