Non-branched microcysts of the pancreas on MR imaging of patients with pancreatic tumors who had pancreatectomy may predict the presence ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-10

AUTHORS

Marie-Pierre Vullierme, Lina Menassa, Anne Couvelard, Vinciane Rebours, Frédérique Maire, Tony Ibrahim, Jerome Cros, Philippe Ruszniewski, Alain Sauvanet, Philippe Levy, Philippe Soyer, Valerie Vilgrain

ABSTRACT

PurposeTo evaluate whether pancreatic parenchymal abnormalities on magnetic resonance imaging (MRI) are associated with pancreatic intraepithelial neoplasia (PanIN) on histology.Materials and methodsRetrospective study approved by institutional review board. One hundred patients (48 men, 52 women; mean age, 53.2 ± 16.29 [SD]) underwent MRI before pancreatectomy for pancreatic tumors analyzed by two independent observers blinded to histopathological results for the presence of non-communicating microcysts and pancreatic atrophy (global or focal) beside tumors. MRI findings were compared to histopathological findings of resected specimens. Interobserver agreement was calculated. The association between parenchymal abnormalities and presence of PanIN was assessed by uni- and multivariate analyses.ResultsPanIN was present in 65/100 patients (65%). The presence of microcysts on MRI had a sensitivity of 52.3% (34/65 [95%CI, 51.92–52.70%]), a specificity of 77.1% (27/35 [95%CI, 76.70–77.59]), and accuracy of 61% (61/100 95%CI [50.7–70.6]) for the diagnosis of PanIN while global atrophy had a sensitivity of 24.6% (16/6 [95%CI, 24.28–24.95]) and a specificity of 97.1% (34/35 [95%CI, 96.97–97.32%]). In multivariate analysis, the presence of microcysts (OR, 3.37 [95%CI, 1.3–8.76]) (p = 0.0127) and global atrophy (OR, 9.79 [95%CI, 1.21–79.129]) (p = 0.0324) were identified as independent predictors of the presence of PanIN. The combination of these two findings was observed in 10/65 PanIN patients and not in patients without PanIN (p = 0.013 with an OR of infinity [95%CI, 1.3–infinity]) and was not discriminant for PanIN-3 and lower grade (p = 0.22). Interobserver agreement for the presence of microcysts was excellent (kappa = 0.92), and for the presence of global atrophy, it was good (kappa = 0.73).ConclusionThe presence of non-communicating microcysts on pre-operative MRI can be a significant predictor of PanIN in patients with pancreatic tumors.Key Points• In patients with pancreatic tumors who had partial pancreatectomy, MR non-communicating pancreatic microcysts have a 52.3% sensitivity, a 77.1% specificity, and a 61% accuracy for the presence of PanIN with univariate and with an odds ratio of 3.37 with multivariate analyses.• The association of global atrophy and non-communicating microcysts increases the predictive risk of PanIN. More... »

PAGES

5731-5741

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-019-06154-3

DOI

http://dx.doi.org/10.1007/s00330-019-06154-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113356254

