RSNA 2003 

Abstract Archives of the RSNA, 2003


M08-1116

Multi-detector Row CT Evaluation of Intraductal Papillary Mucinous Neoplasm of the Pancreas: CT-Pathological Correlation

Scientific Papers

Presented on December 3, 2003
Presented as part of M08: Gastrointestinal (Pancreas: Cystic Neoplasm-CT, MR)

Participants

Satomi Kawamoto MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To describe CT findings of surgically resected intraductal papillary mucinous neoplasm (IPMN) of the pancreas and to evaluate predictive factors for presence of associated invasive carcinoma in IPMN on CT. Methods and Materials: 36 consecutive patients (23 males, 13 females, mean age 66.6 years) who underwent preoperative multi-detector row CT (MDCT) evaluation and had surgical resection and pathological diagnosis of IPMN of the pancreas were retrospectively assessed. CT was performed with 4-slice MDCT scanner with 120 ml of IV contrast material at an injection rate of 3 ml/sec and a pitch of 6. Arterial and venous phase images were acquired at 25 and 50-60 seconds from the start of IV contrast administration. Location, size, degree dilatation of the main and branch pancreatic duct and common bile duct, presence or absence of contrast enhancement, and appearance of tumor were assessed. The tumors were categorized into suspected benign, indeterminate and suspected malignant depending on their appearance. Pathological correlation with CT findings and predictability for presence of invasive carcinoma at CT was retrospectively assessed. Results: Twenty four lesions were located in head and/or uncinate process, 3 in head/neck region, 5 in the body and 5 in the tail. Diffuse or multifocal involvement was seen in 4 patients. Average maximal diameter of the tumor was 3.1 cm. Pancreatic duct dilatation was observed in 26 patients (main pancreatic duct in 22 patients, main and branch duct in 2 patients and branch duct in 4 patients) with average diameter of 6.4 mm on CT. Pathological analysis revealed carcinoma in situ in 9 patients (25%) and invasive carcinoma in 15 patients (42%). The size of tumor (p=0.002), presence of contrast enhancement (p=0.0095), solid appearance of the tumor (p<0.0001), dilatation of the common bile duct (greater than 15 mm or presence of CBD stent) (p=0.0007) were significantly correlated with presence of associated invasive carcinoma. Thirteen out of 15 patients with invasive carcinoma was graded suspicious for presence of malignancy, whereas 4 patients graded suspicious for malignancy did not have invasive carcinoma. Conclusion: The head and/or uncinate process were the most common location of IPMN. The size of the tumor, presence of contrast enhancement, solid appearance of the tumor, and dilatation of the common bile duct were predictive factors for malignancy at CT in this study.      

Cite This Abstract

Kawamoto MD, S, Multi-detector Row CT Evaluation of Intraductal Papillary Mucinous Neoplasm of the Pancreas: CT-Pathological Correlation.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3105169.html