Age-related changes in normal adult pancreas: MR imaging evaluation

Sato, Takahiro; Ito, Katsuyoshi; Tamada, Tsutomu; Sone, Toshio; Noda, Yasufumi; Higaki, Atsushi; Kanki, Akihiko; Tanimoto, Daigo; Higashi, Hideyuki

doi:10.1016/j.ejrad.2011.07.014

Cited by 61 publications

(49 citation statements)

References 11 publications

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“…Sato et al published a study on age-dependent atrophy that stated that atrophy is most prominent in the pancreatic tail on MR images of the normal adult pancreas. They measured the anterioposterior diameter in the head, body and tail [27]. In our study, we can confirm that the longitudinal diameter of the pancreas also decreases with age.…”

Section: Discussionsupporting

confidence: 86%

Diagnostic Value and Interreader Agreement of the Pancreaticolienal Gap in Pancreatic Cancer on MDCT

et al. 2016

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ObjectiveThe aim of this retrospective study was to evaluate the diagnostic value and measure interreader agreement of the pancreaticolienal gap (PLG) in the assessment of imaging features of pancreatic carcinoma (PC) on contrast-enhanced multi-detector computed tomography (CE-MDCT).Materials and MethodsCE-MDCT studies in the portal venous phase were retrospectively reviewed for 66 patients with PC. The age- and gender-matched control group comprised 103 healthy individuals. Three radiologists with different levels of experience independently measured the PLG (the minimum distance of the pancreatic tail to the nearest border of the spleen) in the axial plane. The interreader agreement of the PLG and the receiver operating characteristic (ROC) curve was used to calculate the accuracy of the technique.ResultsWhile the control group (n = 103) showed a median PLG of 3 mm (Range: 0 – 39mm) the PC patients had a significantly larger PLG of 15mm (Range: 0 – 53mm)(p < 0.0001). A ROC curve demonstrated a cutoff-value of >12 mm for PC, with a sensitivity of 58.2% (95% CI = 45.5–70.1), specificity of 84.0% (95% CI = 75.6–90.4) and an area under the ROC curve of 0.714 (95% CI = 0.641 to 0.780). The mean interreader agreement showed correlation coefficient r of 0.9159. The extent of the PLG did not correlate with tumor stage but did correlate with pancreatic density (fatty involution) and age, the density decreased by 4.1 HU and the PLG increased by 0.8 mm within every 10 y.ConclusionThe significant interreader agreement supports the use of the PLG as a characterizing feature of pancreatic cancer independent of the tumor stage on an axial plane. The increase in the PLG with age may represent physiological atrophy of the pancreatic tail.

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Section: Discussionsupporting

confidence: 86%

Diagnostic Value and Interreader Agreement of the Pancreaticolienal Gap in Pancreatic Cancer on MDCT

et al. 2016

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“…However, advancing age, alcohol use, smoking, diabetes, and obesity can cause pancreatic atrophy, fatty degeneration or fibrosis in those who have chronic abdominal pain due to etiologies other than CP (5-7). In addition, chronic narcotic use for pain can lead to narcotic bowel syndrome and central sensitization of pain (9-11), both of which can be difficult to diagnose and treat, and adversely impact the outcomes after pancreatic surgery (12), including TPIAT.…”

Section: Patient Selection Indications and Timing Of Tpiatmentioning

confidence: 99%

Total Pancreatectomy With Islet Autotransplantation

Bellin¹,

Gelrud²,

Arreaza-Rubín³

et al. 2014

Pancreas

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A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis (CP). The session was held on July 23, 2014 and structured into five sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with CP considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of CP and total pancreatectomy outcomes as well as post-surgical diabetes outcomes was repeatedly emphasized.

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“…Pancreatic atrophy has been used to make the diagnosis of chronic pancreatitis but remains controversial (11,32,33), and may also occur as part of the normal aging process (34). In three of these four patients, follow-up EUS was also positive.…”

Section: Discussionmentioning

confidence: 99%

Defining the Accuracy of Secretin Pancreatic Function Testing in Patients With Suspected Early Chronic Pancreatitis

Ketwaroo

Brown

Young

et al. 2013

American Journal of Gastroenterology

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OBJECTIVES The diagnosis of chronic pancreatitis in patients with characteristic symptoms but normal pancreatic imaging is challenging. Assessment of pancreatic function through secretin pancreatic function testing (SPFT) has been advocated in this setting, but its diagnostic accuracy is not fully known. METHODS This was a retrospective review of patients who received SPFT at our tertiary care institution between January 1995 and December 2008 for suspected chronic pancreatitis. For all patients, medical records were reviewed for evidence of subsequent development of chronic pancreatitis by imaging and/or pathology. Patients were then categorized as “true positive” or “true negative” for chronic pancreatitis based on follow-up imaging or histologic evidence. RESULTS In all, 116 patients underwent SPFT. Of the 27 patients who tested positive, 7 were lost to follow-up. Of the remaining 20 SPFT-positive patients, 9 (45 %) developed radiologic or histologic evidence of chronic pancreatitis after a median of 4 years (1–11 years). Of the 89 patients who had negative SPFT testing, 19 were lost to follow-up. Of the remaining 70 patients, 2 were eventually diagnosed with chronic pancreatitis based on subsequent imaging/histology after a median follow-up period of 7 years (3–11 years). The sensitivity of the SPFT in diagnosing chronic pancreatitis was 82 % with a specificity of 86 %. The positive predictive value (PPV) of chronic pancreatitis was 45 % with a negative predictive value (NPV) of 97 %. CONCLUSIONS In patients with suspected early chronic pancreatitis and normal pancreatic imaging, SPFT is highly accurate at ruling out early chronic pancreatitis with a NPV of 97 %.

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Age-related changes in normal adult pancreas: MR imaging evaluation

Cited by 61 publications

References 11 publications

Diagnostic Value and Interreader Agreement of the Pancreaticolienal Gap in Pancreatic Cancer on MDCT

Diagnostic Value and Interreader Agreement of the Pancreaticolienal Gap in Pancreatic Cancer on MDCT

Total Pancreatectomy With Islet Autotransplantation

Defining the Accuracy of Secretin Pancreatic Function Testing in Patients With Suspected Early Chronic Pancreatitis

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