Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience

Yu, Songfeng; Takasu, Naoki; Fukumoto, Toshitaka; Okazaki, Satoshi; Tezuka, Koji; Sugawara, Shuichiro; Hirai, Ichiro; Kimura, Wataru

doi:10.1097/mpa.0000000000000874

Cited by 13 publications

(14 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has the highest risk to exhibit malignant disease (28–81%) [ 10 •, 12 – 20 ]. Therefore, an MPD diameter ≥ 10 mm is considered an absolute indication for surgical resection [ 10 •, 21 ]. Approximately 70% of patients is symptomatic [ 22 ].…”

Section: Classificationmentioning

confidence: 99%

Management of Intraductal Papillary Mucinous Neoplasms: Controversies in Guidelines and Future Perspectives

Levink

Bruno

Cahen

2018

Curr Treat Options Gastro

View full text Add to dashboard Cite

Purpose of reviewManagement of intraductal papillary mucinous neoplasm (IPMN) is currently based on consensus, in the absence of evidence-based guidelines. In recent years, several consensus guidelines have been published, with distinct management strategies. In this review, we will discuss these discrepancies, in order to guide treating physicians in clinical management.Recent findingsThe detection rate of pancreatic cysts has increased substantially with the expanded use of high-quality imaging techniques to up to 45%. Of these cysts, 24–82% are IPMNs, which harbour a malignant potential. Timely detection of high-risk lesions is therefore of great importance. Surgical management is based on the presence of clinical and morphological high-risk features, yet the majority of resected specimens appear to be low risk.SummaryInternational collaboration and incentive large-scale prospective registries of individuals undergoing cyst surveillance are needed to accumulate unbiased data and develop evidence-based guidelines. Additionally, development of non-invasive, accurate diagnostic tools (e.g. biomarkers) is needed to differentiate between neoplastic and non-neoplastic pancreatic cysts and detect malignant transformation at an early stage (i.e. high-grade dysplasia).

show abstract

Section: Classificationmentioning

confidence: 99%

Management of Intraductal Papillary Mucinous Neoplasms: Controversies in Guidelines and Future Perspectives

Levink

Bruno

Cahen

2018

Curr Treat Options Gastro

View full text Add to dashboard Cite

show abstract

“…The guidelines recommended the use of HRS and WF to determine the medical treatment of IPMNs. The diagnostic accuracy in detecting the malignancy of IPMNs was evaluated using the guidelines, but it was not highly sufficient (5–7). In the European guidelines, conservative management and absolute and relative indications for surgery in IPMN cases were defined using potential prognostic factors (8).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Deep Learning Analysis for the Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasms of the Pancreas

Kuwahara

Hara

Mizuno

et al. 2019

Clinical and Translational Gastroenterology

125

112

View full text Add to dashboard Cite

OBJECTIVES: Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions of pancreatic adenocarcinoma. Artificial intelligence (AI) is a mathematical concept whose implementation automates learning and recognizing data patterns. The aim of this study was to investigate whether AI via deep learning algorithms using endoscopic ultrasonography (EUS) images of IPMNs could predict malignancy. METHODS: This retrospective study involved the analysis of patients who underwent EUS before pancreatectomy and had pathologically confirmed IPMNs in a single cancer center. In total, 3,970 still images were collected and fed as input into the deep learning algorithm. AI value and AI malignant probability were calculated. RESULTS: The mean AI value of malignant IPMNs was significantly greater than benign IPMNs (0.808 vs 0.104, P < 0.001). The area under the receiver operating characteristic curve for the ability to diagnose malignancies of IPMNs via AI malignant probability was 0.98 ( P < 0.001). The sensitivity, specificity, and accuracy of AI malignant probability were 95.7%, 92.6%, and 94.0%, respectively; its accuracy was higher than human diagnosis (56.0%) and the mural nodule (68.0%). Multivariate logistic regression analysis showed AI malignant probability to be the only independent factor for IPMN-associated malignancy (odds ratio: 295.16, 95% confidence interval: 14.13–6,165.75, P < 0.001). DISCUSSION: AI via deep learning algorithm may be a more accurate and objective method to diagnose malignancies of IPMNs in comparison to human diagnosis and conventional EUS features.

show abstract

“…Characteristics of articles included for qualitative and quantitative analysis are listed in Table 1 and Table 2 . From the 20 included articles [ 12 , 14 , 15 , 17 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 44 , 45 ], a total of 3982 resected IPMN cases (including BD-IPMN, MD-IPMN, or mixed-type IPMN) were collected. Of the 3982 resected cases, 1516 and 2466 were malignant and non-malignant cases, respectively.…”

Section: Resultsmentioning

confidence: 99%

Ductal Dilatation of ≥5 mm in Intraductal Papillary Mucinous Neoplasm Should Trigger the Consideration for Pancreatectomy: A Meta-Analysis and Systematic Review of Resected Cases

Oba

Beaty

et al. 2021

Cancers

View full text Add to dashboard Cite

Intraductal papillary mucinous neoplasms (IPMN) are common but difficult to manage since accurate tools for diagnosing malignancy are unavailable. This study tests the diagnostic value of the main pancreatic duct (MPD) diameter for detecting IPMN malignancy using a meta-analysis of published data of resected IPMNs. Collected from a comprehensive literature search, the articles included in this analysis must report malignancy cases (high-grade dysplasia (HGD) and invasive carcinoma (IC)) and MPD diameter so that two MPD cut-offs could be created. The sensitivity, specificity, and odds ratios of the two cutoffs for predicting malignancy were calculated. A review of 1493 articles yielded 20 retrospective studies with 3982 resected cases. A cutoff of ≥5 mm is more sensitive than the ≥10 mm cutoff and has pooled sensitivity of 72.20% and 75.60% for classification of HGD and IC, respectively. Both MPD cutoffs of ≥5 mm and ≥10 mm were associated with malignancy (OR = 4.36 (95% CI: 2.82, 6.75) vs. OR = 3.18 (95% CI: 2.25, 4.49), respectively). The odds of HGD and IC for patients with MPD ≥5 mm were 5.66 (95% CI: 3.02, 10.62) and 7.40 (95% CI: 4.95, 11.06), respectively. OR of HGD and IC for MPD ≥10 mm cutoff were 4.36 (95% CI: 3.20, 5.93) and 4.75 (95% CI: 2.39, 9.45), respectively. IPMN with MPD of >5 mm could very likely be malignant. In selected IPMN patients, pancreatectomy should be considered when MPD is >5 mm.

show abstract

Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience

Abstract: As supplementary to the 2012 Fukuoka guideline, we suggest that calculating scores of WF and HRS may have superior diagnostic accuracy in predicting malignant IPMN.

Cited by 13 publications

References 28 publications

Management of Intraductal Papillary Mucinous Neoplasms: Controversies in Guidelines and Future Perspectives

Management of Intraductal Papillary Mucinous Neoplasms: Controversies in Guidelines and Future Perspectives

Usefulness of Deep Learning Analysis for the Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasms of the Pancreas

Ductal Dilatation of ≥5 mm in Intraductal Papillary Mucinous Neoplasm Should Trigger the Consideration for Pancreatectomy: A Meta-Analysis and Systematic Review of Resected Cases

Contact Info

Product

Resources

About