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Systematic review and meta-analysis of MRI features for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma.

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Title: Systematic review and meta-analysis of MRI features for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma.
Authors: Yoon, Seung Bae1, Jeon, Tae Yeon2, Moon, Sung-Hoon3 endomoon@hallym.or.kr, Lee, Sang Min4, Kim, Myung-Hwan5
Source: European Radiology. Oct2022, Vol. 32 Issue 10, p6691-6701. 11p. 5 Black and White Photographs, 1 Diagram, 2 Charts.
Abstract: Objectives: To identify reliable MRI features for differentiating autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC) and to summarize their diagnostic accuracy. Methods: We conducted a systematic literature review and meta-analysis using PubMed, EMBASE, and the Cochrane Library to identify original articles published between January 2006 and July 2021. The pooled diagnostic accuracy, including the diagnostic odds ratios (DORs) with 95% confidence intervals (CIs) of the identified features, was calculated using a bivariate random effects model. Results: Twelve studies were included, and 92 overlapping descriptors were subsumed under 16 MRI features. Ten features favoring AIP were diffuse enlargement (DOR, 75; 95% CI, 9–594), capsule-like rim (DOR, 52; 95% CI, 20–131), multiple main pancreatic duct (MPD) strictures (DOR, 47; 95% CI, 17–129), homogeneous delayed enhancement (DOR, 46; 95% CI, 21–104), low apparent diffusion coefficient value (DOR, 30), speckled enhancement (DOR, 30), multiple pancreatic masses (DOR, 29), tapered narrowing of MPD (DOR, 15), penetrating duct sign (DOR, 14), and delayed enhancement (DOR, 13). Six features favoring PDAC were target type enhancement (DOR, 41; 95% CI, 11–158), discrete pancreatic mass (DOR, 35; 95% CI, 15–80), upstream MPD dilatation (DOR, 13), peripancreatic fat infiltration (DOR, 10), upstream parenchymal atrophy (DOR, 5), and vascular involvement (DOR, 3). Conclusion: This study identified 16 informative MRI features to differentiate AIP from PDAC. Among them, diffuse enlargement, capsule-like rim, multiple MPD strictures, and homogeneous delayed enhancement favored AIP with the highest DORs, whereas discrete mass and target type enhancement favored PDAC. Key Points: • The MRI features with the highest pooled diagnostic odds ratios (DORs) for autoimmune pancreatitis were diffuse enlargement of the pancreas (75), capsule-like rim (52), multiple strictures of the main pancreatic duct (47), and homogeneous delayed enhancement (46). • The MRI features with the highest pooled DORs for pancreatic ductal adenocarcinoma were target type enhancement (41) and discrete pancreatic mass (35). [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Systematic review and meta-analysis of MRI features for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma.
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  Data: <searchLink fieldCode="AR" term="%22Yoon%2C+Seung+Bae%22">Yoon, Seung Bae</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Jeon%2C+Tae+Yeon%22">Jeon, Tae Yeon</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Moon%2C+Sung-Hoon%22">Moon, Sung-Hoon</searchLink><relatesTo>3</relatesTo><i> endomoon@hallym.or.kr</i><br /><searchLink fieldCode="AR" term="%22Lee%2C+Sang+Min%22">Lee, Sang Min</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Kim%2C+Myung-Hwan%22">Kim, Myung-Hwan</searchLink><relatesTo>5</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Oct2022, Vol. 32 Issue 10, p6691-6701. 11p. 5 Black and White Photographs, 1 Diagram, 2 Charts.
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  Label: Abstract
  Group: Ab
  Data: Objectives: To identify reliable MRI features for differentiating autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC) and to summarize their diagnostic accuracy. Methods: We conducted a systematic literature review and meta-analysis using PubMed, EMBASE, and the Cochrane Library to identify original articles published between January 2006 and July 2021. The pooled diagnostic accuracy, including the diagnostic odds ratios (DORs) with 95% confidence intervals (CIs) of the identified features, was calculated using a bivariate random effects model. Results: Twelve studies were included, and 92 overlapping descriptors were subsumed under 16 MRI features. Ten features favoring AIP were diffuse enlargement (DOR, 75; 95% CI, 9–594), capsule-like rim (DOR, 52; 95% CI, 20–131), multiple main pancreatic duct (MPD) strictures (DOR, 47; 95% CI, 17–129), homogeneous delayed enhancement (DOR, 46; 95% CI, 21–104), low apparent diffusion coefficient value (DOR, 30), speckled enhancement (DOR, 30), multiple pancreatic masses (DOR, 29), tapered narrowing of MPD (DOR, 15), penetrating duct sign (DOR, 14), and delayed enhancement (DOR, 13). Six features favoring PDAC were target type enhancement (DOR, 41; 95% CI, 11–158), discrete pancreatic mass (DOR, 35; 95% CI, 15–80), upstream MPD dilatation (DOR, 13), peripancreatic fat infiltration (DOR, 10), upstream parenchymal atrophy (DOR, 5), and vascular involvement (DOR, 3). Conclusion: This study identified 16 informative MRI features to differentiate AIP from PDAC. Among them, diffuse enlargement, capsule-like rim, multiple MPD strictures, and homogeneous delayed enhancement favored AIP with the highest DORs, whereas discrete mass and target type enhancement favored PDAC. Key Points: • The MRI features with the highest pooled diagnostic odds ratios (DORs) for autoimmune pancreatitis were diffuse enlargement of the pancreas (75), capsule-like rim (52), multiple strictures of the main pancreatic duct (47), and homogeneous delayed enhancement (46). • The MRI features with the highest pooled DORs for pancreatic ductal adenocarcinoma were target type enhancement (41) and discrete pancreatic mass (35). [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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