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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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.
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).
Diagnostic performance of contrast-enhanced CT, MRI, and EUS for predicting malignant IPMNs was comparable with each modalities without significant difference.
KeywordsDynamic contrast-enhanced CT Dynamic contrast-enhanced MRI EUS Intraductal papillary mucinous neoplasm of the pancreas Diagnosis
Intraductal papillary mucinous neoplasm
Main pancreatic duct
Magnetic resonance imaging
Magnetic resonance cholangiopancreatography
We would like to thank Bonnie Hami, MA (USA) for her editorial assistance in the preparation of this manuscript.
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
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.
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
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