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

Seo Youn Choi, Jung Hoon Kim, Mi Hye Yu, Hyo Won Eun, Hae Kyung Lee, Joon Koo Han

Research output: Contribution to journalArticle

16 Scopus citations

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.

Original languageEnglish
Pages (from-to)1449-1458
Number of pages10
JournalAbdominal Radiology
Volume42
Issue number5
DOIs
StatePublished - 1 May 2017

Keywords

  • Diagnosis
  • Dynamic contrast-enhanced CT
  • Dynamic contrast-enhanced MRI
  • EUS
  • Intraductal papillary mucinous neoplasm of the pancreas

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