Evidence map›Paper›PMID 34374801›Full record

ArticleEuropean radiology2022

MRI is useful to suggest and exclude malignancy in mucinous cystic neoplasms of the pancreas.

Marie-Pierre Vullierme, Jules Gregory, Vinciane Rebours, Jerome Cros, Yasser Abelhady-Attia, Valerie Vilgrain, Lina Aguilera-Munoz, Lucie Laurent, Philippe Levy, Alain Sauvanet and 1 more

Abstract read
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Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Marie-Pierre VulliermeAssistance Publique-Hôpitaux de Paris, APHP.Nord, Department of Radiology, Beaujon University Hospital, 100 bd general Leclerc, 92110, Clichy, France. marie-pierre.vullierme@aphp.fr.ORCID http://orcid.org/0000-0002-3667-8943
Jules GregoryAssistance Publique-Hôpitaux de Paris, APHP.Nord, Department of Radiology, Beaujon University Hospital, 100 bd general Leclerc, 92110, Clichy, France.
Vinciane ReboursUniversité Paris Diderot-Paris 7, Université de Paris, F-75018, Paris, France.
Jerome CrosUniversité Paris Diderot-Paris 7, Université de Paris, F-75018, Paris, France.
Yasser Abelhady-AttiaDepartment of Radiology, Benha University Hospital, Fareed Nada Street, Benha, Qalubiya Governorate, 13511, Egypt.
Valerie VilgrainAssistance Publique-Hôpitaux de Paris, APHP.Nord, Department of Radiology, Beaujon University Hospital, 100 bd general Leclerc, 92110, Clichy, France.
Lina Aguilera-MunozAssistance Publique-Hôpitaux de Paris, APHP.Nord, Department of Pancreatology, Beaujon Hospital, 100 bd general Leclerc, 92110, Clichy, France.
Lucie LaurentAssistance Publique-Hôpitaux de Paris, APHP.Nord, Department of Pancreatology, Beaujon Hospital, 100 bd general Leclerc, 92110, Clichy, France.
Philippe LevyUniversité Paris Diderot-Paris 7, Université de Paris, F-75018, Paris, France.
Alain SauvanetUniversité Paris Diderot-Paris 7, Université de Paris, F-75018, Paris, France.
Maxime RonotAssistance Publique-Hôpitaux de Paris, APHP.Nord, Department of Radiology, Beaujon University Hospital, 100 bd general Leclerc, 92110, Clichy, France.
Délégation Paris 7 · FRHôpital Beaujon · FRBenha University · EGInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the value of MRI in differentiating benign (b-MCN) and malignant (m-MCN) MCN. European guidelines suggest that certain mucinous cystic neoplasms (MCN) of the pancreas can be conservatively managed.

methodsA retrospective single-center study of consecutive patients with resected MCN. MRIs were independently reviewed by two readers blinded to the pathological results. The authors compared b-MCN (i.e., mucinous-cystadenoma comprising high-grade dysplasia (HGD)) and m-MCN (i.e., cystadenocarcinoma).

resultsSixty-three patients (62 women [98%]) with 63 MCN (6 m-MCN, 2 HGD) were included. m-MCN tumors had a tendency to be larger than b-MCN (median 86 [25-103] vs. 45 [17-130] mm, p = .055). The combination of signal heterogeneity on T2-weighted imaging, wall thickness ≥ 5 mm, the presence of mural nodules ≥ 9 mm, and enhancing septa had an area under the ROC curve of 0.97 (95% CI 0.91-1.00) for the diagnosis of m-MCN. A total of 24 (37%), 20 (32%), 10 (16%), 5 (8%), and 4 (6%) out of 63 MCNs showed 0, 1, 2, 3, and 4 of these features, respectively. The corresponding rate of m-MCN was 0%, 0%, 10%, 20%, and 100%, respectively, with a good-to-excellent inter-reader agreement. Patterns with a high NPV for m-MCN included an absence of enhancing septa or walls (NPV 97% and 100%, respectively), wall thickness < 3 mm (NPV 100%), and no mural nodules (NPV 100%).

conclusionsA combination of 4 imaging features suggests malignant MCN on MRI. On the other hand, visualization of a thin non-enhancing wall with no mural nodules suggests benign MCN. KEY POINTS: • A heterogenous signal on T2-weighted MRI, a ≥ 5-mm-thick wall, mural nodules ≥ 9 mm, and/or enhancing septa suggest malignant MCNs. • A thin non-enhancing wall with no mural nodules suggests benign MCNs. • MRI should be performed in the pre-therapeutic evaluation of MCN to help determine the therapeutic strategy in these patients.

Indexed as

Cystadenoma, MucinousPancreatic NeoplasmsFemaleHumansMagnetic Resonance ImagingPancreasRetrospective StudiesCystadenocarcinoma, MucinousCystadenoma, MucinousMagnetic resonance imagingNeoplams, Cystic Mucinous and SerousPancreas cyst

Identifiers

PMID34374801
OpenAlexW3190881522

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.