Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: recommendations for Standardized Imaging and Reporting f
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Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: recommendations for Standardized Imaging and Reporting from the Society of Abdominal Radiology IPMN disease focused panel Elizabeth M. Hecht1 · Gaurav Khatri2 · Desiree Morgan3 · Stella Kang4 · Priya R. Bhosale5 · Isaac R. Francis6 · Namita S. Gandhi7 · David M. Hough8 · Chenchan Huang4 · Lyndon Luk9 · Alec Megibow4 · Justin M. Ream7 · Dushyant Sahani10 · Vahid Yaghmai11 · Atif Zaheer12 · Ravi Kaza6 Received: 21 August 2020 / Revised: 27 October 2020 / Accepted: 30 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract There have been many publications detailing imaging features of malignant transformation of intraductal papillary mucinous neoplasms (IPMN), management and recommendations for imaging follow-up of diagnosed or presumed IPMN. However, there is no consensus on several practical aspects of imaging IPMN that could serve as a clinical guide for radiologists and enable future data mining for research. These aspects include how to measure IPMN, define reporting terminology, standardize reporting and unify guidelines for surveillance. The Society of Abdominal Radiology (SAR) created multiple Disease-Focused Panels (DFP) comprised multidisciplinary panel members who focus on a particular disease, with the goal to develop ways for radiologists to improve patient care, education, and research. DFP members met to identify the current controversies and limitations of imaging pancreatic IPMN. This paper aims to provide a practical review of the key imaging characteristics of IPMN for trainees and practicing radiologists, to guide uniformity of performance and interpretation of surveillance imaging studies, and to improve communication with clinicians by providing a lexicon and reporting template based on the experience of the SAR-DFP panel members. Keywords Pancreas · Intraductal papillary mucinous neoplasm · MRCP · Template · Surveillance · Computed tomography
Introduction The estimated prevalence of pancreatic cysts in the US population is 2.5% [1]. However, up to 44.7% of magnetic resonance cholangiopancreatography (MRCP) examinations may detect pancreatic cystic lesions with the frequency of cysts increasing with patient age [2, 3]. Incidental detection of pancreatic cystic lesions often leads to further workup with computed tomography (CT), MRI/MRCP and/or endoscopic ultrasound (EUS) with or without cyst aspiration. Incidental pancreatic cystic lesions may be characterized as benign, with no malignant potential (e.g., pseudocysts or serous cystic tumors), or as potentially malignant (e.g., mucinous neoplasms (MCN) and intraductal papillary mucinous neoplasms (IPMN)) [4]. Even after additional diagnostic * Elizabeth M. Hecht [email protected] Extended author information available on the last page of the article
assessment, some pancreatic cystic lesions cannot be definitively characterized and are presumed to represent branch duct IPMN. IPMNs are exocrine neoplasms that arise in the p
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