A comparative study between computed tomography and endoscopic ultrasound in the detection of a mural nodule in intraductal papillary mucinous neoplasm -Multicenter observational study in Japan.


Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 20 12 2022
revised: 20 04 2023
accepted: 22 05 2023
medline: 1 12 2023
pubmed: 8 6 2023
entrez: 7 6 2023
Statut: ppublish

Résumé

The detection of malignancy is a major concern in the management of intraductal papillary mucinous neoplasm (IPMN). The height of the mural nodule (MN), estimated using endoscopic ultrasound (EUS) and computed tomography (CT), has been considered crucial for predicting malignant IPMN. Currently, whether surveillance using CT or EUS alone is sufficient for detecting MNs remains unclear. This study aimed to compare the ability of CT and EUS to detect MNs in IPMN. This multicenter, retrospective observational study was conducted in 11 Japanese tertiary institutions. Patients who underwent surgical resection of IPMN with MN after CT and EUS examinations were eligible to participate. The MN detection rates between CT and EUS were examined. Two-hundred-and-forty patients who underwent preoperative EUS and CT had pathologically confirmed MNs. The MN detection rates of EUS and CT were 83% and 53%, respectively (p < 0.001). Additionally, the MN detection rate of EUS was significantly higher than that of CT regardless of morphological type (76% vs. 47% in branch-duct-type IPMN; 90% vs. 54% in mixed IPMN; 98% vs. 56% in main-duct-type IPMN; p < 0.001). Further, pathologically confirmed MNs ≥5 mm were more frequently observed on EUS than on CT (95% vs. 76%, p < 0.001). EUS was superior to CT for the detection of MN in IPMN. EUS surveillance is essential for the detection of MNs.

Sections du résumé

BACKGROUND/OBJECTIVES OBJECTIVE
The detection of malignancy is a major concern in the management of intraductal papillary mucinous neoplasm (IPMN). The height of the mural nodule (MN), estimated using endoscopic ultrasound (EUS) and computed tomography (CT), has been considered crucial for predicting malignant IPMN. Currently, whether surveillance using CT or EUS alone is sufficient for detecting MNs remains unclear. This study aimed to compare the ability of CT and EUS to detect MNs in IPMN.
METHODS METHODS
This multicenter, retrospective observational study was conducted in 11 Japanese tertiary institutions. Patients who underwent surgical resection of IPMN with MN after CT and EUS examinations were eligible to participate. The MN detection rates between CT and EUS were examined.
RESULTS RESULTS
Two-hundred-and-forty patients who underwent preoperative EUS and CT had pathologically confirmed MNs. The MN detection rates of EUS and CT were 83% and 53%, respectively (p < 0.001). Additionally, the MN detection rate of EUS was significantly higher than that of CT regardless of morphological type (76% vs. 47% in branch-duct-type IPMN; 90% vs. 54% in mixed IPMN; 98% vs. 56% in main-duct-type IPMN; p < 0.001). Further, pathologically confirmed MNs ≥5 mm were more frequently observed on EUS than on CT (95% vs. 76%, p < 0.001).
CONCLUSIONS CONCLUSIONS
EUS was superior to CT for the detection of MN in IPMN. EUS surveillance is essential for the detection of MNs.

Identifiants

pubmed: 37286439
pii: S1424-3903(23)00147-3
doi: 10.1016/j.pan.2023.05.010
pii:
doi:

Types de publication

Observational Study Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

550-555

Informations de copyright

Copyright © 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no conflicts of interests.

Auteurs

Toshifumi Kin (T)

Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan. Electronic address: kin_toshifumi@yahoo.co.jp.

Yasuhiro Shimizu (Y)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

Susumu Hijioka (S)

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Kazuo Hara (K)

Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.

Akio Katanuma (A)

Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan.

Masafumi Nakamura (M)

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Reiko Yamada (R)

Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan.

Takao Itoi (T)

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Toshiharu Ueki (T)

Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.

Atsushi Masamune (A)

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Seiko Hirono (S)

Department of Hepato-Biliary-Pancreatic Surgery, Hyogo College of Medicine, Nishinomiya, Japan; Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan.

Shinsuke Koshita (S)

Department of Gastroenterology, Sendai City Medical Center Sendai Open Hospital, Sendai, Japan.

Keiji Hanada (K)

Department of Gastroenterology, JA Onomichi General Hospital, Hiroshima, Japan.

Ken Kamata (K)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osakasayama, Japan.

Akio Yanagisawa (A)

Department of Pathology and Laboratory Medicine, Kyoto First Red Cross Hospital, Kyoto, Japan.

Yoshifumi Takeyama (Y)

Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Japan.

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