Abdominal Radiology最新文献

{"title":"Differentiation of intrapancreatic accessory spleen from pancreatic neuroendocrine tumor using MRI R2.","authors":"Jun Gu Kang, Jae Hyon Park, Mi-Suk Park, Kyunghwa Han, Hee Seung Lee, Hyun Kyung Yang","doi":"10.1007/s00261-024-04758-y","DOIUrl":"10.1007/s00261-024-04758-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of R2* in distinguishing intrapancreatic accessory spleens (IPASs) from pancreatic neuroendocrine tumors (PNETs).</p><p><strong>Methods: </strong>Two radiologists (R1 and R2) retrospectively reviewed the MRIs of 20 IPAS and 20 PNET patients. IPASs were diagnosed with uptake on 99mTc labeled heat-damaged red blood cell scintigraphy or characteristic findings on CT/MRI and ≥ 12 month-long-stability. PNETs were histopathologically diagnosed with resection. Using McNemar test, sensitivities and specificities of the diagnostic criterion based on R2* mass-to-spleen ratio (MSR) were compared with those of the other criteria using contrast-enhanced (CE) MRI and apparent diffusion coefficient (ADC) MSR.</p><p><strong>Results: </strong>The study included 40 patients (median age, 54; interquartile range, 43-65; 24 men, 16 women). IPASs exhibited spleen-isointensity on T2WI, late arterial and portal phases, and diffusion-weighted images more frequently than PNETs (p <.05). ADC MSRs were lower (p <.001) and R2* MSRs were higher (p <.001) in IPASs compared to PNETs. For R1, sensitivity and specificity were 45.0% and 100.0% for criterion 1 (spleen-isointensity on CE-MRI); 45.0% and 85.0% for criterion 2 (ADC MSR ≤ 1.08); 90.0% and 95.0% for criterion 3 (0.9 ≤ R2* MSR ≤ 1.7). For R2, 75.0% and 100.0%; 45.0% and 90.0%; 90.0% and 100.0%. Criterion 3 showed higher sensitivity than criterion 1 for R1 (p =.004), and criterion 2 for R1 and R2 (p =.012). There was no difference in specificity.</p><p><strong>Conclusion: </strong>For differentiating IPAS from PNET, R2* showed higher sensitivity than, and similar specificity to CE-MRI and ADC.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3674-3684"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion-based grading system using clinicopathological and MRI features for predicting positive surgical margins in prostate cancer.","authors":"Honghao Xu, Di Chen, Yuanhao Ma, Xueyi Ning, Xu Bai, Baichuan Liu, Xiaohui Ding, Yun Zhang, Zhe Dong, Mengqiu Cui, Xiaojing Zhang, Aitao Guo, Xuetao Mu, Huiyi Ye, Baojun Wang, Haiyi Wang","doi":"10.1007/s00261-025-04808-z","DOIUrl":"10.1007/s00261-025-04808-z","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate a lesion-based grading system using clinicopathological and MRI features for predicting positive surgical margin (PSM) following robotic-assisted laparoscopic prostatectomy (RALP) among prostate cancer (PCa) patients.</p><p><strong>Methods: </strong>Consecutive MRI examinations of patients undergoing RALP for PCa were retrospectively collected from two medical institutions. Patients from center 1 undergoing RALP between January 2020 and December 2021 were included in the derivation cohort and those between January 2022 and December 2022 were allocated to the validation cohort. Patients from center 2 were assigned to the test cohort. PSM associated imaging and clinicopathological predictors were assessed. A grading system was developed through fixed effect logistic regression and classification and regression tree analysis. The area under the curve (AUC), sensitivity and specificity were calculated and compared by Delong test and McNemar test.</p><p><strong>Results: </strong>A total 489 lesions from 396 patients were included and 82 (29.1%), 32 (35.6%) and 42 (35.9%) of lesions were observed PSM after RALP in the derivation, validation and test cohorts, respectively. The grading system comprised tumor morphology, tumor location, anatomical feature and clinical risk stratification. The grading system demonstrated good prediction performance for PSM in the derivation (AUC 0.82 [95% CI: 0.77, 0.86]), validation (AUC 0.76 [95% CI: 0.66, 0.85]) and test (AUC 0.81 [95% CI: 0.72, 0.88]) cohorts. When compared with Park's model (AUC: 0.73 [95% CI: 0.64, 0.81]) in the test cohort, our grading system demonstrated significantly higher AUC and specificity (P < 0.05).</p><p><strong>Conclusion: </strong>The lesion-based grading system can assess the likelihood of PSM after RALP, assisting surgeons in minimizing the occurrence rate of PSM while optimizing functional preservation.