Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography
Shuai Ren,1 Xiao Chen,1 Wenjing Cui,1 Rong Chen,2 Kai Guo,1 Huifeng Zhang,1 Shuai Chen,1 Zhongqiu Wang11Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province 210029, People’s Republic of China; 2Department of Diagnostic Radiol...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-08-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/differentiation-of-chronic-mass-forming-pancreatitis-from-pancreatic-d-peer-reviewed-article-CMAR |
| _version_ | 1819195233488863232 |
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| author | Ren S Chen X Cui W Chen R Guo K Zhang H Chen S Wang Z |
| author_facet | Ren S Chen X Cui W Chen R Guo K Zhang H Chen S Wang Z |
| author_sort | Ren S |
| collection | DOAJ |
| description | Shuai Ren,1 Xiao Chen,1 Wenjing Cui,1 Rong Chen,2 Kai Guo,1 Huifeng Zhang,1 Shuai Chen,1 Zhongqiu Wang11Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province 210029, People’s Republic of China; 2Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USACorrespondence: Zhongqiu WangDepartment of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing, Jiangsu Province 210029, People’s Republic of ChinaTel +86 258 086 1278Email zhqwang001@126.comPurpose: Both chronic mass-forming pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) are focal pancreatic lesions and share very similar clinical symptoms and imaging performance. There is great clinical value in preoperative differentiation of those two lesions. The purpose of this study was to investigate the value of computed tomography (CT) features in discriminating CMFP from PDAC.Patients and methods: Forty-seven patients with pathologically confirmed PDAC and 21 patients with CMFP were included in this study. Demographic and CT features, including tumor location, size, margin, pancreatic or bile duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, and tumor contrast enhancement, were retrospectively analyzed and compared. Multivariate logistic regression analyses were adopted to identify relevant CT imaging features to discriminate CMFP from PDAC.Results: There were significant differences between CMFP and PDAC with respect to main pancreatic duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, and tumor contrast enhancement. Delayed contrast enhancement (>70.5 Hounsfield units) showed high sensitivity and specificity of 84.2% and 84.7%. The areas under the curve (AUCs) of the predicting models based on qualitative and quantitative variables were 0.770 (95% CI: 0.660–0.880) and 0.943 (95% CI: 0.888–0.999), respectively. When all significant variables were used in combination to build a predicting model, the AUC was 0.969 (95% CI: 0.930–1.000) with 84.2% sensitivity and 94.7% specificity.Conclusion: Main pancreatic duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, tumor size, and tumor contrast enhancement were shown to be useful CT imaging features in discriminating CMFP from PDAC.Keywords: pancreas, adenocarcinoma, pancreatitis, computed tomography
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| first_indexed | 2024-12-23T02:09:30Z |
| format | Article |
| id | doaj.art-0c47898dfca1411eab1390117c40106a |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-23T02:09:30Z |
| publishDate | 2019-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-0c47898dfca1411eab1390117c40106a2022-12-21T18:03:49ZengDove Medical PressCancer Management and Research1179-13222019-08-01Volume 117857786647970Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomographyRen SChen XCui WChen RGuo KZhang HChen SWang ZShuai Ren,1 Xiao Chen,1 Wenjing Cui,1 Rong Chen,2 Kai Guo,1 Huifeng Zhang,1 Shuai Chen,1 Zhongqiu Wang11Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province 210029, People’s Republic of China; 2Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USACorrespondence: Zhongqiu WangDepartment of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing, Jiangsu Province 210029, People’s Republic of ChinaTel +86 258 086 1278Email zhqwang001@126.comPurpose: Both chronic mass-forming pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) are focal pancreatic lesions and share very similar clinical symptoms and imaging performance. There is great clinical value in preoperative differentiation of those two lesions. The purpose of this study was to investigate the value of computed tomography (CT) features in discriminating CMFP from PDAC.Patients and methods: Forty-seven patients with pathologically confirmed PDAC and 21 patients with CMFP were included in this study. Demographic and CT features, including tumor location, size, margin, pancreatic or bile duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, and tumor contrast enhancement, were retrospectively analyzed and compared. Multivariate logistic regression analyses were adopted to identify relevant CT imaging features to discriminate CMFP from PDAC.Results: There were significant differences between CMFP and PDAC with respect to main pancreatic duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, and tumor contrast enhancement. Delayed contrast enhancement (>70.5 Hounsfield units) showed high sensitivity and specificity of 84.2% and 84.7%. The areas under the curve (AUCs) of the predicting models based on qualitative and quantitative variables were 0.770 (95% CI: 0.660–0.880) and 0.943 (95% CI: 0.888–0.999), respectively. When all significant variables were used in combination to build a predicting model, the AUC was 0.969 (95% CI: 0.930–1.000) with 84.2% sensitivity and 94.7% specificity.Conclusion: Main pancreatic duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, tumor size, and tumor contrast enhancement were shown to be useful CT imaging features in discriminating CMFP from PDAC.Keywords: pancreas, adenocarcinoma, pancreatitis, computed tomography https://www.dovepress.com/differentiation-of-chronic-mass-forming-pancreatitis-from-pancreatic-d-peer-reviewed-article-CMARPancreasAdenocarcinomaPancreatitisComputed Tomography |
| spellingShingle | Ren S Chen X Cui W Chen R Guo K Zhang H Chen S Wang Z Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography Cancer Management and Research Pancreas Adenocarcinoma Pancreatitis Computed Tomography |
| title | Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography |
| title_full | Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography |
| title_fullStr | Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography |
| title_full_unstemmed | Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography |
| title_short | Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography |
| title_sort | differentiation of chronic mass forming pancreatitis from pancreatic ductal adenocarcinoma using contrast enhanced computed tomography |
| topic | Pancreas Adenocarcinoma Pancreatitis Computed Tomography |
| url | https://www.dovepress.com/differentiation-of-chronic-mass-forming-pancreatitis-from-pancreatic-d-peer-reviewed-article-CMAR |
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