The intraductal papillary mucinous neoplasms (IPMN) can evolve through all biological stages, from slight dysplasia to carcinoma. As one of the few surgically curable pancreatic tumors, accurate preoperative prediction of malignancy remains one of the major issues in the optimal treatment of IPMNs, and it also influences the outcome of the resection.
A clinical research article to be published on August 28, 2009 in the World Journal of Gastroenterology addresses the role of multi-detector row computed tomography (MDCT) in predicting malignancy of IPMNs preoperatively. The research team led by Prof. Wang DB from Ruijin Hospital of Shanghai Jiao Tong University School of Medicine recruited a total of 20 patients with pathologically-confirmed IPMNs in their study. Axial MDCT images combined with CT angiography (CTA) and multiplanar volume or curved reformations (MPVR or CR) were preoperatively acquired.
The pathological study revealed 12 malignant IPMNs and 8 benign IPMNs. The diameters of the cystic lesions and main pancreatic ducts (MPDs) were significantly larger in malignant IPMNs compared with those of the benign IPMNs. The combined-type IPMNs had a higher rate of malignancy than the other 2 types of IPMNs. Tumors with mural nodules and thick septa had a significantly higher incidence of malignancy than tumors without these features. Communication of side-branch IPMNs with the MPD was present in 9 cases at pathologic examination. Seven of them were identified from CTA and MPVR or CR images. From comparison with the pathological diagnosis, the sensitivity, specificity, and accuracy of MDCT in characterizing the malignancy of IPMN of the pancreas were determined to be 100%, 87.5%, and 95%, respectively.
MDCT with CTA and MPVR or CR techniques can elucidate the imaging features of IPMNs and help predict the malignancy of these tumors.
Reference: Tan L, Zhao YE, Wang DB, Wang QB, Hu J, Chen KM, Deng XX. Imaging features of intraductal papillary mucinous neoplasms of the pancreas in multi-detector row computed tomography. World J Gastroenterol 2009; 15(32): 4037-4043
Correspondence to: Deng-Bin Wang, MD, PhD, Professor of Radiology, Vice Chair, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, 197 Ruijin Er Road, Shanghai 200025, China.
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.