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Pancreatic IPMN
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Intraductal papillary mucinous neoplasm (IPMN)
        • Synonyms

          • Intraductal papillary mucinous tumor, intraductal mucin-hypersecreting neoplasm, ductectatic mucinous cystadenoma/carcinoma
        • Definitions

          • Mucin-producing papillary tumor arising from epithelium of main pancreatic duct (MPD) or pancreatic duct side branches 

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Ultrasonographic Findings

                • Radiographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Campbell NM et al: Imaging patterns of intraductal papillary mucinous neoplasms of the pancreas: An illustrated discussion of the International Consensus Guidelines for the Management of IPMN. Abdom Imaging. ePub, 2014
                                        2. Kim KW et al: Imaging features to distinguish malignant and benign branch-duct type intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Ann Surg. 259(1):72-81, 2014
                                        3. Kim SH et al: Intraductal Papillary Mucinous Neoplasms of the Pancreas: Evaluation of Malignant Potential and Surgical Resectability by Using MR Imaging with MR Cholangiography. Radiology. 132960, 2014
                                        4. Lennon AM et al: Role of a multidisciplinary clinic in the management of patients with pancreatic cysts: a single-center cohort study. Ann Surg Oncol. 21(11):3668-74, 2014
                                        5. Ogawa T et al: Diffusion-weighted magnetic resonance imaging for evaluating the histological degree of malignancy in patients with intraductal papillary mucinous neoplasm. J Hepatobiliary Pancreat Sci. 21(11):801-8, 2014
                                        6. Kang KM et al: Added value of diffusion-weighted imaging to MR cholangiopancreatography with unenhanced mr imaging for predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm of the pancreas. J Magn Reson Imaging. 38(3):555-63, 2013
                                        7. Perez-Johnston R et al: Frequency and significance of calcification in IPMN. Pancreatology. 13(1):43-7, 2013
                                        8. Raman SP et al: Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know. Abdom Imaging. 38(6):1360-72, 2013
                                        9. Raman SP et al: Histopathologic findings of multifocal pancreatic intraductal papillary mucinous neoplasms on CT. AJR Am J Roentgenol. 200(3):563-9, 2013
                                        10. Kobayashi N et al: Endoscopic ultrasonographic findings predict the risk of carcinoma in branch duct intraductal papillary mucinous neoplasms of the pancreas. Pancreatology. 12(2):141-5, 2012
                                        11. Remotti HE et al: Intraductal papillary mucinous neoplasms of the pancreas: clinical surveillance and malignant progression, multifocality and implications of a field-defect. JOP. 13(2):135-8, 2012
                                        12. Sahara S et al: Differentiation of pancreatic serous cystadenoma from endocrine tumor and intraductal papillary mucinous neoplasm based on washout pattern on multiphase CT. J Comput Assist Tomogr. 36(2):231-6, 2012
                                        13. Tanaka M et al: International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 12(3):183-97, 2012
                                        14. Nara S et al: Preoperative evaluation of invasive and noninvasive intraductal papillary-mucinous neoplasms of the pancreas: clinical, radiological, and pathological analysis of 123 cases. Pancreas. 38(1):8-16, 2009
