Abstract
Objectives
We aimed to evaluate the diagnostic performance of CT and MRI for distinguishing intraductal papillary neoplasm of the bile duct (IPNB) from cholangiocarcinoma (CC) with intraductal papillary growth (IPG).
Methods
Forty-two patients with either IPNB or CC with IPG proven by histopathology were independently reviewed in retrospect. Strict criteria for diagnosis of IPNB included presence of the designated imaging features as follows: local dilatation of the bile duct, nodule within the dilated bile duct, growing along the interior wall of bile duct. Any lesion that was not consistent with the criteria was classified as CC with IPG. Sensitivity, specificity, positive and negative predictive values for characterization of IPNB were calculated, and k test was used to assess the level of agreement.
Results
Two imaging reviewers correctly identified 21 of 26 (80.8 %) and 22 of 26 (84.6 %) IPNB cases, respectively. Alternatively, they correctly identified 14 of 16 (87.5 %) and 15 of 16 (93.8 %) CC with IPG, respectively. Agreement between the two reviewers was perfect (k = 0.81) for the diagnosis of IPNB and differentiation from CC with IPG.
Conclusions
By using our designated diagnostic criteria of CT and MRI, IPNB can be accurately identified and possible to be distinguished from CC with IPG.
Key points
• IPNB can accurately be identified by using defined diagnostic criteria at CT/MRI.
• IPNB has some characteristic CT and MR imaging features.
• IPNB is a rare entity; up until now it might have been misdiagnosed.
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Abbreviations
- IPNB:
-
Intraductal papillary neoplasm of the bile duct
- CC:
-
Cholangiocarcinoma
- IPG:
-
Intraductal papillary growth
- IPN:
-
Intracystic papillary neoplasm
References
Zen Y, Fujii T, Itatsu K et al (2006) Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas. Hepatology 44:1333–1343
Nakanuma Y, Sato Y, Ojima H et al (2014) Clinicopathological characterization of so-called "cholangiocarcinoma with intraductal papillary growth" with respect to "intraductal papillary neoplasm of bile duct (IPNB)". Int J Clin Exp Pathol 7:3112–3122
Ogawa H, Itoh S, Nagasaka T, Suzuki K, Ota T, Naganawa S (2012) CT findings of intraductal papillary neoplasm of the bile duct: assessment with multiphase contrast-enhanced examination using multi-detector CT. Clin Radiol 67:224–231
Wan XS, Xu YY, Qian JY et al (2013) Intraductal papillary neoplasm of the bile duct. World J Gastroenterol 19:8595–8604
Li T, Ji Y, Zhi XT et al (2009) A comparison of hepatic mucinous cystic neoplasms with biliary intraductal papillary neoplasms. Clin Gastroenterol Hepatol 7:586–593
Lim JH, Zen Y, Jang KT, Kim YK, Nakanuma Y (2011) Cyst-forming intraductal papillary neoplasm of the bile ducts: description of imaging and pathologic aspects. AJR Am J Roentgenol 197:1111–1120
Lim JH, Yoon KH, Kim SH et al (2004) Intraductal papillary mucinous tumor of the bile ducts. Radiographics 24:53–66, discussion 66-57
Lim JH, Yi CA, Lim HK, Lee WJ, Lee SJ, Kim SH (2002) Radiological spectrum of intraductal papillary tumors of the bile ducts. Korean J Radiol 3:57–63
Kloek JJ, van der Gaag NA, Erdogan D et al (2011) A comparative study of intraductal papillary neoplasia of the biliary tract and pancreas. Hum Pathol 42:824–832
Adsay V, Jang KT, Roa JC et al (2012) Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are >/=1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases. Am J Surg Pathol 36:1279–1301
Choi SC, Lee JK, Jung JH et al (2010) The clinicopathological features of biliary intraductal papillary neoplasms according to the location of tumors. J Gastroenterol Hepatol 25:725–730
Ayuso JR, Pages M, Darnell A (2013) Imaging bile duct tumors: staging. Abdom Imaging 38:1071–1081
Takanami K, Yamada T, Tsuda M et al (2011) Intraductal papillary mucininous neoplasm of the bile ducts: multimodality assessment with pathologic correlation. Abdom Imaging 36:447–456
Jung G, Park KM, Lee SS, Yu E, Hong SM, Kim J (2012) Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct. J Hepatol 57:787–793
Zen Y, Pedica F, Patcha VR et al (2011) Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct. Mod Pathol 24:1079–1089
Viera AJ, Garrett JM (2005) Understanding interobserver agreement: the kappa statistic. Fam Med 37:360–363
Kundel HL, Polansky M (2003) Measurement of observer agreement. Radiology 228:303–308
Bierry G, Simeone FJ, Borg-Stein JP, Clavert P, Palmer WE (2014) Sacrotuberous ligament: relationship to normal, torn, and retracted hamstring tendons on MR images. Radiology 271:162–171
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310
Park MS, Yu JS, Lee DK, Yoon DS, Cha SW, Kim KW (2007) Gadobenate dimeglumine-enhanced MRI of intraductal papillary mucinous tumor of the bile ducts. J Magn Reson Imaging 25:625–627
Kim BS, Joo SH, Lim SJ, Joo KR (2012) Intrahepatic biliary intraductal papillary mucinous neoplasm with gallbladder agenesis: case report. Surg Laparosc Endosc Percutan Tech 22:e277–e280
Acknowledgments
The scientific guarantor of this publication is Changhong Liang. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, cross sectional study / diagnostic or prognostic study / observational, performed at one institution.
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Liu, Y., Zhong, X., Yan, L. et al. Diagnostic performance of CT and MRI in distinguishing intraductal papillary neoplasm of the bile duct from cholangiocarcinoma with intraductal papillary growth. Eur Radiol 25, 1967–1974 (2015). https://doi.org/10.1007/s00330-015-3618-2
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DOI: https://doi.org/10.1007/s00330-015-3618-2