Association of Average Cyst Diameter Versus Single Maximum Diameter of Pancreatic Cysts to Cyst Volume and Impact on Screening Guideline Classification

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2024.12.005

Sara Babapour MD , Abraham F. Bezuidenhout MD , Miriel Handler MD , Clarissa Lee , Alexander Brook PhD , Leo L. Tsai MD, PhD

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引用次数: 0

Abstract

Objective

To compare the association of single maximum diameter and average cyst diameter of pancreatic cysts measured on magnetic resonance cholangiopancreatography (MRCP) with segmented cyst volume and secondarily evaluate the effect of average cyst diameter on screening guideline classification.

Methods

Consecutive patients with pancreatic cysts < 3 cm on MRCP in 2017 were retrospectively identified. The single maximum diameter and perpendicular short axis diameter of pancreatic cysts obtained on coronal MRCP were measured and their average was taken to determine average cyst diameter. Calculated volume approximations based on single maximum diameter and average cyst diameter were compared with segmented cyst volume. Subsequently, patients were classified based on average cyst diameter versus single maximum diameter according to a currently used screening guideline. Intraclass correlation was used to assess interobserver agreement. Williams’s test was used to compare between-group correlation coefficients.

Results

The mean value of single maximum diameters and average cyst diameter of the 86 included cysts were 15.4 ± 7.3 mm and 12.6 ± 6.1 mm, respectively. The mean volume of segmented cysts was 1,521 ± 1,983 mm³. Interreader agreement for measurement of cyst diameters was excellent (r = 0.99). The volume calculated based on the average cyst diameter correlated better to segmented cyst volume (r = 0.88) than single maximum diameter (r = 0.73, P < .0001). Of 86 patients, 24 (28%) were classified to a less stringent follow-up strategy by using average cyst diameter.

Discussion

The average cyst diameter more accurately reflects the segmented cyst volume than a single maximum diameter. Utilization of average cyst diameter in existing screening guidelines reclassified 28% of patients into lower-risk screening groups, which would reduce subsequent surveillance imaging overall.

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胰腺囊肿平均直径与单个最大直径与囊肿体积的关系及其对筛查指南分类的影响

目的比较磁共振胰胆管造影（MRCP）所测胰腺囊肿单次最大直径与平均囊肿直径与分节囊肿体积的关系，并评价平均囊肿直径对分级筛查指南的影响。方法：连续观察胰腺囊肿患者；回顾性鉴定2017年MRCP上的3cm。测量冠状位MRCP上胰腺囊肿的单个最大直径和垂直短轴直径，取其平均值，确定平均囊肿直径。将基于单个最大直径和平均囊肿直径计算的体积近似与分段囊肿体积进行比较。随后，根据目前使用的筛查指南，根据平均囊肿直径和单个最大直径对患者进行分类。类内相关性用于评估观察者之间的一致性。采用Williams检验比较组间相关系数。结果86例囊肿单次最大直径平均值为15.4±7.3 mm，平均囊肿直径为12.6±6.1 mm。分节囊肿的平均体积为1,521±1,983 mm3。对囊肿直径测量的解读一致性很好（r = 0.99）。基于平均囊肿直径计算的体积与分节囊肿体积的相关性（r = 0.88）优于单一最大直径(r = 0.73, P <；。)。在86例患者中，24例（28%）根据平均囊肿直径被分类为不太严格的随访策略。平均囊肿直径比单个最大直径更准确地反映了分节囊肿体积。在现有的筛查指南中，利用平均囊肿直径将28%的患者重新分类为低风险筛查组，这将总体上减少后续的监测成像。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.