                                        15. Gupta R et al: Pancreatic intraductal papillary mucinous neoplasms: role of CT in predicting pathologic subtypes. AJR Am J Roentgenol. 2008 Nov;191(5):1458-64. Erratum in: AJR Am J Roentgenol. 191(6):1876, 2008
                                        16. Jang JY et al: Treatment guidelines for branch duct type intraductal papillary mucinous neoplasms of the pancreas: when can we operate or observe? Ann Surg Oncol. 15(1):199-205, 2008
                                        17. Ogawa H et al: Intraductal papillary mucinous neoplasm of the pancreas: assessment of the likelihood of invasiveness with multisection CT. Radiology. 248(3):876-86, 2008
                                        18. Takeshita K et al: Differential diagnosis of benign or malignant intraductal papillary mucinous neoplasm of the pancreas by multidetector row helical computed tomography: evaluation of predictive factors by logistic regression analysis. J Comput Assist Tomogr. 32(2):191-7, 2008
                                        19. Waters JA et al: CT vs MRCP: optimal classification of IPMN type and extent. J Gastrointest Surg. 12(1):101-9, 2008
                                        20. Yamada Y et al: Intraductal papillary mucinous neoplasms of the pancreas: correlation of helical CT and dynamic MR imaging features with pathologic findings. Abdom Imaging. 33(4):474-81, 2008
                                        21. Vullierme MP et al: Malignant intraductal papillary mucinous neoplasm of the pancreas: in situ versus invasive carcinoma surgical resectability. Radiology. 245(2):483-90, 2007
                                        22. Kawamoto S et al: MDCT of intraductal papillary mucinous neoplasm of the pancreas: evaluation of features predictive of invasive carcinoma. AJR Am J Roentgenol. 186(3):687-95, 2006
                                        23. Sahani DV et al: Intraductal papillary mucinous neoplasm of pancreas: multi-detector row CT with 2D curved reformations--correlation with MRCP. Radiology. 238(2):560-9, 2006
                                        24. Prasad SR et al: Intraductal papillary mucinous tumors of the pancreas. Abdom Imaging. 28(3):357-65, 2003
                                        25. Sai JK et al: Management of branch duct-type intraductal papillary mucinous tumor of the pancreas based on magnetic resonance imaging. Abdom Imaging. 28(5):694-9, 2003
                                        26. Sugiyama M et al: Predictive factors for malignancy in intraductal papillary-mucinous tumours of the pancreas. Br J Surg. 90(10):1244-9, 2003
                                        27. Taouli B et al: Intraductal papillary mucinous tumors of the pancreas: features with multimodality imaging. J Comput Assist Tomogr. 26(2):223-31, 2002
                                        28. Lim JH et al: Radiologic spectrum of intraductal papillary mucinous tumor of the pancreas. Radiographics. 21(2):323-37; discussion 337-40, 2001
                                        29. Peters HE et al: Magnetic resonance cholangiopancreatography (MRCP) of intraductal papillary-mucinous neoplasm (IPMN) of the pancreas: case report. Magn Reson Imaging. 19(8):1139-43, 2001
                                        30. Silas AM et al: Intraductal papillary mucinous tumors of the pancreas. AJR Am J Roentgenol. 176(1):179-85, 2001
                                        31. Fukukura Y et al: Intraductal papillary mucinous tumors of the pancreas: thin-section helical CT findings. AJR Am J Roentgenol. 174(2):441-7, 2000
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Intraductal papillary mucinous neoplasm (IPMN)
                                              • Synonyms

