Characterization of cystic tumors of the pancreas: CT accuracy.
OBJECTIVE
The purpose of this work was to evaluate the capabilities of CT to accurately characterize cystic tumors of the pancreas.


METHODS
Two observers retrospectively evaluated the CT exams of 100 cystic masses of the pancreas, with pathological confirmation. The two observers, blinded about clinical information and the final diagnosis, tried to categorize the lesions according to well established morphologic features. Statistical analysis was performed to measure the agreement between each radiologist and the consensus diagnosis and to evaluate the usefulness of certain CT findings in differentiating one type of cystic pancreatic neoplasm from another.


RESULTS
Serous cystadenoma was better diagnosed by CT [Youden misclassification index (Ymi) = 0.72] than mucinous cystic tumor (Ymi = 0.44) and solid pseudopapillary tumor (cystic variant) (Ymi = 0.47).


CONCLUSIONS
As patients with previous history of pancreatitis were excluded from the study, CT findings allowed correct characterization of only 60% of cystic pancreatic masses. Among the remaining 40%, 15-20% of the wrong diagnoses could not be corrected by means of CT, given the patterns shown by the tumors. In 20-25% of the cases, a nonspecific diagnosis of cystic mass was made.
Procacci
C
C
Department of Radiology, University of Verona Medical School, Policlinico G.B. Rossi, Italy.
Biasiutti
C
C
Carbognin
G
G
Accordini
S
S
Bicego
E
E
Guarise
A
A
Spoto
E
E
Andreis
I A
IA
De Marco
R
R
Megibow
A J
AJ
D003287:Contrast Media; D018291:Cystadenoma, Mucinous / Q000000981:diagnostic imaging; D018292:Cystadenoma, Papillary / Q000000981:diagnostic imaging; D018293:Cystadenoma, Serous / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008202:Lymphangioma / Q000000981:diagnostic imaging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed
D003287:Contrast Media