Hyo-Jin Kang1, Jeong Min Lee1, Ijin Joo1, Bo Yun Hur1, Ju Hyeon Jeon1, Jin-Young Jang1, Kyoungbun Lee1, Ji Kon Ryu1, Joon Koo Han1, Byung Ihn Choi1. 1. From the Departments of Radiology (H.J.K., J.M.L., I.J., J.H.J., J.K.H.), Surgery (J.Y.J.), Pathology (K.B.L.), and Internal Medicine (J.K.R.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea; Institute of Radiation Medicine, Seoul National University College Medical Research Center, Seoul, Korea (J.M.L., I.J., J.K.H.); Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.H.J., J.K.H.); Department of Radiology, National Cancer Center, Seoul, Korea (B.Y.H.); and Department of Radiology, Chung-Ang University Hospital, Seoul, Korea (B.I.C.).
Abstract
PURPOSE: To compare the diagnostic performance of multidetector computed tomography (CT) and magnetic resonance (MR) imaging with MR cholangiopancreatography (MRCP) in identifying the malignant potential of pancreatic intraductal papillary neoplasms (IPMNs) and evaluate their intermodality agreement. MATERIALS AND METHODS: Institutional review board approval was obtained, and the requirement for informed consent was waived for this retrospective study. In 129 patients with pathologically proved pancreatic IPMNs, three reviewers independently evaluated their preoperative CT and MR imaging with MRCP findings. Intermodality agreement between multidetector CT and MR imaging with MRCP, as well as interobserver agreement of each imaging modality, for depicting high-risk stigmata and worrisome features were assessed. Diagnostic values of other signs of overt malignancy, including the presence of a parenchymal mass and local-regional extension, were analyzed. Diagnostic performance and intermodality agreement were assessed by using receiver operating characteristics (ROC) curve analysis and weighted κ statistics. RESULTS: Overall, multidetector CT and MR imaging with MRCP were similar in their ability to depict signs suspicious or indicative of malignancy in patients with IPMN (area under the ROC curve [AUC] = 0.82 for both), with good intermodality agreement (κ = 0.75) and moderate interobserver agreement (κ = 0.47-0.59) when high-grade dysplasia was used as the cutoff for malignancy. When parenchymal masses and local-regional extensions were also considered as overt signs of malignancy, the ability to identify invasive IPMNs significantly increased (AUC = 0.87 for CT and AUC = 0.88 for MR imaging), with high sensitivity (94.3%), while maintaining specificity (69.1%). CONCLUSION: The diagnostic performance of multidetector CT and MR imaging with MRCP for identifying the malignant potential of pancreatic IPMNs was similar and showed good intermodality agreement, suggesting that follow-up with either modality may be used.
PURPOSE: To compare the diagnostic performance of multidetector computed tomography (CT) and magnetic resonance (MR) imaging with MR cholangiopancreatography (MRCP) in identifying the malignant potential of pancreatic intraductal papillary neoplasms (IPMNs) and evaluate their intermodality agreement. MATERIALS AND METHODS: Institutional review board approval was obtained, and the requirement for informed consent was waived for this retrospective study. In 129 patients with pathologically proved pancreatic IPMNs, three reviewers independently evaluated their preoperative CT and MR imaging with MRCP findings. Intermodality agreement between multidetector CT and MR imaging with MRCP, as well as interobserver agreement of each imaging modality, for depicting high-risk stigmata and worrisome features were assessed. Diagnostic values of other signs of overt malignancy, including the presence of a parenchymal mass and local-regional extension, were analyzed. Diagnostic performance and intermodality agreement were assessed by using receiver operating characteristics (ROC) curve analysis and weighted κ statistics. RESULTS: Overall, multidetector CT and MR imaging with MRCP were similar in their ability to depict signs suspicious or indicative of malignancy in patients with IPMN (area under the ROC curve [AUC] = 0.82 for both), with good intermodality agreement (κ = 0.75) and moderate interobserver agreement (κ = 0.47-0.59) when high-grade dysplasia was used as the cutoff for malignancy. When parenchymal masses and local-regional extensions were also considered as overt signs of malignancy, the ability to identify invasive IPMNs significantly increased (AUC = 0.87 for CT and AUC = 0.88 for MR imaging), with high sensitivity (94.3%), while maintaining specificity (69.1%). CONCLUSION: The diagnostic performance of multidetector CT and MR imaging with MRCP for identifying the malignant potential of pancreatic IPMNs was similar and showed good intermodality agreement, suggesting that follow-up with either modality may be used.
Authors: Lawrence Mj Best; Vishal Rawji; Stephen P Pereira; Brian R Davidson; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2017-04-17
Authors: Katherine S Yang; Debora Ciprani; Aileen O'Shea; Andrew S Liss; Robert Yang; Sarah Fletcher-Mercaldo; Mari Mino-Kenudson; Carlos Fernández-Del Castillo; Ralph Weissleder Journal: Gastroenterology Date: 2020-12-07 Impact factor: 22.682
Authors: Michael Goggins; Kasper Alexander Overbeek; Randall Brand; Sapna Syngal; Marco Del Chiaro; Detlef K Bartsch; Claudio Bassi; Alfredo Carrato; James Farrell; Elliot K Fishman; Paul Fockens; Thomas M Gress; Jeanin E van Hooft; R H Hruban; Fay Kastrinos; Allison Klein; Anne Marie Lennon; Aimee Lucas; Walter Park; Anil Rustgi; Diane Simeone; Elena Stoffel; Hans F A Vasen; Djuna L Cahen; Marcia Irene Canto; Marco Bruno Journal: Gut Date: 2019-10-31 Impact factor: 23.059