Radiological Evaluation of Focal Pancreatic Lesions

Putzer, Daniel; Jaschke, Werner

doi:10.1159/000366045

Cited by 11 publications

(5 citation statements)

References 21 publications

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“…Clinically, it is usually used as a second-line diagnostic method. However, CT has become the preferred method for scanning pancreas due to its high popularity rate and relatively low cost ( 1 ). Therefore, the choice of CT rather than EUS features made the model more convenient and practical during clinical work especially for primary health care institutions without the technology of EUS-FNA.…”

Section: Discussionmentioning

confidence: 99%

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Development and validation of a clinical prediction model to estimate the probability of malignancy in solid pancreatic lesions and explore its value in the atypical diagnostic category after endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA)

Wei¹,

Shi²,

Ting³

2020

Transl Cancer Res TCR

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Background: The diagnosis of solid pancreatic lesions is still a thorny problem for clinicians, even endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) still face problems like false negative. The present study aimed to first establish a model to predict the malignancy in solid pancreatic lesions and then explored its validity with atypical diagnostic category diagnosed by cytologists after EUS-FNA.Methods: Clinical information of 360 cases diagnosed with solid pancreatic lesions between June 2013 and July 2019, and another 20 cases with atypical diagnostic category were collected retrospectively. These cases were divided into group A and group B according to the order of admission. Using the data of group A, multivariate logistic regression analysis was performed to construct a malignancy prediction model which was then verified using group B. Furthermore, the characteristics of the malignancy between the group with atypical diagnostic category and group A were compared in order to evaluate the rationality of the model used in the atypical diagnostic category group, and its predictive ability in these lesions.Results: Multivariate logistic regression analysis revealed that age, density, CA19-9 and carcinoembryonic antigen (CEA) grade, pancreatic duct, swollen lymph nodes, pancreas calcification, and weight loss were independent factors in predicting malignancy (P<0.05). The verification results showed that the area under the receiver operating characteristic (ROC) curve was 0.854±0.042; 95% CI: 0.771-0.936. Univariate analysis showed no significant difference between the malignancy in atypical diagnostic category group and that in group A. For the atypical diagnostic category group, the sensitivity of this model was 83.33%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 40%.Conclusions: Advanced age, low density of lesions, high CA19-9 and CEA grade, dilatation of pancreatic duct, swollen lymph nodes and weight loss were risk factors for malignancy, while calcification was a protective factor. The model had a relatively high predictive ability on malignancy in both solid pancreatic lesions and atypical diagnostic category group.

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Section: Discussionmentioning

confidence: 99%

“…According to the imaging features, the pancreatic mass can be divided into solid and cystic lesions ( 1 ). During the solid lesions, malignant are more common (67.3%) ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a clinical prediction model to estimate the probability of malignancy in solid pancreatic lesions and explore its value in the atypical diagnostic category after endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA)

Wei¹,

Shi²,

Ting³

2020

Transl Cancer Res TCR

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“…Going even further, it could even be envisaged a scenario where patients with suspicious findings on A-MRI could directly undergo chest CT and abdominal MRI with gadoxetate disodium (Gd-EOB-DTPA) or gadobenate dimeglumine (Gd-BOPTA). This would ensure a complete contrast-enhanced imaging assessment of both the pancreatic cystic lesion and the liver parenchyma, as well as provide the opportunity to stage the disease simultaneously [ 101 , 102 , 103 ] ( Figure 1 ). Thereby, the contrast administration would be reserved only for those patients for whom it would actually provide additional useful information.…”

Section: Proposal For a New Algorithmmentioning

confidence: 99%

Towards a Simplified and Cost-Effective Diagnostic Algorithm for the Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Can We Save Contrast for Later?

Brandi,

Renzulli

2024

Cancers

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The increased detection of pancreatic cysts in recent years has triggered extensive diagnostic investigations to clarify their potential risk of malignancy, resulting in a large number of patients undergoing numerous imaging follow-up studies for many years. Therefore, there is a growing need for optimization of the current surveillance protocol to reduce both healthcare costs and waiting lists, while still maintaining appropriate sensibility and specificity. Imaging is an essential tool for evaluating patients with intraductal papillary mucinous neoplasms (IPMNs) since it can assess several predictors for malignancy and thus guide further management recommendations. Although contrast-enhanced magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) has been widely recommended by most international guidelines, recent results support the use of unenhanced abbreviated-MRI (A-MRI) protocols as a surveillance tool in patients with IPMN. In fact, A-MRI has shown high diagnostic performance in malignant detection, with high sensitivity and specificity as well as excellent interobserver agreement. The aim of this paper is, therefore, to discuss the current available evidence on whether the implementation of an abbreviated-MRI (A-MRI) protocol for cystic pancreatic lesion surveillance could improve healthcare economics and reduce waiting lists in clinical practice without significantly reducing diagnostic accuracy.

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“…After injection of contrast agent, the tumor showed low levels of enhanced signal shadow in the arterial phase, portal vein phase and delayed phase (5). MRI can provide better anatomical detail than non-enhanced CT commonly used in PET-CT (6). CT-or EUS-guided fine needle aspiration (FNA) is also effective and accurate method for tumor diagnosis.…”

Section: Puc-ogc Has No Specific Tumor Markers or Imaging Characteris...mentioning

confidence: 99%

Case report: Pathological and genetic features of pancreatic undifferentiated carcinoma with osteoclast-like giant cells

Zhao¹,

Mei²,

Ye³

et al. 2023

Pathol. Oncol. Res.

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Objectives: Pancreatic undifferentiated carcinoma accounts for 2%–7% of pancreatic carcinomas. We aimed to investigate the pathological and genetic characteristics of pancreatic undifferentiated carcinoma with osteoclast-like giant cells and the key points of treatment.Methods: The clinical data and follow-up results of four patients diagnosed with pancreatic undifferentiated carcinoma with osteoclast-like giant cells between May 2015 and May 2020 at the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively analyzed.Results: Chief complaints included “pain and discomfort in the upper abdomen” (2/4), “nausea and vomiting” (1/4) or no symptoms (1/4). Preoperative mildly elevated tumor markers included carcinoembryonic antigen (1/4) and CA19-9 (1/4). The tumors were located in the tail of the pancreas in three patients and the head and neck in one patient. Tumor metastasis was found in pancreatic adipose tissue in two patients and lymph node metastasis in one patient, with microscopic heterogeneous mononuclear cells and scattered osteoclast-like giant cells of various sizes. One patient (1/4) had a mucinous cystic tumor of the pancreas, and two patients (2/4) had adenocarcinoma of the pancreatic duct. Only one patient received postoperative gemcitabine combined with albumin-bound paclitaxel chemotherapy.Conclusion: Currently, treatment guidelines are lacking for PUC-OGC, and prognosis varies markedly. More cases must be reported to clarify its origination. The long-term follow-up of diagnosed patients and genetic mutation testing can also contribute to improving treatment and prognosis of this disease.

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Radiological Evaluation of Focal Pancreatic Lesions

Cited by 11 publications

References 21 publications

Development and validation of a clinical prediction model to estimate the probability of malignancy in solid pancreatic lesions and explore its value in the atypical diagnostic category after endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA)

Development and validation of a clinical prediction model to estimate the probability of malignancy in solid pancreatic lesions and explore its value in the atypical diagnostic category after endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA)

Towards a Simplified and Cost-Effective Diagnostic Algorithm for the Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Can We Save Contrast for Later?

Case report: Pathological and genetic features of pancreatic undifferentiated carcinoma with osteoclast-like giant cells

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