Diffusion weighted magnetic resonance imaging of hepatic metastasis of pancreatic cancer

Background and Aims: Pancreatic cancer is one of the tumors that occurs most commonly, is resistant to medical treatment, and has a poor prognosis. Imaging methods present difficulties in detecting both primary and metastatic tumors. The aim of this study was to compare the contribution of diffusion-weighted magnetic resonance imaging with that of multiple detector computed tomography in the detection of liver metastases based on the operability criteria of pancreatic cancer. Materials and Methods: Multiple detector computed tomography and diffusion-weighted magnetic resonance imaging images of 79 patients diagnosed with pancreatic cancer in our center during 2012-2017 were evaluated retrospectively. Of the 63 patients included in the study, 45 had adenocarcinoma and 18 had pancreatic neuroendocrine tumor. The liver metastases detected via multiple detector computed tomography and diffusion-weighted magnetic resonance imaging images were compared. The liver metastases detected in multiple detector computed tomography and diffusion-weighted magnetic resonance imaging were compared in numbers. In addition, the difference between the apparent diffusion coefficient measurements between the two groups of primer tumors in magnetic resonance imaging and the difference between the apparent diffusion coefficient values between the metastatic masses in both groups were examined. Results: A larger number of metastases were detected in diffusion-weighted magnetic resonance imaging than in multiple detector computed tomography images (38.10%). The distributions of apparent diffusion coefficient values of the measurements made from primary tumors in patients with adenocarcinoma and pancreatic neuroendocrine tumor were not statistically significant (p=0.976). Similarly, there was no statistically significant difference between the apparent diffusion coefficient measurements obtained from the metastases of both groups (p=0.140). Discussion: When we consider the fact that the only treatment method for pancreatic cancers is surgery, it is understood how important it is to recognize both primary masses and metastases using imaging methods to determine the staging and tumor type. Currently, there are no published international guidelines for the identification and specification of liver metastases in patients with pancreatic cancer. However, magnetic resonance imaging has been applied to detect liver masses in contrast-enhanced multiple detector computed tomography, though not specifically. Similar problems can be experienced in conventional magnetic resonance