Lower Interobserver Reliability for Nondimensional Intracystic Features Among Abdominal Radiologists for Characterizing Intraductal Papillary Mucinous Neoplasms Using Magnetic Resonance Imaging

John A. Scherer, Robyn Gebhard, Stephen A. Firkins, Zarine K. Shah, Irma K. Urbina Andersson, Samantha J. Barker, Lauren E. Fiorillo, Ephraim Hollander, Nicholas Shaheen, Eugene J. Koay, Darwin L. Conwell, Somashekar G. Krishna

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Current guidelines recommend magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) for risk stratification of intraductal papillary mucinous neoplasms (IPMNs). We assessed the interobserver agreement among radiologists in evaluating and risk stratifying IPMNs. Methods This single-center study evaluated 30 patients with IPMNs who had undergone MRI/MRCP, endoscopic ultrasound, and/or surgical resection. Six abdominal radiologists evaluated the MRI/MRCPs to document multiple parameters. The analysis applied Landis and Koch κ interpretation for categorical variables and intraclass correlation coefficient (r) for continuous variables. Results Radiologists demonstrated almost perfect agreement for location (κ = 0.81, 95% confidence interval [CI], 0.74-0.87), size (r = 0.95; 95% CI, 0.89-0.98), and main pancreatic duct diameter (r = 0.98; 95% CI, 0.96-0.99). Substantial agreement was observed for communication with the main pancreatic duct (κ = 0.66; 95% CI, 0.57-0.75) and classification of IPMN subtype (κ = 0.77; 95% CI, 0.67-0.86). Presence of intracystic nodules (κ = 0.31; 95% CI, 0.21-0.42) and wall thickening (κ = 0.09; 95% CI, -0.01 to 0.18) reached only fair and slight agreement, respectively. Conclusions Although MRI/MRCP is excellent in the evaluation of spatial aspects, there is lower reliability for nondimensional characteristics of IPMNs. These data support guideline-recommended complementary evaluation of IPMNs with MRI/MRCP and endoscopic ultrasound.

Original languageEnglish
Pages (from-to)1225-1230
Number of pages6
JournalPancreas
Volume51
Issue number9
DOIs
StatePublished - Oct 1 2022

Bibliographical note

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • interobserver variability
  • intraductal papillary mucinous neoplasm
  • magnetic resonance cholangiopancreatography
  • magnetic resonance imaging
  • pancreas
  • pancreas cyst

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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