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Differentiation of Pancreatic Serous Cystadenoma From Endocrine Tumor and Intraductal Papillary Mucinous Neoplasm Based on Washout Pattern on Multiphase CT

Sahara, Shinya MD; Kawai, Nobuyuki MD; Sato, Morio MD; Ikoma, Akira MD; Minamiguchi, Hiroki MD; Nakai, Motoki MD; Sanda, Hiroki MD; Nakata, Kouhei MD; Takeuchi, Taizou MD; Tanaka, Takami MD; Shirai, Shintaro MD; Sonomura, Tetsuo MD

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182483bb7
Abdominal Imaging
Abstract

Objective: To evaluate the washout (WO) pattern of serous cystadenomas (SCAs) compared with endocrine tumors (ETs) and intraductal papillary mucinous neoplasm (IPMN).

Methods: Patients with serous cystadenoma (n = 12), ET (n = 29), and IPMN (n = 35) underwent 4-phase computed tomography CT. Tumors were categorized as hyperdense or hypodense. Computed tomographic values measured were unenhanced attenuation (AU), pancreatic attenuation (A12, 12 seconds), portal attenuation (A35), and equilibrium (A158). Computed tomographic parameters calculated were wash-in (WI) = A12 − AU; WO = A12 − A35; and washout ratio (WOR) = WO/WI × 100/22.

Results: Hyperdense SCAs had significantly higher WOR than did hyperdense ETs (P = 0.001). Among the 3 hypodense tumors, SCAs had the significantly highest WOR (P < 0.05/3). Relative to the pancreas, the WOR of SCAs were equivalent, whereas the WOR of ETs and IPMNs were significantly lower.

Conclusions: Hyperdense SCAs had significantly higher WOR than did hyperdense ETs, and hypodense SCAs had the significantly highest WOR among the three.

Author Information

From the Department of Radiology, Wakayama Medical University, Wakayama, Japan.

Received for publication October 20, 2011; accepted December 24, 2011.

Reprints: Morio Sato, MD, Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan (e-mail: morisato@mail.wakayama-med.ac.jp).

The authors report no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.