European journal of radiology · 2025
Imaging-based surveillance in patients with initially detected pancreatic cystic lesions.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Park Hyo Jung, Kim Sehee, Choi Sang Hyun, Kim Jin Hee, Lee Seung Soo, Kim Hyoung Jung, Byun Jae Ho
Аннотация
PURPOSE: To determine the long-term outcomes of pancreatic cystic lesions (PCLs) undergoing surveillance, and evaluate the associations between imaging monitoring plans and detection of malignant progression.
METHODS: This retrospective observational study included patients with incidentally detected PCLs (0.5-4.0 cm) on MRI between January 2015 and December 2016. Imaging modalities, time intervals, cumulative number of imaging examinations, and occurrence of malignant progression were recorded. The impact of cumulative CT/MRI examinations on detection of malignant progression at 1, 2, and 3-years was assessed using Cox-regression analyses.
RESULTS: A total of 911 patients (mean age, 68.8-years; 445 with intraductal papillary mucinous neoplasm [IPMN]) underwent an average of five examinations during follow-up (median, 45.0-months). All 20 cases of malignant progression occurred in patients with IPMN, increasing steadily over the maximum 9-year follow-up. The cumulative number of MRI examinations was significantly associated with detection of malignant progression at 1-year (hazard ratio [HR] = 1.40; P = 0.035), and 2-year (HR = 1.38; P = 0.047) landmark points, while CT showed no such association. The cumulative number of MRI examinations was associated with malignant progression at both 1-year (HR = 1.63; P = 0.007) and 2-year (HR = 1.59; P = 0.013) landmark points in 350 patients with IPMN without worrisome features, but not in 95 patients with IPMN with worrisome features.
CONCLUSION: Imaging surveillance of incidentally detected PCLs for detecting malignant progression should prioritize IPMNs. MRI-based surveillance would be beneficial in the initial 2-years, especially for patients with IPMN lacking worrisome features.
METHODS: This retrospective observational study included patients with incidentally detected PCLs (0.5-4.0 cm) on MRI between January 2015 and December 2016. Imaging modalities, time intervals, cumulative number of imaging examinations, and occurrence of malignant progression were recorded. The impact of cumulative CT/MRI examinations on detection of malignant progression at 1, 2, and 3-years was assessed using Cox-regression analyses.
RESULTS: A total of 911 patients (mean age, 68.8-years; 445 with intraductal papillary mucinous neoplasm [IPMN]) underwent an average of five examinations during follow-up (median, 45.0-months). All 20 cases of malignant progression occurred in patients with IPMN, increasing steadily over the maximum 9-year follow-up. The cumulative number of MRI examinations was significantly associated with detection of malignant progression at 1-year (hazard ratio [HR] = 1.40; P = 0.035), and 2-year (HR = 1.38; P = 0.047) landmark points, while CT showed no such association. The cumulative number of MRI examinations was associated with malignant progression at both 1-year (HR = 1.63; P = 0.007) and 2-year (HR = 1.59; P = 0.013) landmark points in 350 patients with IPMN without worrisome features, but not in 95 patients with IPMN with worrisome features.
CONCLUSION: Imaging surveillance of incidentally detected PCLs for detecting malignant progression should prioritize IPMNs. MRI-based surveillance would be beneficial in the initial 2-years, especially for patients with IPMN lacking worrisome features.