Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma: assessment by multiphase contrast-enhanced CT

Furuhashi, Naohiro; Suzuki, Kôjiro; Sakurai, Yusuke; Ikeda, Mitsuru; Kawai, Yuichi; Naganawa, Shinji

doi:10.1007/s00330-014-3512-3

Cited by 56 publications

(43 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Contrast-enhanced CT and MRI are helpful for differential diagnosis of benign and malignant lesions based on characteristic vascularization patterns [13, 32, 33]. Several studies showed differences between pancreatic carcinoma and mass-forming focal pancreatitis using contrast-enhanced approaches [31, 33].…”

Section: Discussionmentioning

confidence: 99%

Differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma using magnetic resonance imaging: The value of contrast-enhanced and diffusion weighted imaging

et al. 2017

View full text Add to dashboard Cite

Pancreatic neuroendocrine carcinoma (PNEC) is often misdiagnosed as pancreatic ductal adenocarcinoma (PDAC). This retrospective study differentiated PNEC from PDAC using magnetic resonance imaging (MRI), including contrast-enhanced (CE) and diffusion-weighted imaging (DWI). Clinical data and MRI findings, including the T1/T2 signal, tumor boundary, size, enhancement degree, and apparent diffusion coefficient (ADC), were compared between 37 PDACs and 13 PNECs. Boundaries were more poorly defined in PDAC than PNEC (97.3% vs. 61.5%, p<0.01). Hyper-/isointensity was more common in PNEC than PDAC at the arterial (38.5% vs. 0.0), portal (46.2% vs. 2.7%) and delayed phases (46.2% vs. 5.4%) (all p<0.01). Lymph node metastasis (97.3% vs. 61.5%, p<0.01) and local invasion/distant metastasis (86.5% vs. 46.2%, p<0.01) were more common in PDAC than PNEC. Enhancement degree via CE-MRI was higher in PNEC than PDAC at the arterial and portal phases (p<0.01). PNEC ADC values were lower than those of normal pancreatic parenchyma (p<0.01) and PDAC (p<0.01). Arterial and portal phase signal intensity ratios and ADC values showed the largest areas under the receiver operating characteristic curve and good sensitivities (92.1%–97.2%) and specificities (76.9%–92.3%) for differentiating PNEC from PDAC. Thus the enhancement degree at the arterial and portal phases and the ADC values may be useful for differentiating PNEC from PDAC using MRI.

show abstract

Section: Discussionmentioning

confidence: 99%

Differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma using magnetic resonance imaging: The value of contrast-enhanced and diffusion weighted imaging

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Difficulties of distinguishing autoimmune pancreatitis from pancreatic malignancies on CT have been reported previously, particularly in cases of focal autoimmune pancreatitis 6,7) , which shows partial pancreatic enlargement and abnormal enhancement that mimics pancreatic adenocarcinoma or hypovascular NET. In addition, negative cytology results do not exclude the possibility of pancreatic tumors, resulting in unnecessary pancreatic resections.…”

Section: Clinical Datamentioning

confidence: 91%

Neuroendocrine tumor within main pancreatic duct: a case report

Munekage

Maeda

Namikawa

et al. 2017

Ann. Cancer Res. Therap.

View full text Add to dashboard Cite

Background: Pancreatic neuroendocrine tumor (NET) is a well-known, but uncommon disease that manifests as a heterogeneous, intense, round mass on enhanced computed tomography (CT). Herein, we report a case of pancreatic NET with unusual CT manifestation. A 66-year-old female was referred to our hospital for treatment of intermittent back pain. CT revealed a diffusely swollen pancreas from the head to tail. Imaging enhancement was weak except for a small area at the pancreatic head, and the lumen of the main pancreatic duct seemed narrowed. The entire pancreas showed accumulation of fluoro-D-glucose (FDG) on positron emission tomography (PET), suggesting autoimmune pancreatitis; however, endoscopic ultrasound-fine needle aspiration revealed atypical cells with round nuclei in a rosette formation, resulting in a diagnosis of non-functioning NET. Pathological examination revealed tumor growth within the main pancreatic duct with large areas of necrosis, and an area of viable cells at the head of the pancreas. In conclusion, CT imaging depicted an NET within the main pancreatic duct as a diffusely enlarged pancreas mimicking autoimmune pancreatitis.

show abstract

“…We investigated whether we could distinguish the 14 pancreatic cancer patients from the 34 autoimmune pancreatitis patients who were not diagnosed by EUS-FNA. For differential diagnosis, we used the capsule-like rim sign 26,[29][30][31][32][33] and narrowing of the main pancreatic duct without extension, 8,30,[34][35][36][37] which are characteristic indicators of autoimmune pancreatitis, as well as serum tumor markers (CEA, CA19-9). We reviewed the capsule-like rim sign by enhanced CT and determined the main pancreatic duct diameter by CT or magnetic resonance imaging (MRI).…”

Section: Validationmentioning

confidence: 99%

Endoscopic Ultrasonography‐Guided Fine Needle Aspiration Can Be Used to Rule Out Malignancy in Autoimmune Pancreatitis Patients

Sugimoto

Takagi

Suzuki

et al. 2017

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma: assessment by multiphase contrast-enhanced CT

Abstract: • f-AIP can mimic PC on imaging findings. • The differentiation of f-AIP from PC is important in patient management. • Some CT findings can be used to identify AIP. • The combination of CT findings will improve differentiation from PC.

Cited by 56 publications

References 33 publications

Differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma using magnetic resonance imaging: The value of contrast-enhanced and diffusion weighted imaging

Differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma using magnetic resonance imaging: The value of contrast-enhanced and diffusion weighted imaging

Neuroendocrine tumor within main pancreatic duct: a case report

Endoscopic Ultrasonography‐Guided Fine Needle Aspiration Can Be Used to Rule Out Malignancy in Autoimmune Pancreatitis Patients

Contact Info

Product

Resources

About