Imaging investigation of pancreatic cystic lesions and proposal for therapeutic guidelines

Hilendarov, Atanas; Deenichin, Georgi Petrov; Velkova, K

doi:10.4329/wjr.v4.i8.378

Cited by 2 publications

(5 citation statements)

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“…After title and abstract review, 1359 studies were eligible for full‐text review. Fifteen studies met the inclusion criteria, all of which were retrospective 18,19,27,33–44 …”

Section: Resultsmentioning

confidence: 99%

“…Eight studies reported on PCLs with a PDAC at the time of initial MRI (Table 1). 27,33–35,37–39,44 The median year of publication for the eight publications was 2017 (range, 2010–2022). All studies used single‐center databases from Italy ( N = 4), Bulgaria ( N = 1), Canada ( N = 1), Japan ( N = 1), and South Korea ( N = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies met the inclusion criteria, all of which were retrospective. 18,19,27,[33][34][35][36][37][38][39][40][41][42][43][44] PCLs on MRI with Pancreatic Carcinoma at the Time of Initial MRI Eight studies reported on PCLs with a PDAC at the time of initial MRI (Table 1). 27,[33][34][35][37][38][39]44 The median year of publication for the eight publications was 2017 (range, 2010-2022).…”

Section: Study Selectionmentioning

confidence: 99%

“…18,19,27,[33][34][35][36][37][38][39][40][41][42][43][44] PCLs on MRI with Pancreatic Carcinoma at the Time of Initial MRI Eight studies reported on PCLs with a PDAC at the time of initial MRI (Table 1). 27,[33][34][35][37][38][39]44 The median year of publication for the eight publications was 2017 (range, 2010-2022). All studies used single-center databases from Italy (N = 4), Bulgaria (N = 1), Canada (N = 1), Japan FIGURE 4: Forest plot illustrating the percentage of patients with pancreatic cystic lesions on MRI who were diagnosed with pancreatic adenocarcinoma on a future date while on surveillance, with 95% confidence intervals (95% CI).…”

Section: Study Selectionmentioning

confidence: 99%

“…Five studies were at low risk of bias, 27,33,34,37,44 while three studies were identified as at risk (Figure 3). 35,38,39 Three studies were limited to only patients who had histopathology, each of which was considered at risk for selection bias due to the retrospective exclusion of PCLs that did not meet criteria for resection or fluid/ tissue sampling. One conference presentation had unclear risk of bias across three domains due to insufficient detail reported in the abstract.…”

Section: Study Selectionmentioning

confidence: 99%

See 4 more Smart Citations

Percentage of Pancreatic Cysts on MRI With a Pancreatic Carcinoma: Systematic Review and Meta‐Analysis

Elmi,

McEvoy,

McInnes

et al. 2023

Magnetic Resonance Imaging

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BackgroundPancreatic cystic lesions (PCLs) are frequent on MRI and are thought to be associated with pancreatic adenocarcinoma (PDAC) necessitating long‐term surveillance based on older studies suffering from selection bias.PurposeTo establish the percentage of patients with PCLs on MRI with a present or future PDAC.Study TypeSystematic review, meta‐analysis.PopulationAdults with PCLs on MRI and a present or future diagnosis of PDAC were eligible. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus were searched to April 2022 (PROSPERO:CRD42022320502). Studies limited to PCLs not requiring surveillance, <100 patients, or those with a history/genetic risk of PDAC were excluded.Field Strength/Sequence≥1.5 T with ≥1 T2‐weighted sequence.AssessmentTwo investigators extracted data, with discrepancies resolved by a third. QUADAS‐2 assessed bias. PDAC was diagnosed using a composite reference standard.Statistical TestsA meta‐analysis of proportions was performed at the patient‐level with 95% confidence intervals (95% CI).ResultsEight studies with 1289 patients contributed to the percentage of patients with a present diagnosis of PDAC, and 10 studies with 3422 patients to the percentage with a future diagnosis. Of patients with PCLs on MRI, 14.8% (95% CI 2.4–34.9) had a PDAC at initial MRI, which decreased to 6.0% (2.2–11.3) for studies at low risk of bias. For patients without PDAC on initial MRI, 2.0% (1.1–3.2) developed PDAC during surveillance, similar for low risk of bias studies at 1.9% (0.7–3.6), with no clear trend of increased PDAC for longer surveillance durations. For patients without worrisome features or high‐risk stigmata, 0.9% (0.1–2.2) developed PDAC during surveillance. Of 10, eight studies had a median surveillance ≥3 years (range 3–157 months). Sources of bias included retrospectively limiting PCLs to those with histopathology and inconsistent surveillance protocols.Data ConclusionA low percentage of patients with PCLs on MRI develop PDAC while on surveillance. The first MRI revealing a PCL should be scrutinized for PDAC.Level of Evidence3Technical EfficacyStage 2

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“…After title and abstract review, 1359 studies were eligible for full‐text review. Fifteen studies met the inclusion criteria, all of which were retrospective 18,19,27,33–44 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%