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3836-3846"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic sub-segmentectomy with single-session combined transcatheter arterial embolization/microwave ablation for the treatment of hepatocellular carcinoma: preliminary results.","authors":"Silvio Romano, Ezio Lanza, Angela Ammirabile, Giuseppe Ferrillo, Elisavietta Tenuta, Dario Poretti, Marco Francone, Roberto Ceriani, Alessio Aghemo, Guido Torzilli, Vittorio Pedicini","doi":"10.1007/s00261-024-04784-w","DOIUrl":"10.1007/s00261-024-04784-w","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study aimed to confirm the safety and long-term efficacy of a single-session combined treatment approach with transcatheter arterial embolization (TAE) and microwave ablation (MWA) for inoperable small-to intermediate-sized hepatocellular carcinomas (HCC), focusing on their combined benefits for improving local control.</p><p><strong>Materials and methods: </strong>All consecutive patients with up to 2 small-to-intermediate HCC lesions (≤ 5 cm) treated with a combined single-session MWA-TAE approach were enrolled between April 2020 and October 2023. All procedures were performed in two stages: TAE and MWA. Clinical and radiological follow-up was performed 3, 6, and 12 months after treatment.</p><p><strong>Results: </strong>In the 21 enrolled patients (15 males, mean age 75.9 years), post-procedural contrast-enhanced CT scans confirmed a satisfactory ablation zone in all patients (100%), with minor peri-procedural complications reported in three patients (14%). At the last 12-month follow-up, one patient (8%) displayed local tumor progression, previously classified as LR-TR equivocal at the 6-month follow-up, and half of the patients (6 patients, 50%) exhibited distant tumor progression, predominantly in the form of intra-hepatic recurrence.</p><p><strong>Conclusion: </strong>The combined approach of TAE and MWA is a promising method to enhance the percutaneous treatment of small to intermediate-sized HCCs with a resulting anatomic ablation area resembling a surgical sub-segmentectomy. This technique can potentially reduce the gap between percutaneous treatment and liver resection outcomes, allowing for a safe and effective option for oncological control in patients with > 3 cm lesions.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3543-3552"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying abdominal aortic aneurysm size and presence using Natural Language Processing of radiology reports: a systematic review and meta-analysis.","authors":"Seyed Mohammad Sajjadi, Alisa Mohebbi, Amirhossein Ehsani, Amir Marashi, Aida Azhdarimoghaddam, Shaghayegh Karami, Mohammad Amin Karimi, Mahsa Sadeghi, Kiana Firoozi, Amir Mohammad Zamani, Amirhossein Rigi, Melika Nayebagha, Mahsa Asadi Anar, Pooya Eini, Sadaf Salehi, Mahsa Rostami Ghezeljeh","doi":"10.1007/s00261-025-04810-5","DOIUrl":"10.1007/s00261-025-04810-5","url":null,"abstract":"<p><strong>Background and aim: </strong>Prior investigations of the natural history of abdominal aortic aneurysms (AAAs) have been constrained by small sample sizes or uneven assessments of aggregated data. Natural language processing (NLP) can significantly enhance the investigation and treatment of patients with AAAs by swiftly and effectively collecting imaging data from health records. This meta-analysis aimed to evaluate the efficacy of NLP techniques in reliably identifying the existence or absence of AAAs and measuring the maximal abdominal aortic diameter in extensive datasets of radiology study reports.</p><p><strong>Method: </strong>The PubMed, Scopus, Web of Science, Embase, and Science Direct databases were searched until March 2024 to obtain pertinent papers. The RAYYAN intelligent tool for systematic reviews was utilized to screen the studies. The meta-analysis was conducted using STATA v18 software. Egger's test was employed to evaluate publication bias. The Newcastle Ottawa Scale was employed to assess the quality of the listed studies. A plot digitizer was employed to extract digital data.