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

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Song, Su Jin; Lee, Jeong Min; Kim, Young Jun; Kim, Se Hyung; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn
Issue Date
John Wiley & Sons
J Magn Reson Imaging 2007;26(1):86-93
Adenocarcinoma, Mucinous/*diagnosis/pathology/radiographyAdenocarcinoma, Papillary/*diagnosis/pathology/radiographyAgedDiagnosis, DifferentialFemaleHumansImage Processing, Computer-AssistedMagnetic Resonance Imaging/*methodsMaleMiddle AgedPancreatic Cyst/*diagnosis/pathology/radiographyPancreatic Neoplasms/*diagnosis/pathology/radiographyROC CurveTomography, X-Ray Computed/*methods
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 kappa values indicate good agreement (kappa = 0.61) between observers for MDCT, and excellent agreement (kappa = 0.82) for MRI. CONCLUSION: Pancreatic MRI shows better diagnostic performance than MDCT for differentiating IPMNs from other cystic lesions of the pancreas.
1053-1807 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Radiation Applied Life Science (대학원 협동과정 방사선응용생명과학전공)Journal Papers (저널논문_방사선응용생명과학)
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