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@ARTICLE{Mayer:156803,
      author       = {P. Mayer and Y. Jiang and T. A. Kuder$^*$ and F. Bergmann
                      and E. Khristenko and V. Steinle and J. Kaiser and T.
                      Hackert and H.-U. Kauczor and M. Klauß and M. M. Gaida},
      title        = {{D}iffusion {K}urtosis {I}maging-{A} {S}uperior {A}pproach
                      to {A}ssess {T}umor-{S}troma {R}atio in {P}ancreatic
                      {D}uctal {A}denocarcinoma.},
      journal      = {Cancers},
      volume       = {12},
      number       = {6},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2020-01120},
      pages        = {1656},
      year         = {2020},
      abstract     = {Extensive desmoplastic stroma is a hallmark of pancreatic
                      ductal adenocarcinoma (PDAC) and contributes to tumor
                      progression and to the relative resistance of tumor cells
                      towards (radio) chemotherapy. Thus, therapies that target
                      the stroma are under intense investigation. To allow the
                      stratification of patients who would profit from such
                      therapies, non-invasive methods assessing the stroma content
                      in relation to tumor mass are required. In the current
                      prospective study, we investigated the usefulness of
                      diffusion-weighted magnetic resonance imaging (DW-MRI), a
                      radiologic method that measures the random motion of water
                      molecules in tissue, in the assessment of PDAC lesions, and
                      more specifically in the desmoplastic tumor stroma. We made
                      use of a sophisticated DW-MRI approach, the so-called
                      diffusion kurtosis imaging (DKI), which possesses potential
                      advantages over conventional and widely used monoexponential
                      diffusion-weighted imaging analysis (cDWI). We found that
                      the diffusion constant D from DKI is highly negatively
                      correlated with the percentage of tumor stroma, the latter
                      determined by histology. D performed significantly better
                      than the widely used apparent diffusion coefficient (ADC)
                      from cDWI in distinguishing stroma-rich $(>50\%$ stroma
                      percentage) from stroma-poor tumors $(≤50\%$ stroma
                      percentage). Moreover, we could prove the potential of the
                      diffusion constant D as a clinically useful imaging
                      parameter for the differentiation of PDAC-lesions from
                      non-neoplastic pancreatic parenchyma. Therefore, the
                      diffusion constant D from DKI could represent a valuable
                      non-invasive imaging biomarker for assessment of stroma
                      content in PDAC, which is applicable for the clinical
                      diagnostic of PDAC.},
      cin          = {E020},
      ddc          = {610},
      cid          = {I:(DE-He78)E020-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32580519},
      doi          = {10.3390/cancers12061656},
      url          = {https://inrepo02.dkfz.de/record/156803},
}