</p><p><strong>Result: </strong>A total of 39,094 individuals with AAA were included in this analysis. Twenty-seven thousand three hundred twenty-six patients were male, and 11,383 were female. The mean age of the total participants was 73.1 ± 1.25 years. Analysis results for pooled estimation of performance variables such as: The sensitivity, specificity, precision, and accuracy of the implemented NLP model were analyzed as follows: 0.89(0.88-0.91), 0.88 (0.87-0.89), 0.92 (0.89-0.95), and 0.91 (0.89-0.93) respectively. The aneurysm diameter size difference reported in follow-up before and after NLP implementation in the included studies showed a 0.05 cm reduction in size, which was statistically significant.</p><p><strong>Conclusion: </strong>NLP holds great potential for automating the detection of AAA size and presence in radiology reports, enhancing efficiency and scalability over manual review. However, challenges persist. Variability in report formats, terminology, and unstructured data can compromise accuracy. Additionally, NLP models rely on high-quality, annotated training datasets, which may be incomplete or unrepresentative. While NLP aids in identifying AAA-related data, human oversight is essential to ensure decisions are informed by the patient's broader clinical context. Ongoing algorithm refinement and seamless integration into clinical workflows are key to improving NLP's utility and reliability in this field.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3885-3899"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion-weighted MRI of advanced gastric cancer: correlations of the apparent diffusion coefficient with Borrmann classification, proliferation and aggressiveness.","authors":"Liang Ma, Liling Guo, Xuyou Zhu, Xianghua Yi, Wenxian Du, Xiucai Lan, Peijun Wang","doi":"10.1007/s00261-024-04718-6","DOIUrl":"10.1007/s00261-024-04718-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare apparent diffusion coefficient (ADC) values derived from diffusion-weighted imaging (DWI) of different Borrmann types of advanced gastric cancer (AGC) and correlate these ADC values with Ki-67 expression and serum CEA levels in AGC.</p><p><strong>Methods: </strong>A total of 84 patients with AGC who underwent DWI of the upper abdomen before tumor resection in our hospital between June 2014 and July 2018 were included in the present study. DWI was obtained with a single-shot echo planar imaging sequence in the axial plane (b values: 0, 100, 700 and 1000 s/mm²). Mean ADC values were calculated from tumor regions. Postoperatively, specimens were used to determine Borrmann type (1-4). Then, ADC values for AGCs categorized by Borrmann type were compared by one-way analysis of variance with Bonferroni correction for multiple comparisons. Subsequently, associations between ADC values and Ki-67 expression and serum CEA levels were evaluated by Spearman's correlation analysis.</p><p><strong>Results: </strong>The mean ADC value for Borrmann type 3 AGC was significantly lower compared to the mean ADC value for Borrmann type 2 AGC (p < 0.01). There were significant negative correlations between ADC values and Ki-67 scores (r = -0.639, p < 0.001), and between ADC values and serum CEA levels (r = -0.575, p < 0.001).</p><p><strong>Conclusions: </strong>DWI can help characterize Borrmann types of AGC. ADC values may reflect Ki-67 expression and serum CEA levels in patients with AGC, and have utility as a non-invasive indicator for evaluating the aggressiveness and prognosis of AGC.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3395-3405"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal motility disorders: a gastroenterologists' perspective for radiologists.","authors":"James Callaway, Elizabeth Terry","doi":"10.1007/s00261-024-04793-9","DOIUrl":"10.1007/s00261-024-04793-9","url":null,"abstract":"<p><p>Esophageal motility disorders are commonly encountered in the outpatient setting during the evaluation of difficulty swallowing. They typically present with symptoms of dysphagia to solids or liquids, non-cardiac chest pain, or regurgitation. Practitioners rely on both invasive and non-invasive testing to evaluate these complaints, often utilizing endoscopy, fluoroscopic evaluations, and functional esophageal motility testing to characterize symptoms into formal motility disorders, when able. Many of these tests complement each other and more than one is often needed to fully characterize a patient's symptoms. For the past fifteen years, gastroenterologists have primarily used the Chicago Classification for defining esophageal motility disorders by esophageal manometry and this classification scheme has evolved into its 4th iteration. The following paper will review the initial approach to patients presenting with obstructive esophageal symptoms and provide a working knowledge of the Chicago Classification system and additional motility testing used commonly by gastroenterologists.