Value of diffusion-weighted imaging in distinguishing pancreatic carcinoma from mass-forming chronic pancreatitis: a meta-analysis.

Background: Several previous studies have shown that diffusion-weighted imaging (DWI) can provide additional information for focal pancreatic lesions by demonstrating more restricted diffusion in solid malignant tumors than in chronic pancreatitis, which can be indicated by a decreased apparent diffusion coefficient (ADC). However, these studies have a modest sample size and convey inconclusive results. The aim of this study was to determine, in a meta-analysis, the diagnostic performance of quantitative diffusion-weighted magnetic resonance imaging in distinguishing pancreatic carcinoma from mass-forming chronic pancreatitis.

Methods: We determined the sensitivities and specificities across studies. A summary receiver operator characteristic (sROC) curve was constructed to calculate the area under the curve (AUC).

Results: The pooled sensitivity of DWI was 0.86 (95% CI: 0.80-0.91) and the pooled specificity was 0.82 (95% CI: 0.72-0.89). The AUC of the sROC was 0.91 (95% CI: 0.88-0.93).

Conclusions: DWI may be a potentially technically feasible tool for differentiating pancreatic carcinoma from mass-forming chronic pancreatitis. However, large-scale randomized control trials are necessary to assess its clinical value.