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

✍ Scribed by Su Jin Song; Jeong Min Lee; Young Jun Kim; Se Hyung Kim; Jae Young Lee; Joon Koo Han; Byung Ihn Choi


Publisher
John Wiley and Sons
Year
2007
Tongue
English
Weight
353 KB
Volume
26
Category
Article
ISSN
1053-1807

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✦ Synopsis


Abstract

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.