                                                • Intraductal papillary mucinous tumor, intraductal mucin-hypersecreting neoplasm, ductectatic mucinous cystadenoma/carcinoma
                                              • Definitions

                                                • Mucin-producing papillary tumor arising from epithelium of main pancreatic duct (MPD) or pancreatic duct side branches 

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Radiographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Campbell NM et al: Imaging patterns of intraductal papillary mucinous neoplasms of the pancreas: An illustrated discussion of the International Consensus Guidelines for the Management of IPMN. Abdom Imaging. ePub, 2014
                                                                              2. Kim KW et al: Imaging features to distinguish malignant and benign branch-duct type intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Ann Surg. 259(1):72-81, 2014
                                                                              3. Kim SH et al: Intraductal Papillary Mucinous Neoplasms of the Pancreas: Evaluation of Malignant Potential and Surgical Resectability by Using MR Imaging with MR Cholangiography. Radiology. 132960, 2014
                                                                              4. Lennon AM et al: Role of a multidisciplinary clinic in the management of patients with pancreatic cysts: a single-center cohort study. Ann Surg Oncol. 21(11):3668-74, 2014
                                                                              5. Ogawa T et al: Diffusion-weighted magnetic resonance imaging for evaluating the histological degree of malignancy in patients with intraductal papillary mucinous neoplasm. J Hepatobiliary Pancreat Sci. 21(11):801-8, 2014
                                                                              6. Kang KM et al: Added value of diffusion-weighted imaging to MR cholangiopancreatography with unenhanced mr imaging for predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm of the pancreas. J Magn Reson Imaging. 38(3):555-63, 2013
                                                                              7. Perez-Johnston R et al: Frequency and significance of calcification in IPMN. Pancreatology. 13(1):43-7, 2013
                                                                              8. Raman SP et al: Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know. Abdom Imaging. 38(6):1360-72, 2013
                                                                              9. Raman SP et al: Histopathologic findings of multifocal pancreatic intraductal papillary mucinous neoplasms on CT. AJR Am J Roentgenol. 200(3):563-9, 2013
                                                                              10. Kobayashi N et al: Endoscopic ultrasonographic findings predict the risk of carcinoma in branch duct intraductal papillary mucinous neoplasms of the pancreas. Pancreatology. 12(2):141-5, 2012
                                                                              11. Remotti HE et al: Intraductal papillary mucinous neoplasms of the pancreas: clinical surveillance and malignant progression, multifocality and implications of a field-defect. JOP. 13(2):135-8, 2012
                                                                              12. Sahara S et al: Differentiation of pancreatic serous cystadenoma from endocrine tumor and intraductal papillary mucinous neoplasm based on washout pattern on multiphase CT. J Comput Assist Tomogr. 36(2):231-6, 2012
                                                                              13. Tanaka M et al: International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 12(3):183-97, 2012
                                                                              14. Nara S et al: Preoperative evaluation of invasive and noninvasive intraductal papillary-mucinous neoplasms of the pancreas: clinical, radiological, and pathological analysis of 123 cases. Pancreas. 38(1):8-16, 2009
                                                                              15. Gupta R et al: Pancreatic intraductal papillary mucinous neoplasms: role of CT in predicting pathologic subtypes. AJR Am J Roentgenol. 2008 Nov;191(5):1458-64. Erratum in: AJR Am J Roentgenol. 191(6):1876, 2008
                                                                              16. Jang JY et al: Treatment guidelines for branch duct type intraductal papillary mucinous neoplasms of the pancreas: when can we operate or observe? Ann Surg Oncol. 15(1):199-205, 2008
                                                                              17. Ogawa H et al: Intraductal papillary mucinous neoplasm of the pancreas: assessment of the likelihood of invasiveness with multisection CT. Radiology. 248(3):876-86, 2008
                                                                              18. Takeshita K et al: Differential diagnosis of benign or malignant intraductal papillary mucinous neoplasm of the pancreas by multidetector row helical computed tomography: evaluation of predictive factors by logistic regression analysis. J Comput Assist Tomogr. 32(2):191-7, 2008
                                                                              19. Waters JA et al: CT vs MRCP: optimal classification of IPMN type and extent. J Gastrointest Surg. 12(1):101-9, 2008
                                                                              20. Yamada Y et al: Intraductal papillary mucinous neoplasms of the pancreas: correlation of helical CT and dynamic MR imaging features with pathologic findings. Abdom Imaging. 33(4):474-81, 2008
                                                                              21. Vullierme MP et al: Malignant intraductal papillary mucinous neoplasm of the pancreas: in situ versus invasive carcinoma surgical resectability. Radiology. 245(2):483-90, 2007
                                                                              22. Kawamoto S et al: MDCT of intraductal papillary mucinous neoplasm of the pancreas: evaluation of features predictive of invasive carcinoma. AJR Am J Roentgenol. 186(3):687-95, 2006
                                                                              23. Sahani DV et al: Intraductal papillary mucinous neoplasm of pancreas: multi-detector row CT with 2D curved reformations--correlation with MRCP. Radiology. 238(2):560-9, 2006
                                                                              24. Prasad SR et al: Intraductal papillary mucinous tumors of the pancreas. Abdom Imaging. 28(3):357-65, 2003
                                                                              25. Sai JK et al: Management of branch duct-type intraductal papillary mucinous tumor of the pancreas based on magnetic resonance imaging. Abdom Imaging. 28(5):694-9, 2003
                                                                              26. Sugiyama M et al: Predictive factors for malignancy in intraductal papillary-mucinous tumours of the pancreas. Br J Surg. 90(10):1244-9, 2003
                                                                              27. Taouli B et al: Intraductal papillary mucinous tumors of the pancreas: features with multimodality imaging. J Comput Assist Tomogr. 26(2):223-31, 2002
                                                                              28. Lim JH et al: Radiologic spectrum of intraductal papillary mucinous tumor of the pancreas. Radiographics. 21(2):323-37; discussion 337-40, 2001
                                                                              29. Peters HE et al: Magnetic resonance cholangiopancreatography (MRCP) of intraductal papillary-mucinous neoplasm (IPMN) of the pancreas: case report. Magn Reson Imaging. 19(8):1139-43, 2001
                                                                              30. Silas AM et al: Intraductal papillary mucinous tumors of the pancreas. AJR Am J Roentgenol. 176(1):179-85, 2001
                                                                              31. Fukukura Y et al: Intraductal papillary mucinous tumors of the pancreas: thin-section helical CT findings. AJR Am J Roentgenol. 174(2):441-7, 2000