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T1 signal intensity ratio of the pancreas as an imaging biomarker for the staging of chronic pancreatitis

  • Pancreas
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Our purpose was to validate the T1 SIR (T1 score) as an imaging biomarker for the staging of CP in a large, multi-institutional, prospective study.

Methods

The prospective study population included 820 participants enrolled in the PROCEED study from nine clinical centers between June 2017 and December 2021. A radiologist at each institution used a standardized method to measure the T1 signal intensity of the pancreas and the reference organs (spleen, paraspinal muscle, liver), which was used to derive respective T1 scores. Participants were stratified according to the seven mechanistic stages of chronic pancreatitis (MSCP 0–6) based on their clinical history, MRCP, and CT findings.

Results

The mean pancreas-to-spleen T1 score was 1.30 in participants with chronic abdominal pain, 1.22 in those with acute or recurrent acute pancreatitis, and 1.03 in definite CP. After adjusting for covariates, we observed a linear, progressive decline in the pancreas-to-spleen T1 score with increasing MSCP from 0 to 6. The mean pancreas-to-spleen T1 scores were 1.34 (MSCP 0), 1.27 (MSCP 1), 1.21 (MSCP 2), 1.16 (MSCP 3), 1.18 (MSCP 4), 1.12 (MSCP 5), and 1.05 (MSCP 6) (p < 0.0001). The pancreas-to-liver and pancreas-to-muscle T1 scores showed less linear trends and wider confidence intervals.

Conclusion

The T1 score calculated by SIR of the pancreas-to-spleen shows a negative linear correlation with the progression of chronic pancreatitis. It holds promise as a practical imaging biomarker in evaluating disease severity in clinical research and practice.

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Abbreviations

CP:

Chronic pancreatitis

CT:

Computerized tomography

MRI:

Magnetic resonance imaging

MRCP:

Magnetic resonance cholangiopancreatography

SIR:

Signal intensity ratio

MSCP:

Mechanistic stages of chronic pancreatitis

CPDPC:

The Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer

PROCEED:

Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies

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Funding

Research reported in this publication was supported by the National Cancer Institute (NCI) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under award numbers: U01DK108288 (SSV, SKV, NT); U01DK108300 (WGP, STC); U01DK108306 (DY, AKD); U01DK108314 (AW, SJP); UO1DK108300 (CEF, JG); U01DK108323 (ELF, TT); U01DK108326 (WEF, CAF); U01DK108327 (PAH, DLC, ZKS); U01DK108328 (SL, LL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Radiology & Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd. Suite 0663, Indianapolis, IN, 46202, USA

    Temel Tirkes

  2. Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Anil K. Dasyam

  3. Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Zarine K. Shah

  4. Lehman, Bucksot and Sherman Section of Pancreatobiliary Endoscopy, Indiana University School of Medicine, Indianapolis, IN, USA

    Evan L. Fogel

  5. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Santhi Swaroop Vege

  6. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Liang Li, Shuang Li & Yunlong Yang

  7. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA

    Stephanie T. Chang

  8. Baylor College of Medicine, Radiology Department, TX, Houston, USA

    Carlos A. Farinas

  9. University of Florida College of Medicine, Gainesville, FL, USA

    Joseph R. Grajo

  10. The Permanente Medical Group, South San Francisco Medical Center, South San Francisco, CA, 94080, USA

    Kareem Mawad

  11. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Naoki Takahashi & Sudhakar K. Venkatesh

  12. Department of Radiology, Cedars-Sinai Medical Center, University of California in Los Angeles, Los Angeles, CA, USA

    Ashley Wachsman

  13. Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    William E. Fisher

  14. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, 32610, USA

    Christopher E. Forsmark

  15. Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Phil A. Hart

  16. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Stephen J. Pandol

  17. Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, USA

    Walter G. Park

  18. Kaiser Permanente Division of Research, Oakland, CA, USA

    Stephen K. Van Den Eeden

  19. Mayo Clinic, Rochester, MN, USA

    Mark Topazian

  20. Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA

    Dana K. Andersen & Jose Serrano

  21. Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA

    Darwin L. Conwell

  22. Department of Medicine, Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Dhiraj Yadav

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  1. Temel Tirkes
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  2. Anil K. Dasyam
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  3. Zarine K. Shah
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  4. Evan L. Fogel
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  23. Dana K. Andersen
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  25. Darwin L. Conwell
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  26. Dhiraj Yadav
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Consortia

The Consortium for the Study of Chronic Pancreatitis, Diabetes, Pancreatic Cancer (CPDPC)

Corresponding author

Correspondence to Temel Tirkes.

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Conflict of interest

Dr. Forsmark receives consultant fee or honorarium from Nestle HealthCare Nutrition, Inc., Parexel International Corp and Medialis, Ltd., Dr. Park is a consultant for Abbvie.

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Tirkes, T., Dasyam, A.K., Shah, Z.K. et al. T1 signal intensity ratio of the pancreas as an imaging biomarker for the staging of chronic pancreatitis. Abdom Radiol 47, 3507–3519 (2022). https://doi.org/10.1007/s00261-022-03611-4

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