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:
Notes: Article -- Export Date: 1 April 2019 -- Source: Scopus
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MSK Authors
  1. Ronald P DeMatteo
    602 DeMatteo
  2. Mithat Gonen
    716 Gonen
  3. Peter Allen
    442 Allen
  4. William R Jarnagin
    596 Jarnagin
  5. Kinh Gian Do
    116 Do
  6. T Peter Kingham
    293 Kingham
  7. Amber L Simpson
    52 Simpson
  8. Marc   Attiyeh
    23 Attiyeh
  9. Lior Gazit
    6 Gazit