MRI Prediction of Islet Yield for Autologous Transplantation After Total Pancreatectomy for Chronic Pancreatitis
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The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI.
MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained.
Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19–63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76–17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1–3 versus median 0.5, range 0–3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5–7 versus median 4.0, range 3–7, P = 0.024).
A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.
KeywordsDelayed phase MRI Pancreatic fibrosis Autotransplantation
Autologous islet transplant
- H &E
Hematoxylin and eosin
Magnetic resonance imaging
Conflict of interest