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12-07-2023 | Chronic Pancreatitis | Pancreas

Diagnosis of chronic pancreatitis using semi-quantitative MRI features of the pancreatic parenchyma: results from the multi-institutional MINIMAP study

Authors: Temel Tirkes, Dhiraj Yadav, Darwin L. Conwell, Paul R. Territo, Xuandong Zhao, Scott A. Persohn, Anil K. Dasyam, Zarine K. Shah, Sudhakar K. Venkatesh, Naoki Takahashi, Ashley Wachsman, Liang Li, Yan Li, Stephen J. Pandol, Walter G. Park, Santhi Swaroop Vege, Phil A. Hart, Mark Topazian, Dana K. Andersen, Evan L. Fogel, the Consortium for the Study of Chronic Pancreatitis, Diabetes, Pancreatic Cancer (CPDPC)

Published in: Abdominal Radiology | Issue 10/2023

Abstract

Purpose

To determine the diagnostic performance of parenchymal MRI features differentiating CP from controls.

Methods

This prospective study performed abdominal MRI scans at seven institutions, using 1.5 T Siemens and GE scanners, in 50 control and 51 definite CP participants, from February 2019 to May 2021. MRI parameters included the T1-weighted signal intensity ratio of the pancreas (T1 score), arterial-to-venous enhancement ratio (AVR) during venous and delayed phases, pancreas volume, and diameter. We evaluated the diagnostic performance of these parameters individually and two semi-quantitative MRI scores derived using logistic regression: SQ-MRI Model A (T1 score, AVR venous, and tail diameter) and Model B (T1 score, AVR venous, and volume).

Results

When compared to controls, CP participants showed a significantly lower mean T1 score (1.11 vs. 1.29), AVR venous (0.86 vs. 1.45), AVR delayed (1.07 vs. 1.57), volume (54.97 vs. 80.00 ml), and diameter of the head (2.05 vs. 2.39 cm), body (2.25 vs. 2.58 cm), and tail (1.98 vs. 2.51 cm) (p < 0.05 for all). AUCs for these individual MR parameters ranged from 0.66 to 0.79, while AUCs for the SQ-MRI scores were 0.82 and 0.81 for Model A (T1 score, AVR venous, and tail diameter) and Model B (T1 score, AVR venous, and volume), respectively. After propensity-matching adjustments for covariates, AUCs for Models A and B of the SQ-MRI scores increased to 0.92 and 0.93, respectively.

Conclusion

Semi-quantitative parameters of the pancreatic parenchyma, including T1 score, enhancement ratio, pancreas volume, diameter and multi-parametric models combining these parameters are helpful in diagnosis of CP. Longitudinal analyses including more extensive population are warranted to develop new diagnostic criteria for CP.

Graphical abstract

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Title: Diagnosis of chronic pancreatitis using semi-quantitative MRI features of the pancreatic parenchyma: results from the multi-institutional MINIMAP study
Authors: Temel Tirkes
Dhiraj Yadav
Darwin L. Conwell
Paul R. Territo
Xuandong Zhao
Scott A. Persohn
Anil K. Dasyam
Zarine K. Shah
Sudhakar K. Venkatesh
Naoki Takahashi
Ashley Wachsman
Liang Li
Yan Li
Stephen J. Pandol
Walter G. Park
Santhi Swaroop Vege
Phil A. Hart
Mark Topazian
Dana K. Andersen
Evan L. Fogel
the Consortium for the Study of Chronic Pancreatitis, Diabetes, Pancreatic Cancer (CPDPC)
Publication date: 12-07-2023
Publisher: Springer US
Keywords: Chronic Pancreatitis
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Abdominal Radiology / Issue 10/2023
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-023-04000-1

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