Cheng M, Consul N, Chung R, Del Castillo CF, Hernandez-Barco Y, Kambadakone A. Acinar cell carcinoma of the pancreas: can CT and MR features predict survival?
Cancer Imaging 2025;
25:38. [PMID:
40119414 PMCID:
PMC11929164 DOI:
10.1186/s40644-025-00859-z]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 03/10/2025] [Indexed: 03/24/2025] Open
Abstract
OBJECTIVE
To evaluate the CT and MRI features of pancreatic acinar cell carcinoma (pACC) and their association with patient outcome and survival.
METHODS
This retrospective single-center study included 49 patients with pathology-proven pancreatic acinar cell carcinoma who underwent diagnostic imaging between August 1998 - September 2019. Two radiologists reviewed CT and MRI features independently. Survival was estimated using the Kaplan-Meier method, and Cox proportional-hazards regression model was used to identify factors associated with survival.
RESULTS
pACC tended to present as a solid (31/49, 63.3%) pancreatic head mass (26/49, 53.1%) with ill-defined margins (32/49, 65.3%) and median maximal diameter of 4.1 cm (IQR, 2.9-6.2). Majority of lesions were hypo- or isodense (38/49, 77.6%) compared to normal pancreatic parenchyma, with heterogenous (39/49, 79.6%) enhancement pattern. Biliary ductal dilatation was uncommon, with pancreatic ductal dilatation in 22.4% (11/49) and common bile duct dilatation in 14.3% (7/49). Intralesional calcifications were seen in 6.1% (3/49). Metastasis was present in 71.4% (35/49) of patients at the time of diagnosis. On MRI, 88.9% (16/18) demonstrated diffusion restriction and 59.1% (13/22) with heterogenous enhancement. On multivariate analysis, the imaging presence of T1 hyperintensity (p = 0.02), hypoattenuating necrotic components (p = 0.02), and splenic vein invasion (p = 0.04) were associated with worse survival.
CONCLUSION
Pancreatic acinar cell carcinoma is a rare pancreatic neoplasm that often presents as a large ill-defined heterogeneously enhancing mass without biliary ductal dilation. T1 hyperintensity, presence of hypoattenuating necrotic components, and splenic vein invasion were independent predictors of survival.
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