Preliminary investigation of whole-pancreas 3D histogram ADC metrics for predicting progression of acute pancreatitis

Abstract

Purpose: To evaluate whole-pancreas 3D-histogram ADC metrics in acute pancreatitis.

Methods: In 41 patients with acute pancreatitis undergoing MRI/MRCP with DWI, 3D-volumes-of-interest encompassing the entire pancreas were placed to derive whole-pancreas histogram ADC metrics.

Results: There were trends toward higher 0-10th percentile ADC, higher 10-25th percentile ADC, lower skewness, and higher kurtosis in patients with new complications (p=0.065-0.095). Conventional mean ADC showed no association with new complications (p=0.203). Kurtosis had highest area-under-the-curve (0.784) for predicting new complications (sensitivity=75.0%; specificity=91.9%).

Conclusion: Findings suggest whole-pancreas histogram ADC metrics assist early management of acute pancreatitis, (e.g., patient selection for more intensive monitoring/intervention).

Keywords: Acute pancreatitis; Apparent diffusion coefficient; Diffusion-weighted imaging; MRI.