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Proposed nomogram predicting neoplastic ampullary obstruction in patients with a suspected ampulla of Vater lesion on CT

Title
Proposed nomogram predicting neoplastic ampullary obstruction in patients with a suspected ampulla of Vater lesion on CT
Authors
Jang, Soo YoungKim, Jin SilBaek, Seung YonLee, Hye AhLee, Jeong Kyong
Ewha Authors
백승연이정경김진실이혜아
SCOPUS Author ID
백승연scopus; 이정경scopus; 김진실scopus; 이혜아scopus
Issue Date
2021
Journal Title
ABDOMINAL RADIOLOGY
ISSN
2366-004XJCR Link

2366-0058JCR Link
Citation
ABDOMINAL RADIOLOGY vol. 46, no. 7, pp. 3128 - 3138
Keywords
Ampulla of vaterNeoplasmNomogramCT
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Purpose To stratify and weigh the computed tomography (CT) imaging and clinical features differentiating a neoplastic ampullary obstruction from a non-neoplastic ampullary obstruction and to develop a nomogram for estimating individualized risk of neoplastic potential in patients with a suspected ampulla of Vater (AOV) lesion on CT. Methods 135 patients (92 non-neoplastic and 43 neoplastic) with a suspected ampullary obstruction on a CT scan between February 2015 and May 2019 were included after the exclusion criteria were applied. Significant imaging and clinical findings of the neoplastic lesions were assessed using univariate and multivariate logistic regression analyses. Based on the significant variables in the multivariate analysis, a nomogram was developed to predict neoplastic potential in patients suspected of ampullary obstruction. The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic value in the external validation cohort (36 non-neoplastic and 13 neoplastic). Results The multivariate analysis revealed that the presence of an AOV mass (odds ratio (OR), 77.21; 95% confidence intervals (CI) 1.51-3950.38), AOV size > 12 mm (OR, 23.93; 95% CI 2.96-193.60), total bilirubin > 1.2 mg/dl (OR, 9.99; 95% CI 1.37-73.06) and age <= 63 years (OR, 7.52; 95% CI 1.33-42.48) were independent significant parameters that predicted a neoplastic lesion in the AOV. The AUC for the nomogram was 0.93 on the internal validation and 0.91 (95% CI 0.79-0.97) on the external validation. Conclusions A nomogram using imaging and clinical findings was useful to estimate a neoplastic ampullary obstruction in patients with a suspected AOV lesion on CT and suggests a further evaluation.
DOI
10.1007/s00261-021-02975-3
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의과대학 > 의학과 > Journal papers
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