European Radiology

, Volume 28, Issue 7, pp 2790–2800 | Cite as

Are pancreatic IPMN volumes measured on MRI images more reproducible than diameters? An assessment in a large single-institution cohort

  • Pallavi Pandey
  • Ankur Pandey
  • Farnaz Najmi Varzaneh
  • Mounes Aliyari Ghasabeh
  • Daniel Fouladi
  • Pegah Khoshpouri
  • Nannan Shao
  • Manijeh Zarghampour
  • Ralph H. Hruban
  • Marcia Canto
  • Anne Marie O’Broin-Lennon
  • Ihab R. KamelEmail author
Magnetic Resonance



To assess reproducibility of volume and diameter measurement of intraductal papillary mucinous neoplasms (IPMNs) on MRI images.


Three readers measured the diameters and volumes of 164 IPMNs on axial T2-weighted images and coronal thin-slice navigator heavily T2-weighted images using manual and semiautomatic techniques. Interobserver reproducibility and variability were assessed.


Interobserver intraclass correlation coefficients (ICCs) for the largest diameter measured using manual and semiautomatic techniques were 0.979 and 0.909 in the axial plane, and 0.969 and 0.961 in the coronal plane, respectively. Interobserver ICCs for the volume measurements were 0.973 and 0.970 in axial and coronal planes, respectively. The highest intraobserver reproducibility was noted for coronal manual measurements (ICC 0.981) followed by axial manual measurements (ICC 0.969). For the diameter measurements, Bland-Altman analysis revealed the lowest interobserver variability for manual axial measurements with an average range of 95% limits of agreement (LOA) of 0.68 cm. Axial and coronal volume measurements showed similar 95% LOA ranges (8.9 cm3 and 9.4 cm3, respectively).


Volume and diameter measurements on axial and coronal images show good interobserver and intraobserver reproducibility. The single largest diameter measured manually on axial images showed the highest reproducibility and lowest variability. The 95% LOA may help define reproducible size changes in these lesions using measurements from different readers.

Key Points

• MRI measurements by different radiologists can be used for IPMN follow-up.

• Both diameter and volume measurements demonstrate excellent interobserver and intraobserver reproducibility.

• Manual axial measurements show the highest interobserver reproducibility in determining size.

• Axial and coronal volume measurements show similar limits of agreement.

• Manual axial measurements show the lowest variability in agreement range.


Pancreas Cysts Magnetic resonance imaging Observer variation Reproducibility of results 



American College of Radiology




Confidence interval


Computed tomography


Intraclass correlation coefficient


Intraductal papillary mucinous neoplasm


Limits of agreement


Multidetector computed tomography


Magnetic resonance cholangiopancreatography


Magnetic resonance imaging


Picture archiving and communication system


Pancreatic cystic neoplasm



The authors state that this work did not receive any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Ihab R. Kamel.

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• diagnostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Pallavi Pandey
    • 1
  • Ankur Pandey
    • 1
  • Farnaz Najmi Varzaneh
    • 1
  • Mounes Aliyari Ghasabeh
    • 1
  • Daniel Fouladi
    • 1
  • Pegah Khoshpouri
    • 1
  • Nannan Shao
    • 1
  • Manijeh Zarghampour
    • 1
  • Ralph H. Hruban
    • 2
  • Marcia Canto
    • 3
  • Anne Marie O’Broin-Lennon
    • 3
  • Ihab R. Kamel
    • 1
    Email author
  1. 1.Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of PathologyJohns Hopkins Medical InstitutionsBaltimoreUSA
  3. 3.Division of GastroenterologyJohns Hopkins Medical InstitutionsBaltimoreUSA

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