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Pancreatic Cyst Size Measurement on Magnetic Resonance Imaging Compared to Pathology
Daniel Jeong1,2, Brian Morse1, Stuart Lane Polk3
1Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
Cancers
|January 11, 2024
Summary
Magnetic resonance imaging (MRI) accurately measures pancreatic intraductal papillary mucinous neoplasms (IPMN) size, though it may slightly overestimate length compared to pathology. This finding aids in refining IPMN treatment strategies using MRI measurements.
Area of Science:
- Gastroenterology
- Radiology
- Oncology
Background:
- Pancreatic intraductal papillary mucinous neoplasms (IPMN) require accurate size assessment for treatment decisions.
- Current magnetic resonance imaging (MRI) sequences lack universal standardization for optimal IPMN size measurement.
- T2-weighted sequences are suggested, but their correlation with pathology size needs further investigation.
Purpose of the Study:
- To compare the agreement and bias of IPMN long-axis measurements across seven common MRI sequences with postsurgical pathology.
- To evaluate the correlation between MRI-derived IPMN size and actual pathological size.
- To assess inter-observer agreement for MRI measurements.
Main Methods:
- Retrospective analysis of surgically resected IPMN cases with preoperative MRI.
- Measurement of IPMN long-axis diameter on seven MRI sequences.
- Comparison of MRI measurements with pathology using concordance correlation coefficient (CCC) and Bland-Altman analysis.
- Assessment of inter-observer agreement using intraclass correlation coefficient (ICC).
Main Results:
- Maximum MRI IPMN size showed strong agreement with pathology (CCC = 0.82).
- The maximum size was often observed on axial T1 arterial post-contrast and MRCP coronal series.
- MRI measurements tended to overestimate IPMN size compared to pathology (bias +0.34 cm), possibly due to formalin fixation.
- Radiologist inter-observer agreement was high (ICCs 0.74–0.91).
Conclusions:
- Maximum MRI-determined IPMN size strongly correlates with pathological size.
- MRI measurements may overestimate IPMN length, likely due to tissue processing artifacts.
- These findings support the use of MRI for IPMN size assessment while acknowledging potential overestimation.
