Scholarlink

Background and aim <p>To compare abbreviated (APs) and comprehensive (CP) MRI protocols for branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) surveillance in terms of imaging findings, management recommendations and inter-reader agreement across readers with different levels of expertise, while assessing potential time and cost savings.</p> Methods <p>This single-center retrospective study included patients with BD-IPMN undergoing baseline and follow-up MRI between January 2018 and April 2024. The CP included axial and coronal T2WI, axial fat-saturated T1-weighted images before and after contrast injection (T1WI), 2D- and 3D-MRCP and DWI images. Two APs were obtained from CP follow-up examinations: AP with DWI consisted of axial and coronal T2WI, 2D- 3D-MRCP, axial fat-saturated T1WI and DWI; AP without DWI consisted of the same AP sequences excluding DWI. A senior radiologist (&gt; 20 years of experience in pancreatic imaging) and a junior radiologist (4th-year-radiology resident), blinded to subsequent examinations, independently analysed each protocol according to Kyoto guidelines and management recommendations. Inter-reader and inter-protocol agreement were analysed using Cohen’s and Fleiss’ Kappa. Acquisition times and resource-saving were compared using national reimbursement rates (<i>p</i> &lt; 0.05 statistically significant).</p> Results <p>Overall, 40 patients (25 women and 15 men) with a median age of 67 years (range 48–87) were included. No statistically significant differences were observed among the 3 protocols in identifying worrisome features, including high-risk stigmata, cyst size, main pancreatic duct dilation and mural nodules. The inter-protocol agreement was almost perfect (Fleiss’ Kappa = 0.82). Substantial inter-reader agreement (Cohen’s Kappa &gt; 0.6) was observed for all protocols, with almost perfect agreement (Cohen’s Kappa &gt; 0.8) in some instances. APs demonstrated up to 48% reduction in acquisition time and a 27.4% resource-saving compared to CP. The addition of DWI did not significantly improve inter-reader and inter-protocol agreement or influence management recommendations.</p> Conclusions <p>Abbreviated protocols, particularly without DWI, showed substantial agreement with CP and similar management recommendations, supporting their feasibility as resource-saving alternatives for BD-IPMN surveillance, even among less experienced radiologists.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Abbreviated versus comprehensive MRI protocols in the surveillance of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN): an exploratory analysis of inter-reader agreement, management concordance, time and cost savings

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年8月1日

查看全文
  • Christian Reca,
  • Cristiana Bonifacio,
  • Riccardo Levi,
  • Andrea Laghi

摘要

Background and aim

To compare abbreviated (APs) and comprehensive (CP) MRI protocols for branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) surveillance in terms of imaging findings, management recommendations and inter-reader agreement across readers with different levels of expertise, while assessing potential time and cost savings.

Methods

This single-center retrospective study included patients with BD-IPMN undergoing baseline and follow-up MRI between January 2018 and April 2024. The CP included axial and coronal T2WI, axial fat-saturated T1-weighted images before and after contrast injection (T1WI), 2D- and 3D-MRCP and DWI images. Two APs were obtained from CP follow-up examinations: AP with DWI consisted of axial and coronal T2WI, 2D- 3D-MRCP, axial fat-saturated T1WI and DWI; AP without DWI consisted of the same AP sequences excluding DWI. A senior radiologist (> 20 years of experience in pancreatic imaging) and a junior radiologist (4th-year-radiology resident), blinded to subsequent examinations, independently analysed each protocol according to Kyoto guidelines and management recommendations. Inter-reader and inter-protocol agreement were analysed using Cohen’s and Fleiss’ Kappa. Acquisition times and resource-saving were compared using national reimbursement rates (p < 0.05 statistically significant).

Results

Overall, 40 patients (25 women and 15 men) with a median age of 67 years (range 48–87) were included. No statistically significant differences were observed among the 3 protocols in identifying worrisome features, including high-risk stigmata, cyst size, main pancreatic duct dilation and mural nodules. The inter-protocol agreement was almost perfect (Fleiss’ Kappa = 0.82). Substantial inter-reader agreement (Cohen’s Kappa > 0.6) was observed for all protocols, with almost perfect agreement (Cohen’s Kappa > 0.8) in some instances. APs demonstrated up to 48% reduction in acquisition time and a 27.4% resource-saving compared to CP. The addition of DWI did not significantly improve inter-reader and inter-protocol agreement or influence management recommendations.

Conclusions

Abbreviated protocols, particularly without DWI, showed substantial agreement with CP and similar management recommendations, supporting their feasibility as resource-saving alternatives for BD-IPMN surveillance, even among less experienced radiologists.