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Assessment of Malignant Potential in Intraductal Papillary Mucinous Neoplasms of the Pancreas: Comparison between Multidetector CT and MR Imaging with MR Cholangiopancreatography
- Source :
- Radiology. 279:128-139
- Publication Year :
- 2016
- Publisher :
- Radiological Society of North America (RSNA), 2016.
-
Abstract
- 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.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.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%).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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pathology
Adolescent
Cholangiopancreatography, Magnetic Resonance
Contrast Media
Multidetector ct
030218 nuclear medicine & medical imaging
Mr cholangiopancreatography
03 medical and health sciences
0302 clinical medicine
Multidetector Computed Tomography
Multidetector computed tomography
medicine
Humans
Radiology, Nuclear Medicine and imaging
Child
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Middle Aged
Adenocarcinoma, Mucinous
Mr imaging
Carcinoma, Papillary
Pancreatic Neoplasms
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
Radiology
business
Pancreas
Carcinoma, Pancreatic Ductal
Subjects
Details
- ISSN :
- 15271315 and 00338419
- Volume :
- 279
- Database :
- OpenAIRE
- Journal :
- Radiology
- Accession number :
- edsair.doi.dedup.....0bc92c608849d8f02a74dadcf9ea1fd1
- Full Text :
- https://doi.org/10.1148/radiol.2015150217