Comparison between MRI with MR cholangiopancreatography and endoscopic ultrasonography for differentiating malignant from benign mucinous neoplasms of the pancreas
- 628 Downloads
To compare diagnostic performance of magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) for differentiating malignant from benign intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) of the pancreas.
This retrospective study included 55 patients with 47 surgically confirmed IPMNs (12 malignant, 35 benign) and eight MCNs (two malignant, six benign) who underwent contrast-enhanced pancreas MRI and EUS. Contrast enhancement was not routinely used at EUS examination. Two observers independently evaluated the MRIs, and another reviewed EUS images. They recorded their confidence for malignancy with each imaging modality. We calculated diagnostic performance using the area under the receiver operating characteristic curves (A z ), and to determine the accuracy, sensitivity, specificity, and positive (PPV) and negative predictive (NPV) values.
The A z values of MRI were higher than those of EUS (0.712 and 0.688 for MRI vs. 0.543 for EUS; p = 0.007). The diagnostic accuracies (74.5%), specificity (78.0% and 80.5%) and PPV (50.0%) of MRI in two observers were higher than those (56.4%, 58.5% and 29.2%, respectively) of EUS (p = 0.013–0.049).
MRI showed better diagnostic performance than EUS for differentiating malignant from benign pancreatic IPMN and MCN.
• The A z values of MRI were higher than those of EUS.
• The diagnostic accuracies of MRI were higher than those of EUS.
• The specificities of MRI were higher than those of EUS.
KeywordsMagnetic resonance imaging Endoscopic ultrasonography Intraductal papillary mucinous neoplasm Mucinous cystic neoplasm Mural nodule
Fine needle aspiration
Intraductal papillary mucinous neoplasm
Mucinous cystic neoplasm
Main pancreatic duct
Magnetic resonance imaging
Negative predictive value
Positive predictive value
Receiver operating characteristic
Compliance with ethical standards
The scientific guarantor of this publication is Young Kon Kim in the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
The authors state that this work has not received any funding.
Statistics and biometry
Soohyun Ahn PhD and Hyeon Seon Ahn MS in Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea. kindly provided statistical advice for this manuscript.
Institutional Review Board approval was obtained.
Written informed consent was waived by the Institutional Review Board.
• diagnostic or prognostic study
• performed at one institution
- 4.Bosman FTCF, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system. World Health Organization, GenevaGoogle Scholar
- 8.Goh BK, Thng CH, Tan DM et al (2014) Evaluation of the Sendai and 2012 International Consensus Guidelines based on cross-sectional imaging findings performed for the initial triage of mucinous cystic lesions of the pancreas: a single institution experience with 114 surgically treated patients. Am J Surg 208:202–209CrossRefPubMedGoogle Scholar
- 13.Ohno E, Itoh A, Kawashima H et al (2012) Malignant transformation of branch duct-type intraductal papillary mucinous neoplasms of the pancreas based on contrast-enhanced endoscopic ultrasonography morphological changes: focus on malignant transformation of intraductal papillary mucinous neoplasm itself. Pancreas 41:855–862CrossRefPubMedGoogle Scholar