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Pancreatic Cystic Lesions on MRI: What Is The Likelihood of a Present or Future Diagnosis of Pancreatic Carcinoma?
Alwahbi, Omar; Larocque, Natasha; Kulkarni, Ameya; Gopee-Ramanan, Prasaanthan Prasa; Ghumman, Zonia; Sarkar, Rahul; Kagoma, Yoan K; Alabousi, Abdullah; Tsai, Scott; Wat, Josephine; McInnes, Matthew; van der Pol, Christian B.
Afiliação
  • Alwahbi O; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Larocque N; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Kulkarni A; Department of Diagnostic Imaging, Hamilton General Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.
  • Gopee-Ramanan PP; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Ghumman Z; Department of Diagnostic Imaging, Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada.
  • Sarkar R; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Kagoma YK; Department of Diagnostic Imaging, Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada.
  • Alabousi A; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Tsai S; Department of Diagnostic Imaging, Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada.
  • Wat J; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • McInnes M; Department of Diagnostic Imaging, Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada.
  • van der Pol CB; Department of Radiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
J Magn Reson Imaging ; 57(5): 1567-1575, 2023 05.
Article em En | MEDLINE | ID: mdl-36151888
BACKGROUND: Pancreatic cystic lesions (PCLs) are followed for years due to older and likely biased works demonstrating a strong association with pancreatic carcinoma; more recent data are needed clarifying this relationship. PURPOSE: To determine the association between PCLs on MRI and a synchronous or future diagnosis of pancreatic carcinoma. STUDY TYPE: Single-center retrospective cohort. POPULATION: A total of 192 patients (111 female, 58%) with median age 66 years (range 26-87 years) with PCLs on abdominal MRI from 2011 to 2016. FIELD STRENGTH/SEQUENCES: 1.5 T and 3 T, including T2 WI, T1 WI, diffusion weighted imaging and contrast-enhanced T1 WI. ASSESSMENT: Each PCL was reviewed independently by 2 of 10 fellowship-trained abdominal radiologists. Fukuoka guideline worrisome features and high-risk stigmata were evaluated. Follow-up imaging and clinical notes were reviewed within a system that captures pancreatic carcinoma for the region, for a median follow-up of 67 months (interquartile range: 43-88 months). STATISTICAL TESTS: Pancreatic carcinoma prevalence and incidence rate for future carcinoma with 95% confidence intervals (95% CI). Fisher exact test, logistic regression with odds ratios (OR) and the Wilcoxon rank-sum test were used to assess PCL morphologic features with the Kolmogorov-Smirnov test used to assess for normality. P < 0.05 defined statistical significance. RESULTS: The prevalence of pancreatic carcinoma on initial MRI showing a PCL was 2.4% (95% CI: 0.9%, 5.2%). Thickened/enhancing cyst wall was associated with pancreatic carcinoma, OR 52 (95% CI: 4.5, 1203). Of 189 patients with a PCL but without pancreatic carcinoma at the time of initial MRI, one developed high-grade dysplasia and none developed invasive carcinoma for an incidence rate of 0.97 (95% CI: 0.02, 5.43) and 0 (95% CI: 0, 3.59) cases per 1000 person-years, respectively. DATA CONCLUSION: A low percentage of patients with a PCL on MRI had a pancreatic carcinoma at the time of initial evaluation and none developed carcinoma over a median 67 months of follow-up. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: 5.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cisto Pancreático / Neoplasias Pancreáticas / Carcinoma Tipo de estudo: Diagnostic_studies / Guideline / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: J Magn Reson Imaging Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cisto Pancreático / Neoplasias Pancreáticas / Carcinoma Tipo de estudo: Diagnostic_studies / Guideline / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: J Magn Reson Imaging Ano de publicação: 2023 Tipo de documento: Article