title: Pancreatic cysts: What imaging characteristics are associated with development of pancreatic ductal adenocarcinoma?
abstract: OBJECTIVE
  To assess relationship between pancreatic cysts (PC) and pancreatic ductal adenocarcinoma (PDAC) and to compare imaging features of PC in subjects who develop PDAC and those who do not.
  
  
  METHODS
  This case-control IRB-approved HIPAA-compliant study included patients with PDAC (cases) and lung cancer (controls), diagnosed between 1/1/05-1/1/14. The most recent abdominal CT/MR of each patient done >6months prior to cancer diagnosis date was reviewed by radiologist blinded to case/control status. Presence of PC, number and size of largest PC, presence of main pancreatic duct (MPD) dilatation (MPD >3mm) were recorded. Simple PC was defined as lack of calcifications, septations and enhancement. Logistic regression models with binary outcome of PDAC were constructed.
  
  
  RESULTS
  There were 88 cases and 273 controls with mean ages of 69.6 years (±10.3) and 69.8 years (±12.0), respectively (p=0.864). PC were present in 21.6% (19/88) cases and in 9.2% (25/273) controls (p=0.002). The OR of PC for development of PDAC was 2.83, adjusting for age, sex and race (p=0.001). Mean PC size was 14.8mm (±8.7) in cases and 7.6mm (±8.0) in controls (p=0.007). PC were solitary in 6 (31.6%) of 19 cases and 21 (84.0%) of 25 controls (p=0.001). There was no significant difference in proportions of simple cysts or MPD dilatation between cases and controls. Multiple PC had 8.2 times increased odds of PDAC compared with solitary PC, adjusting for cyst size (p=0.007).
  
  
  CONCLUSIONS
  Multiple PC are associated with 8.2 times higher odds of PDAC compared with solitary PC.
authors: Department of Radiology, Montefiore Medical Center, Bronx, NY, USA. Electronic address: vparoder@gmail.com.
authors: Viktoriya
authors: V
authors: Paroder
authors: Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
authors: Milana
authors: M
authors: Flusberg
authors: Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
authors: Mariya
authors: M
authors: Kobi
authors: Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
authors: Alla M
authors: AM
authors: Rozenblit
authors: Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
authors: Victoria
authors: V
authors: Chernyak
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Cyst-related malignancy; Pancreatic cysts; Pancreatic ductal adenocarcinoma