Criteria for determining malignancy in pancreatic intraductal papillary mucinous neoplasm based on computed tomography
| Autor: | Arnd Giese, Peter Mönnings, Juris J. Meier, Waldemar Uhl, Andrea Tannapfel, Odo Köster, Orlin Belyaev |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Contrast enhancement CA-19-9 Antigen Computed tomography Malignancy Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Germany Medicine Humans In patient ddc:610 Solid tumor Aged Retrospective Studies Pancreatic duct medicine.diagnostic_test Intraductal papillary mucinous neoplasm business.industry Gastroenterology Pancreatic Ducts Imaging Procedures Middle Aged medicine.disease Adenocarcinoma Mucinous Carcinoma Papillary Pancreatic Neoplasms medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Radiology business Tomography X-Ray Computed Carcinoma Pancreatic Ductal |
| Popis: | Introduction: Determining the dignity of intraductal papillary mucinous neoplasms (IPMNs) by imaging procedures is challenging. Various CT-based criteria were evaluated. Patients and Methods: Preoperative CT scans from 47 patients with IPMN were analyzed. Predefined criteria of malignancy were compared between patients with benign (bIPMN; n = 28) and malignant (mIPMN; n = 19) tumors, and a summation score was determined. Results: Preoperative carbohydrate-antigen 19-9 levels were higher in patients with mIPMN (p = 0.013). The diameter of the main pancreatic duct was greater in patients with mIPMN (p < 0.0001). More patients with mIPMN showed bile duct obstruction (p = 0.0076), solid tumor components (p = 0.0076), contrast enhancement in cystic walls (p = 0.0086), peripancreatic lymph nodes (p = 0.0076), and abrupt diameter changes of the main pancreatic duct (p = 0.0008). The CT density of the cysts was higher in mIPMN (p = 0.0063). The diagnostic accuracy of the summation score (sensitivity: 0.84, specificity: 0.96) was greater when compared to each individual CT parameter. Conclusions: The prevalence and extent of various CT-based abnormalities are greater in patients with mIPMN, but the wide overlap limits the diagnostic value of each individual parameter. A simple summation score largely enhances the diagnostic accuracy. |
| Databáze: | OpenAIRE |
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