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Cancer control : journal of the Moffitt Cancer Center
2024 Jan-Dec;31 10732748241263644.

Risk Assessment and Radiomics Analysis in Magnetic Resonance Imaging of Pancreatic Intraductal Papillary Mucinous Neoplasms (IPMN).

Federica Flammia, Roberta Fusco, Sonia Triggiani, Giuseppe Pellegrino, Alfonso Reginelli, Igino Simonetti, Piero Trovato, Sergio Venanzio Setola, Giuseppe Petralia, Antonella Petrillo, Francesco Izzo, Vincenza Granata
Author Information
  1. Federica Flammia: SIRM Foundation, Italian Society of Medical and Interventional Radiology (SIRM), Milan, Italy.
  2. Roberta Fusco: Medical Oncology Division, Igea SpA, Napoli, Italy.
  3. Sonia Triggiani: Postgraduate School of Radiodiagnostics, University of Milan, Milan, Italy.
  4. Giuseppe Pellegrino: Postgraduate School of Radiodiagnostics, University of Milan, Milan, Italy.
  5. Alfonso Reginelli: Division of Radiology, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy.
  6. Igino Simonetti: Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy.
  7. Piero Trovato: Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy.
  8. Sergio Venanzio Setola: Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy.
  9. Giuseppe Petralia: Radiology Division, IEO European Institute of Oncology IRCCS, Milan, Italy.
  10. Antonella Petrillo: Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy.
  11. Francesco Izzo: Divisions of Hepatobiliary Surgery, "Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale", Naples, Italy.
  12. Vincenza Granata: Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy. ORCID
PMID: 39293798 DOI: 10.1177/10732748241263644

Abstract

Intraductal papillary mucinous neoplasms (IPMNs) are a very common incidental finding during patient radiological assessment. These lesions may progress from low-grade dysplasia (LGD) to high-grade dysplasia (HGD) and even pancreatic cancer. The IPMN progression risk grows with time, so discontinuation of surveillance is not recommended. It is very important to identify imaging features that suggest LGD of IPMNs, and thus, distinguish lesions that only require careful surveillance from those that need surgical resection. It is important to know the management guidelines and especially the indications for surgery, to be able to point out in the report the findings that suggest malignant degeneration. The imaging tools employed for diagnosis and risk assessment are Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) with contrast medium. According to the latest European guidelines, MRI is the method of choice for the diagnosis and follow-up of patients with IPMN since this tool has a highest sensitivity in detecting mural nodules and intra-cystic septa. It plays a key role in the diagnosis of worrisome features and high-risk stigmata, which are associated with IPMNs malignant degeneration. Nowadays, the main limit of diagnostic tools is the ability to identify the precursor of pancreatic cancer. In this context, increasing attention is being given to artificial intelligence (AI) and radiomics analysis. However, these tools remain in an exploratory phase, considering the limitations of currently published studies. Key limits include noncompliance with AI best practices, radiomics workflow standardization, and clear reporting of study methodology, including segmentation and data balancing. In the radiological report it is useful to note the type of IPMN so as the morphological features, size, rate growth, wall, septa and mural nodules, on which the indications for surveillance and surgery are based. These features should be reported so as the surveillance time should be suggested according to guidelines.

Keywords

intraductal papillary mucinous neoplasms magnetic resonance imaging pancreatic cancer radiomics risk assessment

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MeSH Term

Humans
Magnetic Resonance Imaging
Risk Assessment
Pancreatic Intraductal Neoplasms
Pancreatic Neoplasms
Carcinoma, Pancreatic Ductal
Adenocarcinoma, Mucinous
Radiomics
Journal Article Review

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