Details

Autor(en) / Beteiligte

• Elmi, Nika
• McEvoy, David
• McInnes, Matthew D.F.
• Alabousi, Mostafa
• Hecht, Elizabeth M.
• Luk, Lyndon
• Asghar, Sunna
• Jajodia, Ankush
• Carvalho, Tiago Lins
• Warnica, William J.
• Zha, Nanxi
• Ullah, Sadaf
• Pol, Christian B.

Titel

Percentage of Pancreatic Cysts on MRI With a Pancreatic Carcinoma: Systematic Review and Meta‐Analysis

Ist Teil von

• Journal of magnetic resonance imaging, 2024-09, Vol.60 (3), p.1063-1075

Ort / Verlag

Hoboken, USA: John Wiley & Sons, Inc

Erscheinungsjahr

2024

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Background Pancreatic cystic lesions (PCLs) are frequent on MRI and are thought to be associated with pancreatic adenocarcinoma (PDAC) necessitating long‐term surveillance based on older studies suffering from selection bias. Purpose To establish the percentage of patients with PCLs on MRI with a present or future PDAC. Study Type Systematic review, meta‐analysis. Population Adults with PCLs on MRI and a present or future diagnosis of PDAC were eligible. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus were searched to April 2022 (PROSPERO:CRD42022320502). Studies limited to PCLs not requiring surveillance, <100 patients, or those with a history/genetic risk of PDAC were excluded. Field Strength/Sequence ≥1.5 T with ≥1 T2‐weighted sequence. Assessment Two investigators extracted data, with discrepancies resolved by a third. QUADAS‐2 assessed bias. PDAC was diagnosed using a composite reference standard. Statistical Tests A meta‐analysis of proportions was performed at the patient‐level with 95% confidence intervals (95% CI). Results Eight studies with 1289 patients contributed to the percentage of patients with a present diagnosis of PDAC, and 10 studies with 3422 patients to the percentage with a future diagnosis. Of patients with PCLs on MRI, 14.8% (95% CI 2.4–34.9) had a PDAC at initial MRI, which decreased to 6.0% (2.2–11.3) for studies at low risk of bias. For patients without PDAC on initial MRI, 2.0% (1.1–3.2) developed PDAC during surveillance, similar for low risk of bias studies at 1.9% (0.7–3.6), with no clear trend of increased PDAC for longer surveillance durations. For patients without worrisome features or high‐risk stigmata, 0.9% (0.1–2.2) developed PDAC during surveillance. Of 10, eight studies had a median surveillance ≥3 years (range 3–157 months). Sources of bias included retrospectively limiting PCLs to those with histopathology and inconsistent surveillance protocols. Data Conclusion A low percentage of patients with PCLs on MRI develop PDAC while on surveillance. The first MRI revealing a PCL should be scrutinized for PDAC. Level of Evidence 3 Technical Efficacy Stage 2