Differentiating pancreatic acinar cell carcinoma from solid pseudopapillary neoplasm using contrast-enhanced computed tomography.

Authors

Jie Yu, Yingying Cao, Anna Jie, Xiaolong He, Zhongqiu Wang, Shuai Ren

Published in

Quantitative imaging in medicine and surgery. Volume 16. Issue 10. Pages 790. Oct 01, 2026. Epub Sep 16, 2026.

Abstract

Solid pseudopapillary neoplasm (SPN) and pancreatic acinar cell carcinoma (PACC) represent two uncommon pancreatic tumors with distinct biological behaviors and management strategies. Both entities can present with overlapping appearances on contrast-enhanced computed tomography (CECT), posing a diagnostic challenge preoperatively. Therefore, reliable imaging differentiation between these tumors is clinically important. This study aimed to evaluate computed tomography (CT) imaging features for differentiating SPN from PACC and to develop a combined model to improve preoperative diagnostic performance.
We retrospectively reviewed 68 patients (51 SPN, 17 PACC) who underwent preoperative CECT. Clinical and CT imaging features were compared between groups. Variables that were significant in univariate analysis were entered into a forward stepwise multivariable logistic regression model to identify independent predictors. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and differences between ROC curves were compared using the DeLong test.
Patients with PACC were significantly older and more likely to be male than those with SPN (both P<0.001). The tumor-to-pancreas enhancement ratio in the pancreatic parenchymal phase (PPP) was significantly higher in PACC (P=0.004). The "floating cloud" sign was observed more frequently in SPN (P=0.010), whereas pancreatic duct dilation occurred more frequently in PACC (P=0.004). Multivariate analysis identified the tumor-to-pancreas enhancement ratio in the PPP [odds ratio (OR) =1.10; P=0.002] and pancreatic duct dilation (OR =4.65; P=0.036) as independent predictors of PACC, whereas the "floating cloud" sign was independently associated with SPN (OR =0.12;P=0.010). The combined model achieved the highest area under the curve (AUC) among all evaluated diagnostic models in this cohort (AUC =0.865).
A combined assessment incorporating the tumor-to-pancreas enhancement ratio in the PPP, the "floating cloud" sign, and pancreatic duct dilation may improve preoperative differentiation between PACC and SPN.

PMID:
42861071
Bibliographic data and abstract were imported from PubMed on 12 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.