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Comparison between MRI with MR cholangiopancreatography and endoscopic ultrasonography for differentiating malignant from benign mucinous neoplasms of the pancreas

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare diagnostic performance of magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) for differentiating malignant from benign intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) of the pancreas.

Methods

This retrospective study included 55 patients with 47 surgically confirmed IPMNs (12 malignant, 35 benign) and eight MCNs (two malignant, six benign) who underwent contrast-enhanced pancreas MRI and EUS. Contrast enhancement was not routinely used at EUS examination. Two observers independently evaluated the MRIs, and another reviewed EUS images. They recorded their confidence for malignancy with each imaging modality. We calculated diagnostic performance using the area under the receiver operating characteristic curves (A z ), and to determine the accuracy, sensitivity, specificity, and positive (PPV) and negative predictive (NPV) values.

Results

The A z values of MRI were higher than those of EUS (0.712 and 0.688 for MRI vs. 0.543 for EUS; p = 0.007). The diagnostic accuracies (74.5%), specificity (78.0% and 80.5%) and PPV (50.0%) of MRI in two observers were higher than those (56.4%, 58.5% and 29.2%, respectively) of EUS (p = 0.013–0.049).

Conclusion

MRI showed better diagnostic performance than EUS for differentiating malignant from benign pancreatic IPMN and MCN.

Key Points

• The A z values of MRI were higher than those of EUS.

• The diagnostic accuracies of MRI were higher than those of EUS.

• The specificities of MRI were higher than those of EUS.

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Abbreviations

DW:

Diffusion-weighted imaging

EUS:

Endoscopic ultrasonography

FNA:

Fine needle aspiration

IPMN:

Intraductal papillary mucinous neoplasm

MCN:

Mucinous cystic neoplasm

MPD:

Main pancreatic duct

MRCP:

MR cholangiopancreatography

MRI:

Magnetic resonance imaging

NPV:

Negative predictive value

PPV:

Positive predictive value

ROC:

Receiver operating characteristic

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Author information

Authors and Affiliations

  1. Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea

    Jiyoung Hwang, Seong Sook Hong & Hyun-joo Kim

  2. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Young Kon Kim & Woo Kyung Jeong

  3. Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea

    Ji Hye Min

Authors
  1. Jiyoung Hwang
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Corresponding author

Correspondence to Young Kon Kim.

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Guarantor

The scientific guarantor of this publication is Young Kon Kim in the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Conflict of interest

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.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

Soohyun Ahn PhD and Hyeon Seon Ahn MS in Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea. kindly provided statistical advice for this manuscript.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Hwang, J., Kim, Y.K., Min, J.H. et al. Comparison between MRI with MR cholangiopancreatography and endoscopic ultrasonography for differentiating malignant from benign mucinous neoplasms of the pancreas. Eur Radiol 28, 179–187 (2018). https://doi.org/10.1007/s00330-017-4926-5

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  • DOI: https://doi.org/10.1007/s00330-017-4926-5

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