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Open AccessArticle

Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients

1
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan
2
Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan
3
Department of Diagnostic Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan
4
Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan
5
Clinical Research Center, Kindai University, Osaka–Sayama, Osaka 589-8511, Japan
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(7), 445; https://doi.org/10.3390/diagnostics10070445
Received: 29 May 2020 / Revised: 26 June 2020 / Accepted: 29 June 2020 / Published: 1 July 2020
(This article belongs to the Section Medical Imaging)
Background: This study aimed to evaluate and identify the specific CT findings by focusing on abnormalities in the main pancreatic duct (MPD) and pancreatic parenchyma in patients with small pancreatic cancer (PC) including carcinoma in situ (CIS). Methods: Nine CT findings indicating abnormalities of MPD and pancreatic parenchyma were selected as candidate findings for the presence of small PC ≤ 10 mm. The proportions of patients positive for each finding were compared between small PC and benign MPD stenosis groups. Interobserver agreement between two independent image reviewers was evaluated using kappa statistics. Results: The final analysis included 24 patients with small PC (including 11 CIS patients) and 28 patients with benign MPD stenosis. The proportion of patients exhibiting partial pancreatic parenchymal atrophy (PPA) corresponding to the distribution of MPD stenosis (45.8% vs. 7.1%, p < 0.01), upstream PPA arising from the site of MPD stenosis (33.3% vs. 3.6%, p = 0.01), and MPD abrupt stenosis (45.8% vs. 14.3%, p = 0.03) was significantly higher in the small PC group than in the benign MPD stenosis group. Conclusions: The presence of partial PPA, upstream PPA, and MPD abrupt stenosis on a CT image was highly suggestive of the presence of small PCs including CIS. View Full-Text
Keywords: carcinoma in situ; computed tomography; early diagnosis; pancreatic parenchymal atrophy; small pancreatic cancer carcinoma in situ; computed tomography; early diagnosis; pancreatic parenchymal atrophy; small pancreatic cancer
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Yamao, K.; Takenaka, M.; Ishikawa, R.; Okamoto, A.; Yamazaki, T.; Nakai, A.; Omoto, S.; Kamata, K.; Minaga, K.; Matsumoto, I.; Takeyama, Y.; Numoto, I.; Tsurusaki, M.; Chikugo, T.; Chiba, Y.; Watanabe, T.; Kudo, M. Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients. Diagnostics 2020, 10, 445.

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