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Diagnostic performance and imaging features for predicting the malignant potential of intraductal papillary mucinous neoplasm of the pancreas: a comparison of EUS, contrast-enhanced CT and MRI

Authors
Choi, Seo-YounKim, Jung HoonYu, Mi HyeEun, Hyo WonLee, Hae KyungHan, Joon Koo
Issue Date
May-2017
Publisher
Springer New York
Keywords
Dynamic contrast-enhanced CT; Dynamic contrast-enhanced MRI; EUS; Intraductal papillary mucinous neoplasm of the pancreas; Diagnosis
Citation
Abdominal Radiology, v.42, no.5, pp 1449 - 1458
Pages
10
Journal Title
Abdominal Radiology
Volume
42
Number
5
Start Page
1449
End Page
1458
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/7636
DOI
10.1007/s00261-017-1053-3
ISSN
2366-004X
2366-0058
Abstract
Purpose: To compare diagnostic performance for prediction of malignant potential in IPMNs between EUS, contrast-enhanced CT and MRI. Material and methods :76 patients with IPMN (benign = 37, malignant = 39) underwent EUS, contrast-enhanced CT, and MRI. EUS was analyzed based on formal reports and contrast-enhanced CT and MRI were retrospectively analyzed by two radiologists according to the consensus guidelines 2012. Diagnostic performance and imaging features of malignant IPMNs were analyzed using ROC analysis and multivariate analyses. Result : Diagnostic performance of contrast-enhanced CT (AUC = 0.792 in R1, 0.830 in R2), MRI (AUC = 0.742 in R1, 0.776 in R2), and EUS (AUC = 0.733) for predicting malignant IPMNs were comparable without significant difference (p > 0.05). In multivariable analysis, enhancing solid component in contrast-enhanced CT and MRI and mural nodule in EUS (OR 1.8 in CT, 1.36 in MRI, 1.47 in EUS), MPD diameter >= 10 mm (OR 1.3 in CT, 1.4 in MRI, 1.66 in EUS), MPD diameter of 5-9 mm (OR 1.23 in CT, 1.31 in MRI), and thickened septa or wall (OR 1.3 in CT and MRI) were significant variables (p < 0.05). Interobserver agreement of thickened cyst septa or wall (k = 0.579-0.617) and abrupt caliber change of MPD (k = 0.689-0.788) was lower than other variables (k > 0.80). Conclusion :Diagnostic performance of contrast-enhanced CT, MRI, and EUS for predicting malignant IPMNs was comparable with each modalities without significant difference.
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