Volume of the whole pancreatic duct is useful in determining indication of surgery for intraductal papillary mucinous neoplasms of the pancreas: Analyses of 3D volumetry with MR cholangiopancreatography

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  • 核磁気共鳴胆管膵管撮影（MRCP)を用いた全膵管体積測定は膵管内乳頭粘液性腫瘍（IPMN）の手術適応決定に有用である

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Background/Aims: To investigate the association between the volume of the pancreatic duct as measured by magnetic resonance cholangiopancreatography (MRCP) and the pathological stage of intraductal papillary mucinous neoplasm (IPMN). Methods: MRCP images were reconstructed in three dimensions by volume rendering, and the association between the volume of the whole pancreatic duct (WPD) and pathological stage, malignancy, Ki67 labeling index and prognosis was retrospectively investigated for 70 IPMN patients. Results: There were 47 patients with low- or intermediate-grade dysplasia, 12 with high-grade dysplasia, and 11 with invasive carcinoma derived from IPMN. The volume of the WPD was significantly greater in cases of high-grade dysplasia and invasive carcinoma. The area under the curve for the volume of the WPD for the prediction of high-grade dysplasia and invasive carcinoma was 0.810. Setting a cutoff value of 30 cm3 predicted with 78.6% accuracy. The volume of the WPD was statistically correlated with the Ki67 labeling index (R = 0.591) and this mean proliferating. Patients for whom the volume of the WPD was 30 cm3 had a significantly poorer prognosis. Conclusions: The volume of the WPD ( 30 cm3), as measured by 3D volumetry using MRCP, is a useful predictive factor for malignancy in IPMN.

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