Viktoriya Paroder MD, Presenter: Nothing to Disclose

Milana Flusberg MD, Abstract Co-Author: Nothing to Disclose

Alla M. Rozenblit MD, Abstract Co-Author: Nothing to Disclose

Victoria Chernyak MD, Abstract Co-Author: Nothing to Disclose

To assess relationship between pancreatic cysts and pancreatic ductal adenocarcinoma (PDAC), and to compare imaging features of pancreatic cysts in subjects who subsequently develop PDAC and in those who do not.

This case-control study was IRB-approved and HIPAA-compliant. Case group included adult subjects with a diagnosis of PDAC and control group included adult subjects with a diagnosis of lung cancer. Cancer diagnosis date was between 1/1/05-1/1/14 as recorded in Cancer Registry, and only subjects with at least one abdominal CT/MR  >6 months before the cancer diagnosis date were included. The most recent abdominal CT/MR of each subject done >6 months prior to cancer diagnosis date was reviewed by a radiologist blinded to case/control status. The presence of pancreatic cyst(s), number, size of the largest cyst, and presence  of main pancreatic duct (MPD) dilatation (defined as MPD ≥4mm) were recorded. A pancreatic cyst was considered simple when it lacked calcifications, septations and enhancement. Frequencies of pancreatic cysts, mean cyst sizes, frequencies of solitary cysts, simple cysts and MPD dilatation were compared between the groups. Logistic regression model with binary outcome of PDAC was constructed.

There were 162 subjects, 85 (52.5%) cases and 77 (47.5%) controls. Women comprised 62.4% (53 of 85) of cases and 58.4% (45 of 77) of controls (p=0.61). Mean ages were 69.2 years (±10.7) and 69.6 years (±12.9) in cases and controls, respectively (p=0.81). Pancreatic cysts were present in 23 (27.1%) of 85 cases and in 4 (5.2%) of 77 controls (p<0.001). The odds ratio of pancreatic cysts for development of PDAC was 7.0, adjusting for age and sex (p=0.001). Mean cyst size was 13.6 mm (±8.4) in cases and 6.5 mm (±3.3) in controls (p=0.01). Pancreatic cysts were solitary in 9 (40.9%) of 23 cases and 4 (100%) of 4 controls (p=0.04), and simple in 16 (69.6%) of 23 cases and 3 (75%) of 4 controls (p>0.99). MPD dilatation was present in 7 (30.4%) of 23 cases and 1 (25%) of 4 controls (p>0.99).

Pancreatic cysts are associated with 7.0 times higher odds of developing pancreatic ductal adenocarcinoma. Pancreatic cysts in subjects who develop  pancreatic ductal adenocarcinoma tend to be larger and more commonly are multiple.

Patients with pancreatic cysts are at higher risk of developing pancreatic ductal adenocarcinoma, particularly if the cysts are larger and multiple.

Paroder, V, Flusberg, M, Rozenblit, A, Chernyak, V, Pancreatic Cysts and Pancreatic Ductal Adenocarcinoma: What Are the Odds?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007266.html