Keywords:
Abdomen, MR-Cholangiography, Imaging sequences, Neoplasia
Authors:
A. Angeli, S. Kashmoola, M. Strudwick, E. Hornsey, N. Kutaiba
DOI:
10.26044/ranzcr2022/R-0028
Purpose
Pancreatic cysts, including branch-duct intraductal papillary mucinous neoplasms (BD-IPMN), are commonly encountered on imaging. Such cysts are initially investigated by assessing clinical status, tumour markers and multiphase contrast magnetic resonance imaging (MRI) including magnetic resonance cholangiopancreatography (MRCP).(1,2) When there are no suspicious features, follow-up is performed with MRCP to assess size change and main pancreatic duct diameter.(2)
Various MRCP protocols for follow-up of BD-IPMN are used depending on institutional preferences. For example, some centres use MRCP with contrast-enhanced pancreatic MRI sequences and diffusion-weighted imaging (DWI) in the initial evaluation and follow-up of BD-IMPN. However, attempts to reduce imaging time by using abbreviated MRI protocols have been suggested.(3) At our centre, once the pancreas and cysts are characterised with MRCP and contrast-enhanced sequences, subsequent imaging follow-up is performed with non-contrast MRCP alone. However, MRCP follow-up in BD-IPMN is performed to assess two specific components: size increase of the cyts and main duct dilatation. To address these two specific components, only a few MRCP sequences are required. We recently changed our pancreatic cysts follow-up MRCP protocol to include fewer sequences aiming to provide relevant information but with reduced imaging time.
The primary of our study was to assess imaging time saved using fewer sequences for follow up of pancreatic cysts and IPMN. The secondary aim was to assess whether any patients scanned with fewer sequences would be recalled for further imaging.