OBJECTIVE-Current generation MDCT technology facilitates identification of small, nonenhancing lesions in the pancreas. The objective of this study was to determine the prevalence of findings of unsuspected pancreatic cysts on 16-MDCT in a population of adult out-patients imaged for disease unrelated to the pancreas. MATERIALS AND METHODS-Contrast-enhancedMDCT scans of the abdomen were reviewed from 2,832 consecutive examinations to identify pancreatic cysts. Patients with a history of pancreatic lesions or predisposing factors for pancreatic disease or who were referred for pancreatic CT were excluded.RESULTS-A total of 73 patients had pancreatic cysts, representing a prevalence of 2.6 per 100 patients (95% CI, 2.0-3.2). Cysts ranged in size from 2 to 38 mm (mean, 8.9 mm) and were solitary in 85% of cases. Analysis of demographic information showed a strong correlation between pancreatic cysts and age, with no cysts identified among patients under 40 years and a prevalence of 8.7 per 100 (95% CI, 4.6-12.9) in individuals from 80 to 89 years. After controlling for age, cysts were more common in individuals of the Asian race than all other race categories, with an odds ratio of 3.57 (95% CI, 1.05-12.13). There was no difference by sex in the prevalence of cysts (p = 0.527); however, cysts were on average 3.6 mm larger (p = 0.014) in men than women.CONCLUSION-In this outpatient population, the prevalence of unsuspected pancreatic cysts identified on 16-MDCT was 2.6%. Cyst presence strongly correlated with increasing age and the Asian race. KeywordsCT; incidence; MDCT; pancreatic cyst; prevalence This year an estimated 37,170 Americans will be diagnosed with pancreaticcancer, and 33,370 will die from the disease [1]. Detection of this disease in its early curable stages is difficult, to the extent that more than 80% of pancreatic cancers have metastasized or are locally unresectable at the time of diagnosis [2]. As a result, the 5-year survival rate for all stages combined is 5% [3]. The detection and treatment of early precursors to invasive pancreatic cancer offer the best hope for improving outcome.Address correspondence to K. M. Horton (E-mail: kmhorton@jhmi.edu). Three histologically distinct precursors to invasive adenocarcinoma of the pancreas have been identified. These include the intraductal papillary mucinous neoplasm, the mucinous cystic neoplasm, and pancreatic intraepithelial neoplasia [4]. Pancreatic intraepithelial neoplasias are too small to be detected by most imaging methods. However, both intraductal papillary mucinous neoplasms and mucinous cystic neoplasms should be detectable, and both appear as cystic pancreatic lesions on cross-sectional imaging [5]. This suggests that an asymptomatic cyst detected in the pancreas could represent a treatable precursor to invasive cancer. NIH Public AccessA limited number of previous studies have reported both the incidence and prevalence of pancreatic cysts across a range of patient populations using autopsy, MRI, and CT [6][7][8][9]. However, curre...

Large macromolecular MRI contrast agents with albumin or dendrimer cores are useful for imaging blood vessels. However, their prolonged retention is a major limitation for clinical use. Although smaller dendrimer-based MRI contrast agents are more quickly excreted by the kidneys, they are also able to visualize vascular structures better than Gd-DTPA due to less extravasation. Additionally, unlike Gd-DTPA, they transiently accumulate in renal tubules and thus also can be used to visualize renal structural and functional damage. However, these dendrimer agents are retained in the body for a prolonged time. The purpose of this study was to obtain information from which a macromolecular dendrimer-based MRI contrast agents feasible for use in further clinical studies could be chosen. Six small dendrimer-based MRI contrast agents were synthesized, and their pharmacokinetics, whole-body retention, and dynamic MRI were evaluated in mice to determine an optimal agent in comparison to Gd-[DTPA]-dimeglumine. Diaminobutane (DAB) dendrimer-based agents cleared more rapidly from the body than polyamidoamine (PAMAM) dendrimer-based agents with the same numbers of branches. Smaller dendrimer conjugates were more rapidly excreted from the body than the larger dendrimer conjugates. Since PAMAM-G2, DAB-G3, and DAB-G2 dendrimer-based contrast agents showed relatively rapid excretion, these three conjugates might be acceptable for use in further clinical applications.

The superior temporal and spatial resolution of micro-MR lymphangiography using the contrast agent G6 may facilitate the study of tumor lymphatic drainage and lymphatic metastasis in both experimental animals and clinical medicine. In addition, this may be a powerful new method for sentinel lymph node localization in human breast cancer.

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