(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts

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Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

Intraductal papillary mucinous neoplasms with high malignant potential appear to have distinct imaging properties. Further validation of these findings may address a major clinical need in this population by identifying those most likely to benefit from surgical resection.

Alexander N. Hanania, BS, Leonidas Bantis, PhD, Ziding Feng, PhD, Huamin Wang, MD, PhD, Eric Tamm, MD, Matthew Katz, MD, Anirban Maitra, MD, Eugene Koay, MD, PhD; UT MD Anderson Cancer Center

BACKGROUND: Pancreatic cysts are identified in over 2% of the population, and a subset of them, including intraductal papillary mucinous neoplasms (IPMNs), represent premalignant lesions. Unfortunately, clinicians cannot accurately predict which of these lesions are likely to progress to pancreatic ductal adenocarcinoma. We explored the use of quantitative imaging to help address this clinical dilemma.

METHODS: We investigated 360 imaging features within the domains of intensity, texture, and shape using pancreatic protocol CT images of 53 cystic lesions in patients diagnosed with IPMN (34 high-grade [HG] and 19 low-grade [LG]) who subsequently underwent surgical resection. We compared the performance of these features with the standard Sendai criteria. We focused on top-performing imaging markers, based on receiver operating characteristic (ROC) and ROC (0.05) performances (a false positive rate of 5%). Additionally, we constructed a panel based on the Akaike information criterion, scrutinizing combinations of top-performing markers. We also considered principal component analysis of the imaging features to further evaluate differences in the IPMNs.

RESULTS: We identified 14 imaging biomarkers within a gray-level co-occurrence matrix (GLCM) that predicted histopathological grade. The most predictive marker differentiated LG and HG lesions with an area under the curve (AUC) value of 0.82 at a sensitivity of 85% and specificity of 68%. Conversely, the Sendai criteria had a sensitivity of 97% and a specificity of 0%. Using a cross-validated design, the best logistic regression model yielded an AUC value of 0.95 (σ = .05). Based on the principal component analysis, LG and HG cysts demonstrated a pattern of separation.

CONCLUSIONS: IPMNs with high malignant potential appear to have distinct imaging properties. Further validation of these findings may address a major clinical need in this population by identifying those most likely to benefit from surgical resection.

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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