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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

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Abstract

Purpose

To compare diagnostic performance for prediction of malignant potential in IPMNs between EUS, contrast-enhanced CT and MRI.

Materials 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.

Results

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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Abbreviations

IPMN:

Intraductal papillary mucinous neoplasm

MPD:

Main pancreatic duct

MRI:

Magnetic resonance imaging

MRCP:

Magnetic resonance cholangiopancreatography

CT:

Computed tomography

EUS:

Endoscopic ultrasound

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Acknowledgements

We would like to thank Bonnie Hami, MA (USA) for her editorial assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, Republic of Korea

    Jung Hoon Kim & Joon Koo Han

  2. Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, 420-767, Republic of Korea

    Seo-Youn Choi & Hae Kyung Lee

  3. Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Republic of Korea

    Mi Hye Yu

  4. Department of Radiology, Samsung Medical Center, 50 Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Republic of Korea

    Hyo Won Eun

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  1. Seo-Youn Choi
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Correspondence to Jung Hoon Kim.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Our institutional review board approved this retrospective study and waived the requirement for informed consent. For this type of study, formal consent is not required.

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Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Choi, SY., Kim, J.H., Yu, M.H. et al. 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. Abdom Radiol 42, 1449–1458 (2017). https://doi.org/10.1007/s00261-017-1053-3

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