Pancreatic steatosis on computed tomography is an early imaging feature of pre-diagnostic pancreatic cancer: A preliminary study in overweight patients

Hoogenboom, Sanne A.; Bolan, Candice W.; Chuprin, Anthony; Raimondo, M; Hooft, Jeanin E. van; Wallace, Michael B.; Raimondo, Massimo

doi:10.1016/j.pan.2021.01.003

Cited by 22 publications

(32 citation statements)

References 22 publications

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“…CT images were evaluated by two radiologists (S Guneyli and H Dogan with 11 and 2 years of experience, respectively) experienced in thoracic and abdominal radiology, who were blinded to the clinical and laboratory results of the patients, using a dedicated workstation based on consensus. Hounsfield unit (HU) of fat tissue ranges between -150 and -30 HU on unenhanced CT [ 14 ]. Both the pancreas-to-spleen (P/S) attenuation ratio and the pancreas minus spleen (P-S) attenuation difference significantly correlated with PS, proven histopathologically [ 17–19 ].…”

Section: Methodsmentioning

confidence: 99%

“…Five different regions of interest (ROIs) were drawn over the uncinate process, the head, neck, body and tail of the pancreas ( Figure 1 ), while three ROIs were drawn from the upper, middle and lower parts of spleen ( Figure 2 ) [ 15 ]. In both organs, a circular ROI of 1 cm 2 was drawn [ 14 ]. To ensure reproducibility of the measurements, the ROIs were drawn by avoiding vessels and parenchymal calcifications.…”

Section: Methodsmentioning

confidence: 99%

“…Hepatosteatosis is one of the pathologies which can be quantitatively evaluated on unenhanced CT. Several studies reported the relationship between hepatosteatosis and COVID-19 prognosis [ 8 , 11–13 ]. Similar to hepatosteatosis, pancreatic steatosis (PS) can be also assessed on CT, and its association with several diseases, such as metabolic syndrome and pancreatic cancer was reported in the literature [ 14 , 15 ]. To the best of our knowledge, the relationship between PS and the prognosis of COVID-19 has never been published.…”

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confidence: 99%

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Computed Tomography Evaluation of Pancreatic Steatosis: Correlation with COVID-19 Prognosis

Güneyli¹,

Doğan

Esengur

et al. 2022

Future Virol.

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Aim: To investigate the relationship between pancreatic steatosis (PS) assessed on computed tomography (CT) and COVID-19 prognosis. Materials & methods: This retrospective study covers 396 patients with COVID-19 (mean age: 52.50 ± 16.86 years), who underwent unenhanced chest CT. PS was compared with clinical findings, comorbidities, requirements for hospitalization, intubation and intensive care unit (ICU), length of hospitalization and death. Results: PS was found to be strongly correlated with the severity of clinical findings and hospitalization rates (p < 0.001). In hospitalized patients, length of hospitalization (p = 0.002) and rates of ICU requirement (p = 0.003) were higher in patients with PS. Conclusion: PS, correlated with clinical severity and hospitalization requirement, is an independent risk factor for COVID-19.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Computed Tomography Evaluation of Pancreatic Steatosis: Correlation with COVID-19 Prognosis

Güneyli¹,

Doğan

Esengur

et al. 2022

Future Virol.

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“…A single-center, retrospective, case–control study was conducted among PDAC patients with a pre-diagnostic CT- and/or MRI-exam 3 years prior to diagnosis, and healthy individuals. Part of the subjects, i.e., 32 cases and 117 control subjects, were used in a previously published study assessing the presence of pancreatic steatosis on non-enhanced CT in patients with pre-diagnostic PDAC [ 20 ]. This current study focuses on distinct imaging features of pre-diagnostic PDAC on CT and MRI, instead of pancreatic steatosis on CT only.…”

