Diffusion-weighted MR Imaging of the Pancreas: Current Status and Recommendations

Advances in image quality over the past few years, mainly due to refinements in hardware and coil systems, have made diffusion-weighted (DW) magnetic resonance (MR) imaging a promising technique for the detection and characterization of pancreatic conditions. DW MR imaging can be routinely implemented in clinical protocols, as it can be performed relatively quickly, does not require administration of gadolinium-based contrast agents, and enables qualitative and quantitative assessment of tissue diffusivity (diffusion coefficients). In this review, acquisition parameters, postprocessing, and quantification methods applied to pancreatic DW MR imaging will be discussed. The current common clinical uses of DW MR imaging (ie, pancreatic lesion detection and characterization) and the less-common applications of DW MR imaging used for the diagnosis of pancreatic parenchymal diseases will be reviewed. Also, the limitations of the technique, mainly image quality and reproducibility of diffusion parameters, as well as future directions for pancreatic DW MR imaging will be discussed. The utility of apparent diffusion coefficient (ADC) measurement for the characterization of pancreatic lesions is now well accepted but there are a number of limitations. Future well-designed, multicenter studies are needed to better determine the most appropriate use of ADC in the area of pancreatic disease.