Differential Features of Pancreatobiliary- and Intestinal-type Ampullary Carcinomas at MR Imaging

Chung, Yong Eun; Kim, Do Young; Park, Mi‐Suk; Choi, Jin Young; Kim, Hoguen; Kim, Sang Kyum; Lee, Myungsu; Kim, Hee Jin; Song, Si Young; Kim, Ki Whang

doi:10.1148/radiol.10100200

Cited by 32 publications

(21 citation statements)

References 27 publications

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“…Chung et al revealed that an oval filling defect at the distal end of the bile duct on MRCP images is likely to suggest an intestinal‐type ampullary carcinoma. Our results were different from their study, since none of the MRCP image features of the tumors in our study were significantly different between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…When ROC curve analysis was performed with combined model of enhancement pattern and ADC min value, the area under the curve increased to 0.807, with the sensitivity and specificity being 70.4% and 78.6%, respectively. Chung et al 26 revealed that an oval filling defect at the distal end of the bile duct on MRCP images is likely to suggest an intestinal-type ampullary carcinoma. Our results were different from their study, since none of the MRCP image features of the tumors in our study were significantly different between the two groups.…”

Section: Discussionmentioning

confidence: 99%

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Differentiation of pancreatobiliary-type from intestinal-type periampullary carcinomas using 3.0T MRI

Yin

Jing

et al. 2015

J. Magn. Reson. Imaging

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Differentiation of pancreatobiliary-type from intestinal-type periampullary carcinomas using 3.0T MRI

Yin

Jing

et al. 2015

J. Magn. Reson. Imaging

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“…Several studies have indicated the significance of a filling defect detected on MRCP and have suggested that a filling defect could be a sign of bile duct carcinoma or papillomatosis [18][19][20] . In addition, intra-ductal debris, sludge, and stones could be causes of a filling defect after LT [21] .…”

Section: Discussionmentioning

confidence: 99%

Risk factors of biliary intervention by imaging after living donor liver transplantation

Lee

Choi

Yeo

et al. 2016

WJG

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AIM:To d e t e r m i n e t h e r i s k f a c t o r s o f b i l i a r y intervention using magnetic resonance cholangiopancreatography (MRCP) after living donor liver transplantation (LDLT). METHODS:We retrospectively enrolled 196 patients who underwent right lobe LDLT between 2006 and 2010 at a single liver transplantation center. Direct duct-to-duct biliary anastomosis was performed in all 196 patients. MRCP images routinely taken 1 mo after LDLT were analyzed to identify risk factors for biliary intervention during follow-up, such as retrograde cholangiopancreatography or percutaneous transhepatic biliary drainage. Two experienced radiologists evaluated the MRCP findings, including the anastomosis site angle on three-dimensional images, the length of the filling defect on maximum intensity projection, bile duct dilatation, biliary stricture, and leakage. 1.02-6.20, P = 0.048) on MRCP were identified in the multivariate analysis as significant risk factors for biliary intervention during follow-up. Moreover, a narrower anastomosis site angle (i.e. , below the median angle of 113.3°) was associated with earlier biliary intervention (38.5 ± 4.2 mo vs 62. 1 ± 4.1 mo, P < 0.001). Kaplan-Meier analysis comparing biliary intervention-free survival according to the anastomosis site angle revealed that lower survival was associated with a narrower anastomosis site angle (36.3% vs 62.0%, P < 0.001). RESULTS: Retrospective Study Risk factors of biliary intervention by imaging after living donor liver transplantation CONCLUSION:The biliary anastomosis site angle in MRCP after LDLT may be associated with the need for biliary intervention. Core tip: Biliary complications and interventions are common after living donor liver transplantation (LDLT). Identifying patients who are at high risk for biliary interventions early after LDLT could help clinicians with patient follow-up. Magnetic resonance cholangiopancreatography (MRCP) imaging was performed 1 mo after LDLT to determine risk factors for biliary intervention. The anastomosis site angle, a filling defect in the anastomosis site, and biliary leakage on MRCP were identified as significant risk factors. Moreover, a narrower anastomosis site angle was related to earlier biliary intervention. Here, for the first time, we have shown that the anastomosis site angle might be associated with the need for biliary intervention.

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“…A qualitative study found that the comprehensive evaluation of multiple CT features of the periampullary area could differentiate the histological subtypes, but required optimal duodenal distention and was highly dependent on the expertise of the radiologists[15]. An oval filling defect at the end of the bile duct on magnetic resonance cholangiopancreatography images tended to suggest IPAC but controversy still existed[16,17].…”

Section: Introductionmentioning

confidence: 99%

Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma

Zou

et al. 2019

WJG

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BACKGROUNDFor periampullary adenocarcinoma, the histological subtype is a better prognostic predictor than the site of tumor origin. Intestinal-type periampullary adenocarcinoma (IPAC) is reported to have a better prognosis than the pan-creatobiliary-type periampullary adenocarcinoma (PPAC). However, the classification of histological subtypes is difficult to determine before surgery. Apparent diffusion coefficient (ADC) histogram analysis is a noninvasive, non-enhanced method with high reproducibility that could help differentiate the two subtypes.AIMTo investigate whether volumetric ADC histogram analysis is helpful for distinguishing IPAC from PPAC.METHODSBetween January 2015 and October 2018, 476 consecutive patients who were suspected of having a periampullary tumor and underwent magnetic resonance imaging (MRI) were reviewed in this retrospective study. Only patients who underwent MRI at 3.0 T with different diffusion-weighted images (b-values = 800 and 1000 s/mm2) and who were confirmed with a periampullary adenocarcinoma were further analyzed. Then, the mean, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values and ADCmin, ADCmax, kurtosis, skewness, and entropy were obtained from the volumetric histogram analysis. Comparisons were made by an independent Student's t-test or Mann-Whitney U test. Multiple-class receiver operating characteristic curve analysis was performed to determine and compare the diagnostic value of each significant parameter.RESULTSIn total, 40 patients with histopathologically confirmed IPAC (n = 17) or PPAC (n = 23) were enrolled. The mean, 5th, 25th, 50th, 75th, 90th, and 95th percentiles and ADCmax derived from ADC1000 were significantly lower in the PPAC group than in the IPAC group (P < 0.05). However, values derived from ADC800 showed no significant difference between the two groups. The 75th percentile of ADC1000 values achieved the highest area under the curve (AUC) for differentiating IPAC from PPAC (AUC = 0.781; sensitivity, 91%; specificity, 59%; cut-off value, 1.50 × 10-3 mm2/s).CONCLUSIONVolumetric ADC histogram analysis at a b-value of 1000 s/mm2 might be helpful for differentiating the histological subtypes of periampullary adenocarcinoma before surgery.

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Differential Features of Pancreatobiliary- and Intestinal-type Ampullary Carcinomas at MR Imaging

Cited by 32 publications

References 27 publications

Differentiation of pancreatobiliary-type from intestinal-type periampullary carcinomas using 3.0T MRI

Differentiation of pancreatobiliary-type from intestinal-type periampullary carcinomas using 3.0T MRI

Risk factors of biliary intervention by imaging after living donor liver transplantation

Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma

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