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Branch duct-intraductal papillary mucinous neoplasms (BD-IPMNs): an MRI-based radiomic model to determine the malignant degeneration potential

  • Abdominal Radiology
  • Published:
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Abstract

Background

Branch duct-intraductal papillary mucinous neoplasms (BD-IPMNs) are the most common pancreatic cystic tumors and have a low risk of malignant transformation. Features able to early identify high-risk BD-IPMNs are lacking, and guidelines currently rely on the occurrence of worrisome features (WF) and high-risk stigmata (HRS).

Aim

In our study, we aimed to use a magnetic resonance imaging (MRI) radiomic model to identify features linked to a higher risk of malignant degeneration, and whether these appear before the occurrence of WF and HRS.

Methods

We retrospectively evaluated adult patients with a known BD-IPMN who had had at least two contrast-enhanced MRI studies at our center and a 24-month minimum follow-up time. MRI acquisition protocol for the two examinations included pre- and post-contrast phases and diffusion-weighted imaging (DWI)/apparent diffusion coefficient (ADC) map. Patients were divided into two groups according to the development of WF or HRS at the end of the follow-up (Group 0 = no WF or HRS; Group 1 = WF or HRS). We segmented the MRI images and quantitative features were extracted and compared between the two groups. Features that showed significant differences (SF) were then included in a LASSO regression method to build a radiomic-based predictive model.

Results

We included 50 patients: 31 in Group 0 and 19 in Group 1. No patients in this cohort developed HRS. At baseline, 47, 67, 38, and 68 SF were identified for pre-contrast T1-weighted (T1-W) sequence, post-contrast T1-W sequence, T2-weighted (T2- W) sequence, and ADC map, respectively. At the end of follow-up, we found 69, 78, 53, and 91 SF, respectively. The radiomic-based predictive model identified 16 SF: more particularly, 5 SF for pre-contrast T1-W sequence, 6 for post-contrast T1-W sequence, 3 for T2-W sequence, and 2 for ADC.

Conclusion

We identified radiomic features that correlate significantly with WF in patients with BD-IPMNs undergoing contrast-enhanced MRI. Our MRI-based radiomic model can predict the occurrence of WF.

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Author notes

  1. Federica Flammia and Tommaso Innocenti have contributed equally.

Authors and Affiliations

  1. Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy

    Federica Flammia, Antonio Galluzzo, Ginevra Danti, Giuditta Chiti, Giulia Grazzini & Vittorio Miele

  2. Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale G.B. Morgagni 50, 50134, Florence, Italy

    Tommaso Innocenti, Gabriele Dragoni, Matteo Gottin & Andrea Galli

  3. Clinical Gastroenterology Unit, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy

    Tommaso Innocenti, Gabriele Dragoni, Matteo Gottin & Andrea Galli

  4. Department of Health Physics, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy

    Silvia Bettarini, Paolo Tortoli & Simone Busoni

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  1. Federica Flammia
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Correspondence to Ginevra Danti.

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The research did not involve human and/or animal participants. Patients signed informed consent form. The study was approved by the Biomedical Research Ethics Committee of our institution (protocol number: 20256_oss) and conformed to the criteria of the Declaration of Helsinki on Ethical Principles and Good Clinical Practice.

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Flammia, F., Innocenti, T., Galluzzo, A. et al. Branch duct-intraductal papillary mucinous neoplasms (BD-IPMNs): an MRI-based radiomic model to determine the malignant degeneration potential. Radiol med 128, 383–392 (2023). https://doi.org/10.1007/s11547-023-01609-6

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