Abdominal ultrasound in the characterization of branch-duct intraductal papillary mucinous neoplasms: A new tool for surveillance of low-risk patients?

Echography Follow-up IPMN Trans-abdominal US Worrisome feature

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
01 Dec 2023
Historique:
received: 05 07 2023
revised: 06 10 2023
accepted: 07 11 2023
medline: 3 12 2023
pubmed: 3 12 2023
entrez: 2 12 2023
Statut: aheadofprint

Résumé

Magnetic resonance imaging (MRI) is regarded as gold-standard for intraductal papillary mucinous neoplasms (IPMNs) follow-up. Given the low risk of transformation and the increasing population under surveillance, there is growing interest in identifying optimal follow-up strategies. To evaluate reliability of abdominal ultrasound (US) for characterization of low-risk IPMN, compared to MRI. Prospective monocentric study among 79 consecutive patients with a suspected BD-IPMN on US. Each patient underwent confirmatory MRI. We evaluated Cohen's kappa statistic and concordance rate (CR) between MRI and US. Of 79 suspected IPMNs on US, MRI confirmed 71 BD-IPMNs. There was high agreement for cyst location and number (CR and kappa of 77.5 % and 81.7 % and 0.66±0.08 and 0.62±0.11 respectively). We found high agreement for cyst size (CR=96.5 %, kappa=0.93±0.05) and main pancreatic duct (MPD) dilatation (CR=100 %, kappa=1). There was a good agreement for thickened septa (CR=80.3 %, kappa=0.38±0.12). US seems inferior to MRI for the identification of mural nodules < 5 mm (CR=97.2 %, kappa=0). In a cohort of low-risk BD-IPMN, US presented high agreement rate with MRI regarding location, number, and size. There was a good agreement for MPD dilatation and thickened septa, while US underperform for detection of mural nodules < 5 mm.

Sections du résumé

BACKGROUND BACKGROUND
Magnetic resonance imaging (MRI) is regarded as gold-standard for intraductal papillary mucinous neoplasms (IPMNs) follow-up. Given the low risk of transformation and the increasing population under surveillance, there is growing interest in identifying optimal follow-up strategies.
AIM OBJECTIVE
To evaluate reliability of abdominal ultrasound (US) for characterization of low-risk IPMN, compared to MRI.
METHODS METHODS
Prospective monocentric study among 79 consecutive patients with a suspected BD-IPMN on US. Each patient underwent confirmatory MRI. We evaluated Cohen's kappa statistic and concordance rate (CR) between MRI and US.
RESULTS RESULTS
Of 79 suspected IPMNs on US, MRI confirmed 71 BD-IPMNs. There was high agreement for cyst location and number (CR and kappa of 77.5 % and 81.7 % and 0.66±0.08 and 0.62±0.11 respectively). We found high agreement for cyst size (CR=96.5 %, kappa=0.93±0.05) and main pancreatic duct (MPD) dilatation (CR=100 %, kappa=1). There was a good agreement for thickened septa (CR=80.3 %, kappa=0.38±0.12). US seems inferior to MRI for the identification of mural nodules < 5 mm (CR=97.2 %, kappa=0).
CONCLUSIONS CONCLUSIONS
In a cohort of low-risk BD-IPMN, US presented high agreement rate with MRI regarding location, number, and size. There was a good agreement for MPD dilatation and thickened septa, while US underperform for detection of mural nodules < 5 mm.

Identifiants

pubmed: 38042636
pii: S1590-8658(23)01029-0
doi: 10.1016/j.dld.2023.11.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest Nothing to report.

Auteurs

Marco Ferronato (M)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy. Electronic address: marco.ferronato@studio.unibo.it.

Chiara Elide Lizzio (CE)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Dante Berardinelli (D)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Desy Marini (D)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Eleonora Elia (E)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Lorenzo Andreetto (L)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Alice Trentini (A)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Maria Chiara Potenza (MC)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Carla Serra (C)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Interventional Utrasound Unit, Italy.

Elena Mazzotta (E)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Claudio Ricci (C)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Pancreas and Endocrine Surgery Unit, Italy.

Riccardo Casadei (R)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Pancreas and Endocrine Surgery Unit, Italy.

Marina Migliori (M)

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Internal Medicine Unit, Italy.

Classifications MeSH