Systematic review and meta-analysis of MRI features for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma

Yoon, Seung Bae; Jeon, Tae Yeon; Moon, Sung Hoon; Lee, Sang Min; Kim, Myung–Hwan

doi:10.1007/s00330-022-08816-1

Cited by 7 publications

(6 citation statements)

References 39 publications

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“…Additionally, our research also supported the evidence that peripancreatic fat infiltration and necrosis, two semantic features of imaging, were indicators for poor prognosis, in accordance with previous studies (15,38). Peripancreatic fat infiltration might reflect the extent of tumor invasion, not simple a desmoplastic reaction or edema (13,15,39). The presence of peripancreatic fat infiltration reduces the chance of R0 resection and leads to poor survival outcomes (13,40).…”

Section: Discussionsupporting

confidence: 91%

Combined CT and serum CA19-9 for stratifying risk for progression in patients with locally advanced pancreatic cancer receiving intraoperative radiotherapy

et al. 2023

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Background and purposeThe aim of this study was to evaluate the significance of baseline computed tomography (CT) imaging features and carbohydrate antigen 19-9 (CA19-9) in predicting prognosis of locally advanced pancreatic cancer (LAPC) receiving intraoperative radiotherapy (IORT) and to establish a progression risk nomogram that helps to identify the potential beneficiary of IORT.MethodsA total of 88 LAPC patients with IORT as their initial treatment were enrolled retrospectively. Clinical data and CT imaging features were analyzed. Cox regression analyses were performed to identify the independent risk factors for progression-free survival (PFS) and to establish a nomogram. A risk-score was calculated by the coefficients of the regression model to stratify the risk of progression.ResultsMultivariate analyses revealed that relative enhanced value in portal-venous phase (REV-PVP), peripancreatic fat infiltration, necrosis, and CA19-9 were significantly associated with PFS (all p < 0.05). The nomogram was constructed according to the above variables and showed a good performance in predicting the risk of progression with a concordance index (C-index) of 0.779. Our nomogram stratified patients with LAPC into low- and high-risk groups with distinct differences in progression after IORT (p < 0.001).ConclusionThe integrated nomogram would help clinicians to identify appropriate patients who might benefit from IORT before treatment and to adapt an individualized treatment strategy.

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Section: Discussionsupporting

confidence: 91%

Combined CT and serum CA19-9 for stratifying risk for progression in patients with locally advanced pancreatic cancer receiving intraoperative radiotherapy

et al. 2023

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“…10,17,18 Diagnostic clues obtained from imaging features are important, to minimize unnecessary surgical procedures and health-care costs. In addition to TB, local autoimmune pancreatitis 19 and initial polyarteritis nodosa 20 are rare but can mimic pancreatic cancer, highlighting the need to pay more attention to the differential diagnosis of masses within or around the head of pancreas when CT or MRI images show atypical manifestations. The sensitivity of multidetector CT for pancreatic carcinoma was reported to be >85% to 90%, 21,22 but its specificity was unsatisfactory at only 58%.…”

Section: Discussionmentioning

confidence: 99%

Isolated pancreatic tuberculosis masquerading as malignancy in an immunocompetent host: a case report and review of the literature

Xiao

Wan

et al. 2023

J Int Med Res

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A 41-year-old man was admitted to our department with a 7-day history of jaundice of the skin. He was misdiagnosed with carcinoma because imaging tests showed a space-occupying lesion in the pancreatic head, and laboratory examinations showed elevated liver enzymes, and elevated serum bilirubin, alpha-fetoprotein, carbohydrate antigen 19-9, and ferroprotein levels. However, there was slight calcification in the lesion and a subsequent T-Spot test result was positive. The patient then underwent endoscopic retrograde cholangiopancreatography for biopsy and bile drainage. Histologically, the pancreatic mass showed granulomatosis, and the pathologic diagnosis of the isolated pancreatic neoplasm was tuberculosis. The patient accordingly received anti-tuberculosis agents, resulting in a significant decrease in the size of the pancreatic mass. The patient recovered well. Pancreatic tuberculosis can masquerade as malignancy; however, careful attention to a differential diagnosis can prevent the need for laparotomy.

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“…To differentiate AIP from pancreatic cancer, the MRI features favoring AIP are diffuse enlargement (diagnostic OR, 75), a capsule-like rim (52), multiple strictures of the main pancreatic duct (47), and homogeneous delayed enhancement (46). 47 In contrast, the MRI features favoring pancreatic cancer are target-type enhancement (diagnostic OR, 41) and a discrete pancreatic mass (35).…”

Section: 47mentioning

confidence: 99%

Autoimmune Pancreatitis and Immunoglobulin G4-related Sclerosing Cholangitis: Past, Present, and Future

Moon

Kim

2022

Korean J Gastroenterol

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The emergence of glucocorticoid-responsive autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-SC), a new disease entity, has attracted considerable interest within the international gastroenterology community. The typical manifestations of AIP/IgG4-SC are obstructive jaundice and pancreatic enlargement in the elderly, which may mimic the presentations of pancreatobiliary malignancies. The timely diagnosis of AIP/IgG4-SC can lead to adequate glucocorticoid treatment, whereas a misdiagnosis can result in unnecessary major surgery. The diagnostic criteria used to diagnose AIP include several cardinal features of AIP that can be detected via pancreatic parenchymal imaging, ductal imaging, serum IgG4 levels, histopathology, other organ involvement, and response to glucocorticoid therapy. The differential diagnosis of AIP/IgG4-SC may include pancreatobiliary malignancies and primary sclerosing cholangitis. Although most patients with AIP/IgG4-SC respond well to glucocorticoid therapy, there is a frequent relapse of the disease in the long term. This review describes the evolution of the concept of AIP and IgG4-related disease, including the development of diagnostic criteria, discusses the current practice for diagnosis and treatment, and suggests prospects for research.

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Systematic review and meta-analysis of MRI features for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma

Cited by 7 publications

References 39 publications

Combined CT and serum CA19-9 for stratifying risk for progression in patients with locally advanced pancreatic cancer receiving intraoperative radiotherapy

Combined CT and serum CA19-9 for stratifying risk for progression in patients with locally advanced pancreatic cancer receiving intraoperative radiotherapy

Isolated pancreatic tuberculosis masquerading as malignancy in an immunocompetent host: a case report and review of the literature

Autoimmune Pancreatitis and Immunoglobulin G4-related Sclerosing Cholangitis: Past, Present, and Future

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