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30972547


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    "description": "PurposeTo evaluate whether pancreatic parenchymal abnormalities on magnetic resonance imaging (MRI) are associated with pancreatic intraepithelial neoplasia (PanIN) on histology.Materials and methodsRetrospective study approved by institutional review board. One hundred patients (48 men, 52 women; mean age, 53.2\u2009\u00b1\u200916.29 [SD]) underwent MRI before pancreatectomy for pancreatic tumors analyzed by two independent observers blinded to histopathological results for the presence of non-communicating microcysts and pancreatic atrophy (global or focal) beside tumors. MRI findings were compared to histopathological findings of resected specimens. Interobserver agreement was calculated. The association between parenchymal abnormalities and presence of PanIN was assessed by uni- and multivariate analyses.ResultsPanIN was present in 65/100 patients (65%). The presence of microcysts on MRI had a sensitivity of 52.3% (34/65 [95%CI, 51.92\u201352.70%]), a specificity of 77.1% (27/35 [95%CI, 76.70\u201377.59]), and accuracy of 61% (61/100 95%CI [50.7\u201370.6]) for the diagnosis of PanIN while global atrophy had a sensitivity of 24.6% (16/6 [95%CI, 24.28\u201324.95]) and a specificity of 97.1% (34/35 [95%CI, 96.97\u201397.32%]). In multivariate analysis, the presence of microcysts (OR, 3.37 [95%CI, 1.3\u20138.76]) (p\u2009=\u20090.0127) and global atrophy (OR, 9.79 [95%CI, 1.21\u201379.129]) (p\u2009=\u20090.0324) were identified as independent predictors of the presence of PanIN. The combination of these two findings was observed in 10/65 PanIN patients and not in patients without PanIN (p\u2009=\u20090.013 with an OR of infinity [95%CI, 1.3\u2013infinity]) and was not discriminant for PanIN-3 and lower grade (p\u2009=\u20090.22). Interobserver agreement for the presence of microcysts was excellent (kappa\u2009=\u20090.92), and for the presence of global atrophy, it was good (kappa\u2009=\u20090.73).ConclusionThe presence of non-communicating microcysts on pre-operative MRI can be a significant predictor of PanIN in patients with pancreatic tumors.Key Points\u2022 In patients with pancreatic tumors who had partial pancreatectomy, MR non-communicating pancreatic microcysts have a 52.3% sensitivity, a 77.1% specificity, and a 61% accuracy for the presence of PanIN with univariate and with an odds ratio of 3.37 with multivariate analyses.\u2022 The association of global atrophy and non-communicating microcysts increases the predictive risk of PanIN.", 
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29 schema:description PurposeTo evaluate whether pancreatic parenchymal abnormalities on magnetic resonance imaging (MRI) are associated with pancreatic intraepithelial neoplasia (PanIN) on histology.Materials and methodsRetrospective study approved by institutional review board. One hundred patients (48 men, 52 women; mean age, 53.2 ± 16.29 [SD]) underwent MRI before pancreatectomy for pancreatic tumors analyzed by two independent observers blinded to histopathological results for the presence of non-communicating microcysts and pancreatic atrophy (global or focal) beside tumors. MRI findings were compared to histopathological findings of resected specimens. Interobserver agreement was calculated. The association between parenchymal abnormalities and presence of PanIN was assessed by uni- and multivariate analyses.ResultsPanIN was present in 65/100 patients (65%). The presence of microcysts on MRI had a sensitivity of 52.3% (34/65 [95%CI, 51.92–52.70%]), a specificity of 77.1% (27/35 [95%CI, 76.70–77.59]), and accuracy of 61% (61/100 95%CI [50.7–70.6]) for the diagnosis of PanIN while global atrophy had a sensitivity of 24.6% (16/6 [95%CI, 24.28–24.95]) and a specificity of 97.1% (34/35 [95%CI, 96.97–97.32%]). In multivariate analysis, the presence of microcysts (OR, 3.37 [95%CI, 1.3–8.76]) (p = 0.0127) and global atrophy (OR, 9.79 [95%CI, 1.21–79.129]) (p = 0.0324) were identified as independent predictors of the presence of PanIN. The combination of these two findings was observed in 10/65 PanIN patients and not in patients without PanIN (p = 0.013 with an OR of infinity [95%CI, 1.3–infinity]) and was not discriminant for PanIN-3 and lower grade (p = 0.22). Interobserver agreement for the presence of microcysts was excellent (kappa = 0.92), and for the presence of global atrophy, it was good (kappa = 0.73).ConclusionThe presence of non-communicating microcysts on pre-operative MRI can be a significant predictor of PanIN in patients with pancreatic tumors.Key Points• In patients with pancreatic tumors who had partial pancreatectomy, MR non-communicating pancreatic microcysts have a 52.3% sensitivity, a 77.1% specificity, and a 61% accuracy for the presence of PanIN with univariate and with an odds ratio of 3.37 with multivariate analyses.• The association of global atrophy and non-communicating microcysts increases the predictive risk of PanIN.
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36 schema:keywords ConclusionThe presence
37 MR imaging
38 MRI findings
39 MethodsRetrospective study
40 PanIN
41 PanIN-3
42 PurposeTo
43 abnormalities
44 accuracy
45 agreement
46 analysis
47 association
48 atrophy
49 board
50 combination
51 diagnosis
52 findings
53 global atrophy
54 grade
55 histology
56 histopathological findings
57 histopathological results
58 imaging
59 independent observers
60 independent predictors
61 institutional review board
62 interobserver agreement
63 intraepithelial neoplasia
64 low grade
65 magnetic resonance imaging
66 materials
67 microcysts
68 multivariate analysis
69 neoplasia
70 observer
71 odds ratio
72 pancreas
73 pancreatectomy
74 pancreatic atrophy
75 pancreatic intraepithelial neoplasia
76 pancreatic parenchymal abnormalities
77 pancreatic tumors
78 parenchymal abnormalities
79 partial pancreatectomy
80 patients
81 pre-operative magnetic resonance imaging
82 predictive risk
83 predictors
84 preliminary study
85 presence
86 presence of PanIN
87 presence of microcysts
88 ratio
89 resonance imaging
90 results
91 review board
92 risk
93 sensitivity
94 significant predictors
95 specificity
96 specimens
97 study
98 tumors
99 univariate
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