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Differentiation of aggressive from non-aggressive pancreatic solid pseudopapillary neoplasms using computed
Jianhua Wang1, Xiao Chen1, Cheng Wang1
1Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing, 210029, Jiangsu, China.
Abdominal Radiology (New York)
|March 10, 2019
Summary
Aggressive pancreatic solid pseudopapillary neoplasms (SPNs) are linked to specific CT features like ill-defined margins and lack of capsule. Age over 40.5 and lack of capsule predict aggressive SPNs, aiding in diagnosis.
Area of Science:
- Radiology
- Oncology
- Gastroenterology
Background:
- Solid pseudopapillary neoplasms (SPNs) are rare pancreatic tumors.
- Microscopic aggressive behaviors in SPNs may influence patient prognosis.
- Differentiating aggressive from non-aggressive SPNs is crucial for treatment planning.
Purpose of the Study:
- To investigate computed tomography (CT) features differentiating aggressive from non-aggressive SPNs of the pancreas.
- To assess the diagnostic performance of CT findings and patient age in predicting SPN aggressiveness.
Main Methods:
- Retrospective analysis of CT scans from 122 patients with pathologically proven pancreatic SPNs.
- Evaluation of tumor characteristics including margins, capsule, hemorrhage, and enhancement patterns.
- Logistic regression and ROC curve analysis to determine diagnostic accuracy.
Main Results:
- Aggressive SPNs (30 cases) were associated with ill-defined margins, age > 40.5 years, and smaller tumor size (< 42.1 mm).
- Complete capsule and hemorrhage were less frequent in aggressive SPNs.
- Lack of complete capsule and age > 40.5 years were independent risk factors for aggressive SPNs (OR 7.08 and 3.1).
Conclusions:
- CT features such as ill-defined margins, lack of complete capsule, and absent bleeding can predict aggressive SPNs.
- Patient age > 40.5 years and lack of a complete capsule demonstrate acceptable diagnostic performance for discriminating aggressive SPNs.
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