Main Pancreatic Duct Intraductal Papillary Mucinous Neoplasms: Accuracy of MR Imaging in Differentiation between Benign and Malignant Tumors Compared with Histopathologic Analysis

Manfredi, Riccardo; Graziani, Rossella; Motton, Massimiliano; Mantovani, William; Baltieri, Susanna; Tognolini, Alessia; Crippa, Stefano; Capelli, Paola; Salvia, Roberto; Mucelli, Roberto Pozzi

doi:10.1148/radiol.2531080604

Cited by 70 publications

(37 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The reported sensitivity, specificity, positive and negative predictive values and accuracy of these findings (with 2 or more present) for correctly characterizing these tumors as malignant are 83%, 81%, 85%, 78% and 82% respectively [32] . MRI depicts mural nodules in up to 60% of patients with malignant IPMN and 4% of patients with a benign or borderline IPMN [9] . Wall enhancement in the MPD after gadolinium administration is also more common in malignant (74%) than benign tumors (21%) [9] .…”

Section: Imaging Predictors Of Malignancy and Resectability In Intradmentioning

confidence: 99%

“…MRI depicts mural nodules in up to 60% of patients with malignant IPMN and 4% of patients with a benign or borderline IPMN [9] . Wall enhancement in the MPD after gadolinium administration is also more common in malignant (74%) than benign tumors (21%) [9] . Malignant tumors have a larger median diameter of the MPD (18 mm) than benign lesions (11 mm) on MRCP [9] .…”

Section: Imaging Predictors Of Malignancy and Resectability In Intradmentioning

confidence: 99%

“…Wall enhancement in the MPD after gadolinium administration is also more common in malignant (74%) than benign tumors (21%) [9] . Malignant tumors have a larger median diameter of the MPD (18 mm) than benign lesions (11 mm) on MRCP [9] . When analyzing the CT features of malignancy in IPMN, most lesions (93%) with mural nodules correlate with in situ carcinoma at histopathology whereas the majority (90%) of infiltrating masses represent IPMN with invasive carcinoma [13] .…”

Section: Imaging Predictors Of Malignancy and Resectability In Intradmentioning

confidence: 99%

“…The importance of cross-sectional imaging in the presurgical evaluation of IPMN has been extensively emphasized in the literature [7][8][9][10][11][12][13][14] . The tight correlation between imaging findings and histopathological features of these neoplasms, with further sub-classification based on the location and degree of involvement of the pancreas, provides the basis for including imaging in a decision-making algorithm proposed for the management of IPMN [15] .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Imaging considerations in intraductal papillary mucinous neoplasms of the pancreas

Pedrosa

Boparai

2010

WJGS

View full text Add to dashboard Cite

With the widespread use of cross-sectional imaging, particularly computed tomography (CT) and magnetic resonance imaging (MRI), and the continuous improvement in the image quality of these techniques, the diagnosis of incidental pancreatic cysts has increased dramatically in the last decades. While the vast majority of these cysts are not clinically relevant, a small percentage of them will evolve into an invasive malignant tumor making their management challenging. Mucinous cystic neoplasms and intraductal papillary mucinous neoplasms (IPMN) are the most common pancreatic cystic lesions with malignant potential. Imaging findings on CT and MRI correlate tightly with the presence of malignant degeneration in these neoplasms. IPMN can be classified based on their distribution as main duct, branch duct or mixed type lesions. MRI is superior to CT in demonstrating the communication of a branch duct IPMN with the main pancreatic duct (MPD). Most branch duct lesions are benign whereas tumors involving the MPD are frequently associated with malignancy. The presence of solid nodules, thick enhancing walls and/or septae, a wide (> 1 cm) connection of a side-branch lesion with the MPD and the size of the tumor > 3 cm are indicative of malignancy in October 27, 2010|Volume 2|Issue 10| a branch and mixed type IPMN. A main pancreatic duct > 6 mm, a mural nodule > 3 mm and an abnormal attenuating area in the adjacent pancreatic parenchyma on CT correlates with malignant disease in main duct and mixed type IPMN. An accurate characterization of these neoplasms by imaging is thus crucial for selecting the best management options. In this article, we review the imaging findings of IPMN including imaging predictors of malignancy and surgical resectability. We also discuss follow-up strategies for patients with surgically resected IPMN and patients with incidental pancreatic cysts.

show abstract

Section: Imaging Predictors Of Malignancy and Resectability In Intradmentioning

confidence: 99%

Section: Imaging Predictors Of Malignancy and Resectability In Intradmentioning

confidence: 99%

Section: Imaging Predictors Of Malignancy and Resectability In Intradmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Imaging considerations in intraductal papillary mucinous neoplasms of the pancreas

Pedrosa

Boparai

2010

WJGS

View full text Add to dashboard Cite

show abstract

“…Three types of IPMNs have been described [1,7]: the main-duct type (MD-IPMN) [8], the branch-duct type (BD-IPMN) [2], and the mixed type [9], which meets the diagnostic criteria for both MD-IPMN and BD-IPMN.…”

Section: Introductionmentioning

confidence: 99%

Intraductal Papillary Mucinous Neoplasm (IPMN)

Morana

D’Onofrio²,

Martini³

et al. 2014

Imaging and Pathology of Pancreatic Neoplasms

Self Cite

View full text Add to dashboard Cite

PathologyIntraductal neoplasms of the pancreas are cystic or mass-forming epithelial tumors with ductal differentiation, that typically grow primarily within the ductal system [14]. Two main groups have been defined: intraductal papillary mucinous neoplasms (IPMNs) and intraductal tubulopapillary neoplasms (ITPNs).Epithelial morphology and mucin expression patterns define four main histologic subtypes of IPMN [15]: intestinal, gastric, oncocytic, and pancreaticobiliary. Recent papers support the hypothesis of distinct pathways for carcinogenesis among the different IPMN subtypes [16,17].IPMNs are defined as an intraductal grossly visible (typically >1 cm, a threshold useful to distinguish IPMNs from PanINs) epithelial neoplasm made up of mucin-producing cells, arising in pancreatic ductal system [14].

show abstract

Imaging modalities for characterising focal pancreatic lesions

Best

Rawji

Pereira

et al. 2017

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Main Pancreatic Duct Intraductal Papillary Mucinous Neoplasms: Accuracy of MR Imaging in Differentiation between Benign and Malignant Tumors Compared with Histopathologic Analysis

Abstract: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.2531080604/-/DC1.

Cited by 70 publications

References 28 publications

Imaging considerations in intraductal papillary mucinous neoplasms of the pancreas

Imaging considerations in intraductal papillary mucinous neoplasms of the pancreas

Intraductal Papillary Mucinous Neoplasm (IPMN)

Imaging modalities for characterising focal pancreatic lesions

Contact Info

Product

Resources

About