Differential Diagnosis of Benign or Malignant Intraductal Papillary Mucinous Neoplasm of the Pancreas by Multidetector Row Helical Computed Tomography

Abstract

Main duct-type IPMN is highly suggestive for malignancy. Combination factors of main ductal dilation and mural nodule, and main ductal dilation, and large cystic tumor size are thought to be predictive factors for malignant branch-type IPMN.

Utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in differential diagnosis of benign and malignant intraductal papillary-mucinous neoplasm of the pancreas

“…The sensitivity, specificity, and accuracy of the presence/ absence of mural nodule in the differentiation of malignant IPMN were 93, 80 and 86%, respectively. This diagnostic value of the presence/absence of mural nodule was in agreement with some previous reports (15,16).…”

“…This study also showed the low power of other imaging parameters, apart from mural nodule, such as large/small size of cystic lesion and dilated/nondilated MPD, in the differentiation of malignant from benign IPMN, which may be partly due to the potential prejudices in selection of the enrolled patients; the enrolled patients might be necessary for surgery. On the other hand, the presence/ absence of mural nodule, which has been considered an indicator of malignancy in IPMN, was found to be useful in the differentiation of malignancy in this study (12,13,(15)(16)(17). The sensitivity, specificity, and accuracy of the presence/ absence of mural nodule in the differentiation of malignant IPMN were 93, 80 and 86%, respectively.…”

“…These values were superior to those of CT parameters that had been reported previously to be associated with a higher likelihood of malignancy (5,(9)(10)(11)(12)(13)(14)(15)(16)(17), including large cystic lesion size (≥3.0 vs. <3.0 cm), and large dilatation of MPD (≥7 vs. <7 mm) (Table II). In comparison to the presence/absence of mural nodules, which is also previously reported to be associated with malignancy, though the sensitivity was almost equal, the specificity and accuracy were superior (Table II).…”

“…Therefore, preoperative differentiation between benign IPMN and malignant IPMN is important in order to determine the management of patients. To date, various features of malignant IPMN tumors using imaging techniques have been proposed, such as large lesion size, dilatation of the main pancreatic duct (MPD), and presence of mural nodules (5,(9)(10)(11)(12)(13)(14)(15)(16). However, some of these features are controversial, and their accuracy depends on the imaging modalities used.…”

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

“…1). Of these studies, 33 investigated mural nodules5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 21 examined dilatation of the main pancreatic duct (MPD)7 9, 15 16, 18 21, 23 26, 27 30, 32 36, 38, 39, 40, 41, 42, 43, 44, 45, 46, 21 analysed cyst size5 7, 8, 9 14, 15 18, 20 23, 25 27, 28 31, 36 38, 40 41, 43 47, 48, 49, 17 assessed CA19‐9 increase…”