title: Pancreatic MRI for the surveillance of cystic neoplasms: comparison of a short with a comprehensive imaging protocol.
abstract: OBJECTIVE
  The study aims were to evaluate: (1) whether a short-protocol (SP) MRI for the surveillance of pancreatic cystic neoplasms (PCN) provides equivalent clinical information as a comprehensive-protocol (CP), and (2) the cost reduction from substituting CP with SP for patient surveillance.
  
  
  METHODS
  This retrospective study included 154 consecutive patients (median age: 66, 52 % men) with working-diagnosis of PCN and available contrast-enhanced MRI/MRCP. Three radiologists evaluated independently two imaging sets (SP/CP) per patient. The CP included: T2-weighted (HASTE/MRCP), DWI and T1-weighted (chemical-shift/pre-/post-contrast) images [acquisition time (AT) ≈ 35 min], whereas the SP included: T2-weighted HASTE and T1-weighted pre-contrast images (AT ≈ 8 min). Mean values of largest cyst/main pancreatic duct diameter (DC/DMPD) were compared. Agreement regarding presence/absence of cystic/MPD mural nodules (MNC/MNMPD), inter-observer agreement and cost differences between SP/CP were calculated.
  
  
  RESULTS
  For DCand DMPD, mean values with SP/CP were 21.4/21.7 mm and 3.52/3.58 mm, while mean differences SP-CP were 0.3 mm (p = 0.02) and 0.06 mm (p = 0.12), respectively. For presence/absence of MNCand MNMPD, SP/CP coincided in 93 % and 98 % of cases, respectively. Inter-observer agreement was strong for SP/CP. SP-cost was 25 % of CP-cost.
  
  
  CONCLUSIONS
  For the surveillance of PCN, short-protocol MRI provides information equivalent to the more time-consuming and costly comprehensive-protocol.
  
  
  CONCLUSIONS
  • Pancreatic cystic neoplasms (PCN) are increasingly diagnosed in the general population. • Multiple imaging controls are recommended for the surveillance of patients with PCN. • Short and comprehensive MRI-protocols are equivalent for decision-making in PCN under surveillance. • Evaluation of imaging risk factors in PCNs is comparable with both MRI-protocols. • Use of the short MRI-protocol may rationalise healthcare resources.
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Radiology, C1-46 Karolinska University Hospital, 14186, Stockholm, Sweden.
authors.forename: Raffaella Maria
authors.initials: RM
authors.lastname: Pozzi-Mucelli
authors.affiliation: Department of Radiology, Medical Imaging Centre of Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland.
authors.forename: Irina
authors.initials: I
authors.lastname: Rinta-Kiikka
authors.affiliation: Department of Radiology, St.Olavs University Hospital, Trondheim, Norway.
authors.forename: Katharina
authors.initials: K
authors.lastname: Wünsche
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Laukkarinen
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.
authors.forename: Knut Jørgen
authors.initials: KJ
authors.lastname: Labori
authors.affiliation: Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.
authors.forename: Kim
authors.initials: K
authors.lastname: Ånonsen
authors.affiliation: Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway.|Department of Pathology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Caroline
authors.initials: C
authors.lastname: Verbeke
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Marco
authors.initials: M
authors.lastname: Del Chiaro
authors.affiliation: Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Radiology, C1-46 Karolinska University Hospital, 14186, Stockholm, Sweden. nikolaos.kartalis@karolinska.se.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kartalis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cysts; Interdisciplinary communication; Magnetic Resonance Imaging; Neoplasms; Pancreas