Differentiation of intraductal papillary mucinous neoplasms from other pancreatic cystic masses: Comparison of multirow-detector CT and MR imaging using ROC analysis

• Published in: Journal of magnetic resonance imaging 2007-07, Vol.26 (1), p.86-93
• Main Authors: Song, Su Jin, Lee, Jeong Min, Kim, Young Jun, Kim, Se Hyung, Lee, Jae Young, Han, Joon Koo, Choi, Byung Ihn
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - diagnosis; Adenocarcinoma, Mucinous - diagnostic imaging; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Papillary - diagnosis; Adenocarcinoma, Papillary - diagnostic imaging; Adenocarcinoma, Papillary - pathology; Aged; Diagnosis, Differential; Female; Humans; Image Processing, Computer-Assisted; intraductal papillary mucinous neoplasm; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; multirow-detector computed tomography; pancreas; Pancreatic Cyst - diagnosis; Pancreatic Cyst - diagnostic imaging; Pancreatic Cyst - pathology; pancreatic cystic mass; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; ROC Curve; Tomography, X-Ray Computed - methods
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.21001

Purpose To compare the diagnostic performance of multirow‐detector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the differentiation of intraductal papillary mucinous neoplasms (IPMNs) from other pancreatic cystic masses. Materials and Methods A total of 53 patients with pathologically proven pancreatic cystic lesions who had undergone MDCT and MRI were included in this study. Two radiologists analyzed the morphologic features of the lesions and graded the lesion conspicuity on each examination. The readers assigned their confidence level regarding the differentiation of IPMN from other lesions and predicting ductal communication of the lesion. The radiologists' diagnostic confidence was compared using receiver operating characteristic (ROC) analysis. Results The Az values for each observer for predicting ductal communication of the lesion and differentiating IPMN from other lesions were as follows: For MRI they were respectively 0.949 and 0.995 for reader 1, and 0.916 and 0.932 for reader 2. For MDCT they were respectively 0.790 and 0.875 for reader 1, and 0.774 and 0.850 for reader 2. In addition, for differentiating IPMNs from other lesions, MRI was significantly more accurate than MDCT (P < 0.05) for one observer, but for the other observer there was no significant difference between the two examinations (P = 0.059). For predicting ductal communication of the cystic lesions for both observers, MRI was significantly more accurate than MDCT (P < 0.05). The weighted κ values indicate good agreement (κ = 0.61) between observers for MDCT, and excellent agreement (κ = 0.82) for MRI. Conclusion Pancreatic MRI shows better diagnostic performance than MDCT for differentiating IPMNs from other cystic lesions of the pancreas. J. Magn. Reson. Imaging 2007;26:86–93. © 2007 Wiley‐Liss, Inc.