Synapse - Preoperative risk prediction for intraductal papillary mucinous neoplasms by quantitative CT image analysis

Preoperative risk prediction for intraductal papillary mucinous neoplasms by quantitative CT image analysis Journal Article

Authors:	Attiyeh, M. A.; Chakraborty, J.; Gazit, L.; Langdon-Embry, L.; Gonen, M.; Balachandran, V. P.; D'Angelica, M. I.; DeMatteo, R. P.; Jarnagin, W. R.; Kingham, T. P.; Allen, P. J.; Do, R. K.; Simpson, A. L.
Article Title:	Preoperative risk prediction for intraductal papillary mucinous neoplasms by quantitative CT image analysis
Abstract:	Background: Intraductal papillary mucinous neoplasms (IPMNs) are radiographically identifiable potential precursor lesions of pancreatic adenocarcinoma. While resection is recommended when main duct dilation is present, management of branch duct IPMN (BD-IPMN) remains controversial. This study sought to evaluate whether preoperative quantitative imaging features of BD-IPMNs could distinguish low-risk disease (low- and intermediate-grade dysplasia) from high-risk disease (high-grade dysplasia and invasive carcinoma). Methods: Patients who underwent resection between 2005 and 2015 with pathologically proven BD-IPMN and a preoperative CT scan were included in the study. Quantitative image features were extracted using texture analysis and a novel quantitative mural nodularity feature developed for the study. Significant features on univariate analysis were combined with clinical variables to build a multivariate prediction model. Results: Within the study group of 103 patients, 76 (74%) had low-risk disease and 27 (26%) had high-risk disease. Quantitative imaging features were prognostic of low-vs. high-risk disease. The model based only on clinical variables achieved an AUC of 0.67 and 0.79 with the addition of quantitative imaging features. Conclusion: Quantitative image analysis of BD-IPMNs is a novel method that may enable risk stratification. External validation may provide a reliable non-invasive prognostic tool for clinicians. © 2018 International Hepato-Pancreato-Biliary Association Inc.
Keywords:	adult; controlled study; aged; middle aged; cancer surgery; major clinical study; area under the curve; patient selection; cancer patient; computer assisted tomography; image analysis; intraductal papillary mucinous tumor; validation study; quantitative analysis; clinical evaluation; surgical risk; cancer classification; human; male; female; article
Journal Title:	HPB
Volume:	21
Issue:	2
ISSN:	1365-182X
Publisher:	Elsevier Science, Inc.
Date Published:	2019-02-01
Start Page:	212
End Page:	218
Language:	English
DOI:	10.1016/j.hpb.2018.07.016
PUBMED:	30097414
PROVIDER:	scopus
PMCID:	PMC6367060
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85051009543&doi=10.1016%2fj.hpb.2018.07.016&partnerID=40&md5=e5c7472f189a070f4e8b6b6ad7ff9ee7
Notes:	Article -- Export Date: 1 April 2019 -- Source: Scopus