Paper Proffered Program Diagnostic and Interventional Radiology Physics

Evaluation of Magnetic Resonance Fingerprinting for the Early Detection of Pancreatic Disease

Abstract
Purpose

To compare how T1, T2 and T1ρ relaxation times in patients with increased risk of pancreatic cancer compare to known diseases of the pancreas.

Methods

101 patients were divided into 5 groups based on their most severe indicator of pancreatic disease, based on clinical notes and radiology reports. Indicators include family history (13 patients), genetic risk (22), intraductal papillary mucinous neoplasm (IPMN)/cystic lesion (53), pancreatitis (acute or chronic) (10), and PDAC (3). A 2D T1ρ magnetic resonance fingerprinting sequence was used to acquire values for T1, T2 and T1ρ relaxation times. The entire pancreas was segmented for each patient by a board-certified radiologist, avoiding cysts and blood vessels. Mean relaxation times across the entire pancreas were obtained.

Results

Mean T1 relaxation times in ms are 782.5± 71.0(family), 815.7± 53.6(genetic), 956.9± 185.6(IPMN), 975.5± 58.7(pancreatitis), and 1581.0± 303.8(PDAC). Mean T2 relaxation times in ms are 42.7± 5.1(family), 40.9± 2.7(genetic), 43.3± 5.1(IPMN), 42.2± 4.2(pancreatitis), 53.3± 3.9(PDAC). Mean T1ρ relaxation times are 41.4± 4.6(family), 41.9± 4.6(genetic), 41.8± 5.8(IPMN), 42.4± 3.9(pancreatitis), and 53.1± 4.5(PDAC). Patients with IPMN showed significantly higher average T1 relaxation times compared to patients with family history (p=0.00153, two-sided t-test) and patients with genetic risk (p=0.00081, two-sided t-test). Similarly, patients with pancreatitis showed significantly higher average T1 relaxation times compared to patients with family history ( p=0.00078, two-sided t-test) and patients with genetic risk (p=0.000175, two-sided t-test). No significant differences were found for T2 and T1ρ, although T2 approached significance.

Conclusion

This work demonstrates the potential of MRI relaxation times in the evaluation of various pancreatic disease that involve fibrosis, inflammation, or a combination of the two. Significant increases were found in the T1 relaxation times when comparing patients with IPMN to patients with genetic risk and family history, suggesting subtle changes in the pancreatic parenchyma not seen in qualitative assessments.

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