Dynamic computed tomography findings of malignant intraductal papillary mucinous tumor compared with invasive ductal adenocarcinoma.
OBJECTIVE
We evaluated the effectiveness of dynamic computed tomography (CT) imaging in differentiating malignant intraductal papillary mucinous tumor (IPMT) with a large mural nodule from invasive ductal adenocarcinoma (IDAC).


METHODS
Dynamic CT was done in six IPMT and nine IDAC cases. In the IPMT cases, we made a histological map of the tumor. A region of interest (ROI) was established in the mural nodule of the IPMT, in the IDAC, and in the noncancerous portion of the pancreas. The change of density was analyzed statistically during preenhancement and the early and late phases. These results were compared between the IPMT and IDAC cases.


RESULTS
Histologically, most of the mural nodule was papillary adenocarcinoma. In the IPMT cases, the postenhancement density of the mural nodule was significantly higher during the early phase than during the late phase. In IDAC cases, the postenhancement density was significantly higher in the late phase than in the early phase. In the early phase, tumor-pancreas density was significantly higher in the IPMT than in the IDAC. In the late phase, tumor-pancreas density was significantly higher in the IDAC than in the IPMT.


CONCLUSIONS
Dynamic CT is useful for differentiating malignant IPMT with a large mural nodule from IDAC.
Ozaki
Toshiro
T
Department of Radiation Oncology, Niigata Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan. ganoz@cpost.plala.or.jp
Kamura
Takeshi
T
Ajioka
Yoichi
Y
Shirai
Yoshio
Y
Kurosaki
Isao
I
Yamamoto
Satoshi
S
Sasai
Keisuke
K
D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D018291:Cystadenoma, Mucinous / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media