Table 3. Imaging and tumor marker characteristics suggestive of malignancy in IPMN (all types).
| Characteristic | Sensitivity (95%CI) | Specificity (95% CI) | Area under the curve (95% CI) | Q-test for heterogeneity |
|---|---|---|---|---|
| Presence of risk features on CT/MRI | 0.809 (0.714–0.883) | 0.762 (0.654–0.851) | 0.856 (0.778–0.915) | 5.24 (0.15) |
| Presence of risk features on PET | 0.968 (0.900–0.995) | 0.911 (0.815–0.998) | 0.985 (0.949–0.998) | 7.82 (0.02) |
| Mural nodule presence | 0.69 (0.585–0.793) | 0.798 (0.722–0.862) | 0.819 (0.719–0.925) | 21.7 (0.36) |
| Main pancreatic ductal dilation | 0.614 (0.471–0.746) | 0.687 (0.564–0.799) | 0.702 (0.596–0.838) | 7.48 (0.88) |
| Cyst size >3 cm | 0.682 (0.575–0.789) | 0.574 (0.43–0.702) | 0.657 (0.575–0.766) | 17.14 (0.004) |
| Cyst fluid elevated CEA levels | 0.636 (0.179–0.926) | 0.72 (0.48–0.894) | 0.843 (0.481–0.997) | 22.41 (0.1) |
| Elevated serum CEA levels | 0.169 (0.074–0.321) | 0.933 (0.867–0.972) | 0.691 (0.375–0.996) | 3.24 (0.78) |
| Elevated serum CA19-9 levels | 0.38 (0.156–0.634) | 0.903 (0.846–0.947) | 0.729 (0.651– 0.792) | 6.05 (0.42) |
| Combinations | 0.743 (0.542–0.9) | 0.906 (0.782–0.963) | 0.907 (0.701–0.999) | 8.34 (0.3) |
CA19-9, carbohydrate antigen 19-9; CEA, carcinoembryonic antigen; CI, confidence interval; CT/MRI, computed tomography/magnetic resonance imaging; IPMN, intraductal papillary mucinous neoplasia; PET, positron emission tomography.
Risk features on imaging were presence of mural nodule/septation, cyst size >3 cm, main pancreatic duct dilation, and uptake on PET.