Morphological characterization of atypical pancreatic ductal adenocarcinoma with cystic lesion on DCE-CT: a comprehensive retrospective study.

IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING BMC Medical Imaging Pub Date : 2025-03-14 DOI:10.1186/s12880-025-01586-4
Jing Chen, Qi Wu, Ling Liu, Yuan Yuan, Shengsheng Lai, Zhe Wu, Ruimeng Yang
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引用次数: 0

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) with cystic features presents significant challenges in achieving an accurate preoperative diagnosis and in implementing appropriate clinical management. The aim of this study was to analyze the dynamic contrast-enhanced computed tomography (DCE-CT) findings of PDACs with cystic lesions and correlate them with histopathological findings.

Methods: We retrospectively reviewed 40 patients with pathology-proven PDACs exhibiting cystic lesions who underwent preoperative DCE-CT imaging. The CT manifestations were classified into three subtypes based on the morphological characteristics of the cystic lesions: Type 1, small proportion (< 50%) of intratumoral cystic lesions, with or without associated peritumoral cystic lesions; Type 2, large proportion (≥ 50%) of intratumoral cystic lesions, with or without associated peritumoral cystic lesions; Type 3, a solid pancreatic mass with accompanying peritumoral cystic lesions. The DCE-CT findings were analyzed based on location, size, contour, enhancement patterns, and secondary findings, and compared with the corresponding pathological diagnoses.

Results: Among the 40 patients, 23 (57.5%) tumors were located in the pancreatic body or tail. Type 1 was identified in 21 cases, Type 2 in 6 cases, and Type 3 in 13 cases. All masses exhibited a bulging pancreatic contour, with 4 cases showing isoattenuating enhancement on DCE-CT. Secondary signs were present in 87.5% (35/40) of cases. Notably, 15 cases (37.5%) were misdiagnosed or missed. Surgical resection specimens demonstrated common pathological features, including large duct-like cysts and coagulative necrosis.

Conclusion: Atypical PDAC with cystic lesions is a relatively uncommon variant that exhibits a range of DCE-CT features, along with distinct pathological characteristics. Familiarity with these imaging features is essential for radiologists in order to minimize the risk of misdiagnosis and guide appropriate clinical management of these challenging cases.

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来源期刊
BMC Medical Imaging
BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.60
自引率
3.70%
发文量
198
审稿时长
27 weeks
期刊介绍: BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.
期刊最新文献
Morphological characterization of atypical pancreatic ductal adenocarcinoma with cystic lesion on DCE-CT: a comprehensive retrospective study. AI-ready rectal cancer MR imaging: a workflow for tumor detection and segmentation. Deep learning-based evaluation of panoramic radiographs for osteoporosis screening: a systematic review and meta-analysis. Quantifying anterior segment vascular changes in thyroid eye disease using optical coherence tomography angiography. Convolutional block attention gate-based Unet framework for microaneurysm segmentation using retinal fundus images.
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