mri监测胰腺癌高危人群的表现

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-07-02 DOI:10.1016/j.ejrad.2025.112275

Raffaella M. Pozzi Mucelli , Miroslav Vujasinovic , Ana Farah-Mwais , Peter Gustavsson , Carlos Fernández Moro , Poya Ghorbani , Johannes-Matthias Löhr , Nikolaos Kartalis

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引用次数: 0

摘要

目的：胰腺癌（PC）高危人群（HRIs）推荐进行监测，因为它似乎对发现恶性/癌前病变有效。大多数监测项目都是基于核磁共振成像和内窥镜超声的结合。本研究旨在评估在单中心HRIs队列中相关影像学发现（PC和高级别发育不良病变）的发生率以及基于mri的监测表现。方法对2002-2023年前瞻性收集的274例HRIs进行单中心回顾性研究。自2010年起仅通过MRI进行监测；2002-2009年MRI和/或CT。记录MRI表现、人口学、临床和组织病理学数据。计算了监测程序的诊断准确度。结果中位随访时间为5.8年。59%的患者检出局灶性病变，56%（152/274）检出囊肿，3%（8/274）检出囊性和实性病变，1%（2/274）检出实性病变。4例（1%,4/274）有可疑囊肿(3例切除；组织病理学未见高度发育不良)。6例(2%；6/274)有PC: 2例在I期（0.7%），1例在II期（0.4%），3例在IV期（1.1%）。6例患者中有3例在诊断时有肝转移。监测诊断准确度指标：敏感性67% (95% CI 22 - 96%)，特异性98% (95% CI 96 - 99%)，阳性预测值（PPV） 44% (95% CI 14 - 79%)，阴性预测值99% （95% CI 97 - 99%）。结论HRIs中PC的发生率较低（0.32 / 100人年），I期和IV期PC的比例相似。未发现高级别发育不良的病变。敏感性和PPV较低，提示MRI监测环境下PC的早期诊断具有挑战性。关键词：胰腺，胰腺癌，早期诊断，监测，MRI，发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Performance of MRI-based surveillance for high-risk individuals for pancreatic cancer

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Performance of MRI-based surveillance for high-risk individuals for pancreatic cancer

Purpose

Surveillance is recommended in high-risk individuals (HRIs) for pancreatic cancer (PC), as it seems effective in detecting malignant/premalignant lesions. Most surveillance programs are based on a combination of MRI and endoscopic ultrasound.

This study aimed to evaluate the incidence of relevant imaging findings (PC and lesions with high-grade dysplasia) and the performance of MRI-based surveillance in a single-centre HRIs cohort.

Methods

Single-centre, retrospective study on 274 prospectively collected HRIs (2002–2023). Surveillance was performed exclusively with MRI from 2010; MRI and/or CT in 2002–2009. MRI findings, demographic, clinical, and histopathological data were recorded. Diagnostic accuracy measures for the surveillance program were calculated.

Results

The median follow-up was 5.8 years. Focal lesions were detected in 59 % of the patients: cysts in 56 % (152/274), cystic and solid lesions in 3 % (8/274), and solid lesions in 1 % (2/274). Four patients (1 %, 4/274) had suspicious cysts (3 resected; no high-grade dysplasia at histopathology). Six patients (2 %; 6/274) had PC: two in stage I (0.7 %), one in stage II (0.4 %), three in stage IV (1.1 %). Three out of six patients had liver metastases at diagnosis. Surveillance diagnostic accuracy measures: sensitivity 67 % (95 %CI 22–96 %), specificity 98 % (95 %CI 96–99 %), positive predictive value (PPV) 44 % (95 %CI 14–79 %), negative predictive value 99 % (95 %CI 97–99 %).

Conclusions

The incidence of PC in HRIs was low (0.32 per 100-person-years), with similar proportion of stage I and IV PC. No lesions with high-grade dysplasia were identified. Sensitivity and PPV were low, suggesting that early diagnosis of PC in MRI surveillance setting is challenging.

Keywords (Mesh terms)

Pancreas, Pancreatic Cancer, Early Diagnosis, Surveillance, MRI, Incidence.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.