Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma
Abstract Intraductal tubulopapillary neoplasms (ITPN) are rare pancreatic tumors (< 1% of exocrine neoplasms) and are considered to have better prognosis than classical pancreatic ductal adenocarcinoma (PDAC). The present study aimed to evaluate imaging features of ITPN in computed tomography (CT...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-09-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-19517-6 |
| _version_ | 1798036297345925120 |
|---|---|
| author | Ekaterina Khristenko Thomas Hank Matthias M. Gaida Hans-Ulrich Kauczor Thilo Hackert Miriam Klauß Philipp Mayer |
| author_facet | Ekaterina Khristenko Thomas Hank Matthias M. Gaida Hans-Ulrich Kauczor Thilo Hackert Miriam Klauß Philipp Mayer |
| author_sort | Ekaterina Khristenko |
| collection | DOAJ |
| description | Abstract Intraductal tubulopapillary neoplasms (ITPN) are rare pancreatic tumors (< 1% of exocrine neoplasms) and are considered to have better prognosis than classical pancreatic ductal adenocarcinoma (PDAC). The present study aimed to evaluate imaging features of ITPN in computed tomography (CT) and magnetic resonance (MR) imaging. We performed monocentric retrospective analysis of 14 patients with histopathologically verified ITPN, operated in 2003–2018. Images were available for 12 patients and were analysed independently by two radiologists, blinded to reports. Imaging features were compared to a matched control group consisting of 43 patients with PDAC, matched for sex and age. Histopathologic analysis showed invasive carcinoma component in all ITPN patients. CT-attenuation values of ITPN were higher in arterial and venous phases (62.3 ± 14.6 HU and 68 ± 15.6 HU) than in unenhanced phase (39.2 ± 7.9 HU), compatible with solid lesion enhancement. Compared to PDAC, ITPN lesions had significantly higher HU-values in both arterial and venous phases (arterial and venous phases, p < 0.001). ITPN were significantly larger than PDAC (4.1 ± 2.0 cm versus 2.6 ± 0.84 cm, p = 0.021). ITPN lesions were more often well-circumscribed (p < 0.002). Employing a multiple logistic regression analysis with forward stepwise method, higher HU density in the arterial phase (p = 0.012) and well-circumscribed lesion margins (p = 0.047) were found to be significant predictors of ITPN versus PDAC. Our study identified key imaging features for differentiation of ITPN and PDAC. Isodensity or moderate hypodensity and well-circumscribed margins favor the diagnosis of ITPN over PDAC. Being familiar with CT-features of these rare pancreatic tumors is essential for radiologists to accelerate the diagnosis and narrow the differentials. |
| first_indexed | 2024-04-11T21:10:58Z |
| format | Article |
| id | doaj.art-34632872fa934f0f93cc15f327eab27e |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T21:10:58Z |
| publishDate | 2022-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-34632872fa934f0f93cc15f327eab27e2022-12-22T04:03:03ZengNature PortfolioScientific Reports2045-23222022-09-0112111010.1038/s41598-022-19517-6Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinomaEkaterina Khristenko0Thomas Hank1Matthias M. Gaida2Hans-Ulrich Kauczor3Thilo Hackert4Miriam Klauß5Philipp Mayer6Clinic for Diagnostic and Interventional Radiology, Heidelberg University HospitalDivision of Visceral Surgery, Department of General Surgery, Medical University of ViennaInstitute of Pathology, University Medical Center Mainz, JGU-MainzClinic for Diagnostic and Interventional Radiology, Heidelberg University HospitalDepartment of General, Visceral, and Transplantation Surgery, Heidelberg University HospitalClinic for Diagnostic and Interventional Radiology, Heidelberg University HospitalClinic for Diagnostic and Interventional Radiology, Heidelberg University HospitalAbstract Intraductal tubulopapillary neoplasms (ITPN) are rare pancreatic tumors (< 1% of exocrine neoplasms) and are considered to have better prognosis than classical pancreatic ductal adenocarcinoma (PDAC). The present study aimed to evaluate imaging features of ITPN in computed tomography (CT) and magnetic resonance (MR) imaging. We performed monocentric retrospective analysis of 14 patients with histopathologically verified ITPN, operated in 2003–2018. Images were available for 12 patients and were analysed independently by two radiologists, blinded to reports. Imaging features were compared to a matched control group consisting of 43 patients with PDAC, matched for sex and age. Histopathologic analysis showed invasive carcinoma component in all ITPN patients. CT-attenuation values of ITPN were higher in arterial and venous phases (62.3 ± 14.6 HU and 68 ± 15.6 HU) than in unenhanced phase (39.2 ± 7.9 HU), compatible with solid lesion enhancement. Compared to PDAC, ITPN lesions had significantly higher HU-values in both arterial and venous phases (arterial and venous phases, p < 0.001). ITPN were significantly larger than PDAC (4.1 ± 2.0 cm versus 2.6 ± 0.84 cm, p = 0.021). ITPN lesions were more often well-circumscribed (p < 0.002). Employing a multiple logistic regression analysis with forward stepwise method, higher HU density in the arterial phase (p = 0.012) and well-circumscribed lesion margins (p = 0.047) were found to be significant predictors of ITPN versus PDAC. Our study identified key imaging features for differentiation of ITPN and PDAC. Isodensity or moderate hypodensity and well-circumscribed margins favor the diagnosis of ITPN over PDAC. Being familiar with CT-features of these rare pancreatic tumors is essential for radiologists to accelerate the diagnosis and narrow the differentials.https://doi.org/10.1038/s41598-022-19517-6 |
| spellingShingle | Ekaterina Khristenko Thomas Hank Matthias M. Gaida Hans-Ulrich Kauczor Thilo Hackert Miriam Klauß Philipp Mayer Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma Scientific Reports |
| title | Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma |
| title_full | Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma |
| title_fullStr | Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma |
| title_full_unstemmed | Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma |
| title_short | Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma |
| title_sort | imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma |
| url | https://doi.org/10.1038/s41598-022-19517-6 |
| work_keys_str_mv | AT ekaterinakhristenko imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma AT thomashank imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma AT matthiasmgaida imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma AT hansulrichkauczor imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma AT thilohackert imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma AT miriamklauß imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma AT philippmayer imagingfeaturesofintraductaltubulopapillaryneoplasmofthepancreasanditsdifferentiationfromconventionalpancreaticductaladenocarcinoma |