Jae Ho Byun MD, Abstract Co-Author: Nothing to Disclose

Nieun Seo MD, Presenter: Nothing to Disclose

Jin Hee Kim MD, Abstract Co-Author: Nothing to Disclose

Seung Soo Lee MD, Abstract Co-Author: Nothing to Disclose

Hyoung Jung Kim MD, Abstract Co-Author: Nothing to Disclose

Moon-Gyu Lee MD, Abstract Co-Author: Nothing to Disclose

To investigate the diagnostic performance of CT and MR in patients with intraductal papillary mucinous neoplasm (IPMN) of pancreas according to international consensus guidelines 2012.

158 patients with surgically confirmed IPMN of pancreas who underwent preoperative both CT and MR imaging were included in this retrospective study. According to pathologic results, IPMN was categorized into branch-duct (BD) IPMN and main duct (MD) IPMN including combined IPMN. Two abdominal radiologists evaluated the “high-risk stigmatas” and “worrisome features” according to international consensus guidelines 2012 on CT and MR imaging in consensus. Univariate and multivariate analyses were used to identify significant predictors of malignancy in pancreas IPMN, including invasive carcinoma and high-grade dysplasia. Sensitivity and specificity of each significant finding for diagnosing malignant IPMN were also calculated. McNemar test was used to compare diagnostic accuracy of CT and MR.

60 patients had BD IPMN and 98 patients had MD IPMN. In 60 patients with BD IPMN, diameter of main pancreatic duct, presence of mural nodule, mural nodule size, enhancement of mural nodule, and thick septa were significant on univariate analysis (P<.05), with sensitivity of 62.5–84.6% and specificity of 50–84.6% on CT and of 62.5–84.6% and 50–82.7% on MR. In 98 patients with MD IPMN, presence of mural nodule, mural nodule size, enhancement of mural nodule, and lymphadenopathy were significant on univariate analysis (P<.05), with sensitivity of 34.1–68.2% and specificity of 81.5–92.6% on CT and of 29.6–72.7% and 83.3–96.3% on MR. On multivariate analysis, presence of mural nodule was the most important predictor in both types of IPMN (P<.05), whereas mural nodule size and lymphadenopathy were significant in only MD IPMN (P<.05). Diagnostic performance of CT and MR for each significant finding was not statistically different in both types of IPMN (P>.05). 

According to international consensus guidelines 2012, presence of mural nodule was the most important predictor of malignancy in both types of IPMN. CT and MR showed no significant difference in differentiating malignant from benign IPMN.

This study provided predictors of malignancy and their diagnostic performance in BD IPMN and MD IPMN according to the international consensus guidelines 2012 on CT and MR imaging. 

Byun, J, Seo, N, Kim, J, Lee, S, Kim, H, Lee, M, Intraductal Papillary Mucinous Neoplasm of Pancreas: Diagnostic Performance of CT and MR According to International Consensus Guidelines 2012.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045524.html