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3457-3466"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary bladder diverticula: imaging features and complications.","authors":"Grace G Zhu, Cary L Siegel, Douglas M Rogers, Jonathan Sagel, Glen Morrell, Jeffrey D Olpin, Bogdana Schmidt, Mark J Hoegger","doi":"10.1007/s00261-024-04714-w","DOIUrl":"10.1007/s00261-024-04714-w","url":null,"abstract":"<p><p>Urinary bladder diverticula are common and are frequently incidentally discovered. Many downstream complications can occur due to urinary stasis, such as bladder diverticular stones, infection, and malignancy. Understanding the physiology of bladder diverticula and potential pitfalls and mimics is critical to an accurate description of bladder diverticula and early detection of potential downstream complications. This pictorial review will first review the normal bladder histology and function, bladder diverticular types, and typical imaging features. The paper will then draw attention to technical pitfalls and potential mimics. Finally, we will review the downstream complications, including stones, infection, malignancy, and BCG-related changes.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3584-3598"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel MRI-based radiomics for preoperative prediction of lymphovascular invasion in rectal cancer.","authors":"Xiaoxiang Ning, Dengfa Yang, Weiqun Ao, Yuwen Guo, Li Ding, Zhen Zhang, Luyao Ma","doi":"10.1007/s00261-025-04800-7","DOIUrl":"10.1007/s00261-025-04800-7","url":null,"abstract":"<p><strong>Background: </strong>To develop and validate a clinical-radiomics model for preoperative prediction of lymphovascular invasion (LVI) in rectal cancer.</p><p><strong>Methods: </strong>This retrospective study included data from 239 patients with pathologically confirmed rectal adenocarcinoma from two centers, all of whom underwent MRI examinations. Cases from the first center (n = 189) were randomly divided into a training set and an internal validation set at a 7:3 ratio, while cases from the second center (n = 50) constituted the external validation set. The clinical features and MRI imaging characteristics of the patients in the training set were analyzed. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for LVI in rectal cancer, and these risk factors were then used to construct a clinical model. Regions of interest (ROIs) were delineated on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) sequences for feature extraction. After feature reduction and selection, the most strongly correlated features were identified, and their respective regression coefficients were calculated to construct the radiomics model. Finally, a combined clinical-radiomics model was built using a weighted linear combination of features and was visualized as a nomogram. The predictive performance of each model was quantified using receiver operating characteristics (ROC) curves and the area under the curve (AUC) in both training and validation sets, with DeLong analysis being used to compare model performance. Decision curve analysis (DCA) was used to evaluate the clinical utility of each model in the validation sets.</p><p><strong>Results: </strong>In the 239 patients, the combined model outperformed the clinical and radiomics models in predicting LVI in rectal cancer. The combined model showed excellent predictive performance in the training, internal validation, and external validation sets, with AUCs of 0.90 (0.88-0.97), 0.88 (0.78-0.99), and 0.88 (0.78-0.95), respectively. The sensitivity values were 75.9%, 68.8%, and 80.0%, respectively, and the specificity values were 90.3%, 92.7%, and 88.6%. DCA results indicated that the nomogram of the combined model had superior clinical utility compared with the clinical and radiomics models.</p><p><strong>Conclusions: </strong>The clinical-radiomics nomogram serves as a valuable tool for non-invasive preoperative prediction of LVI status in patients with rectal cancer.