Evaluation of Qualitative Magnetic Resonance Imaging Features for Diagnosis of Chronic Pancreatitis

Sainani, Nisha I.; Kadiyala, Vivek; Mortelé, Koenraad J.; Lee, Linda; Suleiman, Shadeah; Rosenblum, Jessica; Wang, Wei; Banks, Peter A.; Conwell, Darwin L.

doi:10.1097/mpa.0000000000000466

Cited by 18 publications

(11 citation statements)

References 44 publications

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“…Among the prior reports [22, 24–30], the most comparable study correlating the T1-weighted signal intensity of the pancreas with pancreatic function test was by Balci et al [28]. In that study, there was no T1 signal difference between normal and low bicarbonate groups, pancreatic juice was sampled from the duodenal lumen, and there were only 12 patients in the decreased exocrine function group compared to 22 in our study.…”

Section: Discussionsupporting

confidence: 49%

Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

et al. 2016

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Purpose To determine if T1-weighted MR signal of the pancreas can be used to detect early CP. Methods A retrospective analysis was performed on 51 suspected CP patients, who had both secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) and an intraductal secretin stimulation test (IDST). There were 29 patients in normal and 22 patients in the low bicarbonate group. Bicarbonate level, total pancreatic juice volume, and excretory flow rate were recorded during IDST. Signal intensity ratio of pancreas (SIR), fat signal fraction, pancreatograms findings, and grade of duodenal filling were recorded on S-MRCP by two blinded radiologists. Results There was a significant difference in the signal intensity ratio of the pancreas to spleen (SIRp/s) between the normal and low bicarbonate groups (p < 0.0001). A significant positive correlation was found between pancreatic fluid bicarbonate level and SIRp/s (p < 0.0001). SIRp/s of 1.2 yielded sensitivity of 77% and specificity of 83% for detection of pancreatic exocrine dysfunction (AUC: 0.89). Conclusion T1-weighted MR signal of the pancreas has a high sensitivity and specificity for the detection of parenchymal abnormalities related to exocrine dysfunction and can therefore be helpful in evaluation of suspected early CP.

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Section: Discussionsupporting

confidence: 49%

Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

et al. 2016

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“…Sensitivity and specificity of ECV fraction and T1 mapping were superior to T1-weighted SIR of pancreas to either spleen or paraspinal muscle, duodenal filling after secretin stimulation, and arteriovenous enhancement ratio of the pancreas. Sensitivity and specificity were also higher than in published studies that examined qualitative imaging criteria of CP using multiple qualitative MRCP findings, DWI to detect pancreatic fibrosis, T1-weighted SIR of the pancreas to paraspinal muscle correlated with histopathology, and grading of duodenal filling to detect the decreased exocrine fluid volume of the pancreas [12, 19, 25, 27, 28]. Prior studies often reported difficulty in assessing the severity of CP.…”

Section: Discussionmentioning

confidence: 85%

Quantitative MR Evaluation of Chronic Pancreatitis: Extracellular Volume Fraction and MR Relaxometry

Tirkes

Lin

Cui

et al. 2018

American Journal of Roentgenology

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“…44 Finally, MR cholangiopancreatography, in conjunction with stimulation of the pancreas by secretin, has been used to assay pancreatic secretory responses by quantitative assessment of fluid secreted into the gut lumen and for simultaneous assessment of duct morphology and compliance. 45 There is need for a quantitative scoring system as a biomarker for CP. Such a scoring system is the focus of the MINIMAP study (MRI as a noninvasive method for the assessment of pancreatic fibrosis), which is funded by NIDDK.…”

Section: Quantitative Imaging Of Cpmentioning

confidence: 99%

Precision Medicine in Pancreatic Disease—Knowledge Gaps and Research Opportunities

et al. 2019

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A workshop on research gaps and opportunities for Precision Medicine in Pancreatic Disease was sponsored by the National Institute of Diabetes and Digestive Kidney Diseases on July 24, 2019, in Pittsburgh. The workshop included an overview lecture on precision medicine in cancer and 4 sessions: (1) general considerations for the application of bioinformatics and artificial intelligence; (2) omics, the combination of risk factors and biomarkers; (3) precision imaging; and (4) gaps, barriers, and needs to move from precision to personalized medicine for pancreatic disease. Current precision medicine approaches and tools were reviewed, and participants identified knowledge gaps and research needs that hinder bringing precision medicine to pancreatic diseases. Most critical were (a) multicenter efforts to collect large-scale patient data sets from multiple data streams in the context of environmental and social factors; (b) new information systems that can collect, annotate, and quantify data to inform disease mechanisms; (c) novel prospective clinical trial designs to test and improve therapies; and (d) a framework for measuring and assessing the value of proposed approaches to the health care system. With these advances, precision medicine can identify patients early in the course of their pancreatic disease and prevent progression to chronic or fatal illness. Lowe et al.

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Evaluation of Qualitative Magnetic Resonance Imaging Features for Diagnosis of Chronic Pancreatitis

Abstract: Qualitative MRI parenchymal and ductal features are associated with CP. Presence of 6 or more features results in a higher specificity for the diagnosis of CP in advanced disease.

Cited by 18 publications

References 44 publications

Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis

Quantitative MR Evaluation of Chronic Pancreatitis: Extracellular Volume Fraction and MR Relaxometry

Precision Medicine in Pancreatic Disease—Knowledge Gaps and Research Opportunities

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