Section: Methodsmentioning

confidence: 99%

Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study

et al. 2022

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Purpose To characterize the prevalence of missed pancreatic masses and pancreatic ductal adenocarcinoma (PDAC)-related findings on CT and MRI between pre-diagnostic patients and healthy individuals. Materials and methods Patients diagnosed with PDAC (2010–2016) were retrospectively reviewed for abdominal CT- or MRI-examinations 1 month—3 years prior to their diagnosis, and subsequently matched to controls in a 1:4 ratio. Two blinded radiologists scored each imaging exam on the presence of a pancreatic mass and secondary features of PDAC. Additionally, original radiology reports were graded based on the revised RADPEER criteria. Results The cohort of 595 PDAC patients contained 60 patients with a pre-diagnostic CT and 27 with an MRI. A pancreatic mass was suspected in hindsight on CT in 51.7% and 50% of cases and in 1.3% and 0.9% of controls by reviewer 1 (p < .001) and reviewer 2 (p < .001), respectively. On MRI, a mass was suspected in 70.4% and 55.6% of cases and 2.9% and 0% of the controls by reviewer 1 (p < .001) and reviewer 2 (p < .001), respectively. Pancreatic duct dilation, duct interruption, focal atrophy, and features of acute pancreatitis is strongly associated with PDAC (p < .001). In cases, a RADPEER-score of 2 or 3 was assigned to 56.3% of the CT-reports and 71.4% of MRI-reports. Conclusion Radiological features as pancreatic duct dilation and interruption, and focal atrophy are common first signs of PDAC and are often missed or unrecognized. Further investigation with dedicated pancreas imaging is warranted in patients with PDAC-related radiological findings. Graphical abstract

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“… 242 When combined with metabolic dysregulation, such as the dyslipidemia and excessive visceral adipose accumulation in obesity and T2DM, fatty infiltration can be even more severe, and it is positively associated with the risk of PC. 243 Unlike in hepatosteatosis, human samples have demonstrated that adipocytes infiltrate the pancreatic parenchyma in a scattered pattern (intralobular fat) and accumulate in the perilobular space, mainly around large vessels (interlobular fat). 244 While intralobular fat is speculated to be produced by transforming fibroblasts or acinar cells to fill in the spaces created by the loss of damaged acinar cells, interlobular fat is seemingly related to obesity and T2DM.…”

Section: Mechanisms Of Obesity- and Dm-related Pancreatic Carcinogenesismentioning

confidence: 99%

Mechanisms of obesity- and diabetes mellitus-related pancreatic carcinogenesis: a comprehensive and systematic review

Ruze

Song

Yin

et al. 2023

Sig Transduct Target Ther

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Research on obesity- and diabetes mellitus (DM)-related carcinogenesis has expanded exponentially since these two diseases were recognized as important risk factors for cancers. The growing interest in this area is prominently actuated by the increasing obesity and DM prevalence, which is partially responsible for the slight but constant increase in pancreatic cancer (PC) occurrence. PC is a highly lethal malignancy characterized by its insidious symptoms, delayed diagnosis, and devastating prognosis. The intricate process of obesity and DM promoting pancreatic carcinogenesis involves their local impact on the pancreas and concurrent whole-body systemic changes that are suitable for cancer initiation. The main mechanisms involved in this process include the excessive accumulation of various nutrients and metabolites promoting carcinogenesis directly while also aggravating mutagenic and carcinogenic metabolic disorders by affecting multiple pathways. Detrimental alterations in gastrointestinal and sex hormone levels and microbiome dysfunction further compromise immunometabolic regulation and contribute to the establishment of an immunosuppressive tumor microenvironment (TME) for carcinogenesis, which can be exacerbated by several crucial pathophysiological processes and TME components, such as autophagy, endoplasmic reticulum stress, oxidative stress, epithelial-mesenchymal transition, and exosome secretion. This review provides a comprehensive and critical analysis of the immunometabolic mechanisms of obesity- and DM-related pancreatic carcinogenesis and dissects how metabolic disorders impair anticancer immunity and influence pathophysiological processes to favor cancer initiation.

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Pancreatic steatosis on computed tomography is an early imaging feature of pre-diagnostic pancreatic cancer: A preliminary study in overweight patients

Cited by 22 publications

References 22 publications

Computed Tomography Evaluation of Pancreatic Steatosis: Correlation with COVID-19 Prognosis

Computed Tomography Evaluation of Pancreatic Steatosis: Correlation with COVID-19 Prognosis

Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study

Mechanisms of obesity- and diabetes mellitus-related pancreatic carcinogenesis: a comprehensive and systematic review

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