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Branch-duct intradu...
Branch-duct intraductal papillary mucinous neoplasm (IPMN) : Are cyst volumetry and other novel imaging features able to improve malignancy prediction compared to well-established resection criteria?
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- Pozzi Mucelli, Raffaella M. (författare)
- Karolinska Institutet
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- Moro, Carlos Fernández (författare)
- Karolinska Institutet
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- Del Chiaro, Marco (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave #6117, CO, Aurora, United States
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- Valente, Roberto (författare)
- Umeå universitet,Kirurgi,Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, Stockholm, Sweden; Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave #6117, CO, Aurora, United States
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- Blomqvist, Lennart (författare)
- Karolinska Institutet
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- Papanikolaou, Nikolaos (författare)
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, Stockholm, Sweden; Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasília, Doca de Pedrouços, Lisbon, Portugal; Department of Radiology, Royal Marsden Hospital and The Institute of Cancer Research, London, United Kingdom; Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece
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- Löhr, Johannes-Matthias (författare)
- Karolinska Institutet
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- Kartalis, Nikolaos (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2022-03-11
- 2022
- Engelska.
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Ingår i: European Radiology. - : Springer Science+Business Media B.V.. - 0938-7994 .- 1432-1084. ; 32:8, s. 5144-5155
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Objectives: Current guidelines base the management of intraductal papillary mucinous neoplasms (IPMN) on several well-established resection criteria (RC), including cyst size. However, malignancy may occur in small cysts. Since branch-duct (BD) IPMN are not perfect spheres, volumetric and morphologic analysis might better correlate with mucin production and grade of dysplasia. Nonetheless, their role in malignancy (high-grade dysplasia/invasive cancer) prediction has been poorly investigated. Previous studies evaluating RC also included patients with solid-mass-forming pancreatic cancer (PC), which may affect the RC yield. This study aimed to assess the role of volume, morphology, and other well-established RC in malignancy prediction in patients with BD- and mixed-type IPMN after excluding solid masses.Methods: Retrospective ethical review-board-approved study of 106 patients (2008–2019) with histopathological diagnosis of BD- and mixed-type IPMN (without solid masses) and preoperative MRI available. Standard imaging and clinical features were collected, and the novel imaging features cyst-volume and elongation value [EV = 1 − (width/length)] calculated on T2-weighted images. Logistic regression analysis was performed. Statistical significance set at two-tails, p < 0.05.Results: Neither volume (odds ratio (OR) = 1.01, 95% CI: 0.99–1.02, p = 0.12) nor EV (OR = 0.38, 95% CI: 0.02–5.93, p = 0.49) was associated with malignancy. Contrast-enhancing mural nodules (MN), main pancreatic duct (MPD) ≥ 5 mm, and elevated carbohydrate antigen (CA) 19-9 serum levels (> 37 μmol/L) were associated with malignancy (MN OR: 4.32, 95% CI: 1.18–15.76, p = 0.02; MPD ≥ 5 mm OR: 4.2, 95% CI: 1.34–13.1, p = 0.01; CA19-9 OR: 6.72; 95% CI: 1.89 – 23.89, p = 0.003).Conclusions: Volume and elongation value cannot predict malignancy in BD- and/or mixed-type IPMN. Mural nodules, MPD ≥ 5 mm and elevated CA19-9 serum levels are associated with higher malignancy risk even after the exclusion of solid masses. Key Points: • Novel and well-established resection criteria for IPMN have been evaluated after excluding solid masses. • BD-IPMN volume and elongation value cannot predict malignancy. • Main pancreatic duct ≥ 5 mm, mural nodules, and elevated carbohydrate antigen 19-9 levels are associated with malignancy.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- Cysts
- Logistic models
- Magnetic resonance imaging
- Pancreatic carcinoma
- Pancreatic intraductal neoplasm
- Surgery
- kirurgi
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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