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3377-3390"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoplastic premalignant pancreatobiliary lesions: current update on the spectrum of lesions and their imaging appearances.","authors":"Anil K Dasyam, Nikhil V Tirukkovalur, Amir A Borhani, Venkata S Katabathina, Aatur Singhi, Alessandro Furlan, Srinivasa Prasad","doi":"10.1007/s00261-024-04795-7","DOIUrl":"10.1007/s00261-024-04795-7","url":null,"abstract":"<p><p>Common pancreatobiliary epithelial malignancies such as pancreatic ductal adenocarcinoma, cholangiocarcinoma and gallbladder carcinoma have poor prognosis. A small but significant portion of these malignancies arise from mass-forming grossly and radiologically visible premalignant epithelial neoplasms in the pancreatobiliary tree. Several lesions, including a few recently described entities, fall under this category and predominantly include papillary epithelial lesions with or without mucin production. These include common lesions such as intraductal papillary mucinous lesions (IPMN) in pancreas and less common to rare lesions such intraductal papillary neoplasms of the bile ducts (IPNB), pancreatic and biliary intraductal oncocytic papillary neoplasms (IOPN) and intraductal tubulopapillary neoplasms (ITPN), intracholecystic neoplasms (ICN) in the gallbladder, intra-ampullary papillary-tubular neoplasms (IAPN) in the ampulla and mucinous cystic neoplasms in the pancreas, biliary tree and gallbladder. These lesions have an excellent prognosis before malignant transformation and even with malignant transformation, often fare better than the conventional malignant counterparts. These lesions have characteristic histologic, radiologic, and molecular characteristic features. Several of these neoplastic lesions are associated with field-effect phenomenon which means that in presence of even one of these lesions, the entire background ductal epithelium is at risk of developing synchronous or metachronous malignancies. Awareness of these lesions and their imaging appearances as well as utilization of relevant molecular diagnostics can help practicing radiologists and clinicians improve patient outcomes by detecting early and treating or surveilling such lesions before malignant transformation or before metastatic dissemination.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3647-3661"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of main pancreatic duct involvement in intraductal papillary mucinous neoplasms on magnetic resonance imaging.","authors":"Dong Wook Kim, Boyeon Koo, Jae Ho Byun, In Hye Song, Hwajin Lee, Jin Hee Kim, Seung Soo Lee, Hyoung Jung Kim, Ki Byung Song, Jae Hoon Lee, Dae Wook Hwang","doi":"10.1007/s00261-025-04801-6","DOIUrl":"10.1007/s00261-025-04801-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the measurement of main pancreatic duct (MPD) diameter on MRI for predicting MPD involvement in intraductal papillary mucinous neoplasms (IPMN).</p><p><strong>Methods: </strong>This retrospective study included 595 patients with surgically confirmed IPMN who underwent preoperative MRI from 2015 to 2022. Three independent readers measured the maximum MPD diameter on two-dimensional axial and coronal T2-weighted imaging. Inter-plane and inter-reader agreements were assessed using the intraclass correlation coefficient (ICC). Multivariable logistic regression identified clinical and radiological factors associated with MPD involvement. Accuracy, sensitivity, and specificity of MPD diameter cutoffs, including the 5-mm threshold from the 2024 International Consensus Guidelines, were calculated.</p><p><strong>Results: </strong>Of the 595 patients (mean age: 64.6 years ± 8.6, 394 men), 423 (71.1%) had IPMN with MPD involvement, whereas 172 (28.9%) did not have MPD involvement. The mean maximum MPD diameter was 7.9 ± 5.1 mm. Inter-plane agreement was excellent (ICC = 0.977-0.988), as was inter-reader agreement (ICC = 0.963). Only a large MPD diameter on MRI was independently associated with MPD involvement (odds ratio = 1.29 [95% confidence interval; 1.14-1.47], p <.01). Use of a maximum MPD diameter cutoff of ≥ 5 mm for MPD involvement yielded accuracy, sensitivity, and specificity of 76.0%, 79.2%, and 68.0%, respectively.</p><p><strong>Conclusion: </strong>Despite excellent inter-plane and inter-reader agreement, the MRI-based prediction of MPD involvement in IPMN has limitations.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":"3712-3721"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}