Differentiating Autoimmune Pancreatitis From Pancreatic Adenocarcinoma Using Dual-Phase Computed Tomography

Zaheer, Atif; Singh, Vikesh K.; Akshintala, Venkata S.; Kawamoto, Satomi; Tsai, Salina; Gage, Kenneth L.; Fishman, Elliot K.

doi:10.1097/rct.0b013e3182a9a431

Cited by 30 publications

(36 citation statements)

References 29 publications

(45 reference statements)

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“…In one of the more recent studies, Zaheer et al [28] observed diffuse pancreatic involvement more frequently in autoimmune pancreatitis (41%) than in pancreatic ductal adenocarcinoma (9%). In that study, the extrapancreatic findings of common bile duct stricture (63%) and biliary wall enhancement (47%) were the most common imaging features of autoimmune pancreatitis, whereas in our study the pancreatic findings of sausage shape (64%) and low-attenuation halo (59%) were the most common.…”

Section: Mdct Of Pancreatitis and Cancermentioning

confidence: 96%

“…Several studies [8,10,16,28] have evaluated the utility of MDCT for differentiating autoimmune pancreatitis and pancreatic ductal adenocarcinoma. In one of the more recent studies, Zaheer et al [28] observed diffuse pancreatic involvement more frequently in autoimmune pancreatitis (41%) than in pancreatic ductal adenocarcinoma (9%).…”

Section: Mdct Of Pancreatitis and Cancermentioning

confidence: 99%

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JOURNAL CLUB: Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis

Lee‐Felker

Felker

Kadell

et al. 2015

American Journal of Roentgenology

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Section: Mdct Of Pancreatitis and Cancermentioning

confidence: 96%

Section: Mdct Of Pancreatitis and Cancermentioning

confidence: 99%

JOURNAL CLUB: Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis

Lee‐Felker

Felker

Kadell

et al. 2015

American Journal of Roentgenology

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“…2 a) (described as a “halo” by some sources), which is thought to represent a combination of fibrotic tissue, fluid and phlegmon. The presence of this peripancreatic capsule has been suggested to be a useful distinguishing feature between AIP and pancreatic cancer [ 14 ]. Notably, AIP is not usually associated with pancreatic pseudocysts, peripancreatic collections or retroperitoneal fluid, and the lack of these features may favour AIP over acute or chronic pancreatitis.…”

Section: Imaging Findingsmentioning

confidence: 99%

Abdominal manifestations of IgG4-related disease: a pictorial review

2018

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In the last decade, autoimmune pancreatitis has become recognised as part of a wider spectrum of IgG4-related disease, typically associated with elevated serum IgG4 levels and demonstrating a response to corticosteroid therapy. Radiologically, there is imaging overlap with other benign and neoplastic conditions. This pictorial review discusses the intra-abdominal manifestations of this disease on cross-sectional imaging before and after steroid treatment and the main radiological features which help to distinguish it from other key differentials.Teaching Points• Autoimmune pancreatitis is part of a spectrum of IgG4-related disease.• Diagnosis is based on raised serum IgG4, clinical, radiological and histopathological findings.• Cross-sectional imaging can demonstrate the typical findings of abdominal IgG4-related disease.• Cross-sectional imaging can be used to monitor response to corticosteroid treatment.

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“…Previous studies attempted to establish secondary CT findings specific for advanced and early PCs in terms of abnormality in main pancreatic duct (MPD) and parenchymal structures [ 6 , 7 , 8 , 9 ]. Localized MPD stenosis with or without upstream MPD dilation is generally observed in PC [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is now generally accepted that the detection of small PC ≤ 10 mm including CIS is indispensable to improve the prognosis of PC. However, there are no reports regarding the characteristic CT findings in patients with small PC (≤10 mm) [ 6 , 7 , 8 , 9 , 13 , 14 , 15 , 16 , 17 ]. In this study, we attempted to identify the specific CT findings of small PC by focusing on abnormalities in MPD and pancreatic parenchyma in patients with small PC including CIS.…”

Section: Introductionmentioning

confidence: 99%

Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients

et al. 2020

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Background: This study aimed to evaluate and identify the specific CT findings by focusing on abnormalities in the main pancreatic duct (MPD) and pancreatic parenchyma in patients with small pancreatic cancer (PC) including carcinoma in situ (CIS). Methods: Nine CT findings indicating abnormalities of MPD and pancreatic parenchyma were selected as candidate findings for the presence of small PC ≤ 10 mm. The proportions of patients positive for each finding were compared between small PC and benign MPD stenosis groups. Interobserver agreement between two independent image reviewers was evaluated using kappa statistics. Results: The final analysis included 24 patients with small PC (including 11 CIS patients) and 28 patients with benign MPD stenosis. The proportion of patients exhibiting partial pancreatic parenchymal atrophy (PPA) corresponding to the distribution of MPD stenosis (45.8% vs. 7.1%, p < 0.01), upstream PPA arising from the site of MPD stenosis (33.3% vs. 3.6%, p = 0.01), and MPD abrupt stenosis (45.8% vs. 14.3%, p = 0.03) was significantly higher in the small PC group than in the benign MPD stenosis group. Conclusions: The presence of partial PPA, upstream PPA, and MPD abrupt stenosis on a CT image was highly suggestive of the presence of small PCs including CIS.

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Differentiating Autoimmune Pancreatitis From Pancreatic Adenocarcinoma Using Dual-Phase Computed Tomography

Cited by 30 publications

References 29 publications

JOURNAL CLUB: Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis

JOURNAL CLUB: Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis

Abdominal manifestations of IgG4-related disease: a pictorial review

Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients

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