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Two nomograms for differentiating mass-forming chronic pancreatitis from pancreatic ductal adenocarcinoma in patients with chronic pancreatitis

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To develop and validate a CT nomogram and a radiomics nomogram to differentiate mass-forming chronic pancreatitis (MFCP) from pancreatic ductal adenocarcinoma (PDAC) in patients with chronic pancreatitis (CP).

Methods

In this retrospective study, the data of 138 patients with histopathologically diagnosed MFCP or PDAC treated at our institution were retrospectively analyzed. Two radiologists analyzed the original cross-sectional CT images based on predefined criteria. Image segmentation, feature extraction, and feature reduction and selection were used to create the radiomics model. The CT and radiomics models were developed using data from a training cohort of 103 consecutive patients. The models were validated in 35 consecutive patients. Multivariable logistic regression analysis was conducted to develop a model for the differential diagnosis of MFCP and PDAC and visualized as a nomogram. The nomograms’ performances were determined based on their differentiating ability and clinical utility.

Results

The mean age of patients was 53.7 years, 75.4% were male. The CT nomogram showed good differentiation between the two entities in the training (area under the curve [AUC], 0.87) and validation (AUC, 0.94) cohorts. The radiomics nomogram showed good differentiation in the training (AUC, 0.91) and validation (AUC, 0.93) cohorts. Decision curve analysis showed that patients could benefit from the CT and radiomics nomograms, if the threshold probability was 0.05–0.85 and > 0.05, respectively.

Conclusions

The two nomograms reasonably accurately differentiated MFCP from PDAC in patients with CP and hold potential for refining the management of pancreatic masses in CP patients.

Key Points

• A CT nomogram and a computed tomography-based radiomics nomogram reasonably accurately differentiated mass-forming chronic pancreatitis from pancreatic ductal adenocarcinoma in patients with chronic pancreatitis (CP).

• The two nomograms can monitor the cancer risk in patients with CP and hold promise to optimize the management of pancreatic masses in patients with CP.

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Abbreviations

AIC:

Akaike information criterion

AUC:

Area under the curve

BMI:

Body mass index

CI:

Confidence interval

CT:

Computed tomography

DCA:

Decision curve analysis

DECT:

Dual-energy computed tomography

DWI:

Diffusion-weighted imaging

ICC:

Intraclass correlation coefficient

LASSO:

Least absolute shrinkage and selection operator

MFCP:

Mass-forming chronic pancreatitis

MRI:

Magnetic resonance imaging

OR:

Odds ratio

OS:

Overall survival

PDAC:

Pancreatic ductal adenocarcinoma

PV:

Predictive value

ROC:

Receiver operating characteristic

SE:

Standard error

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Funding

This work was supported in part by the National Science Foundation for Scientists of China (81871352, 82171915, and 82171930), The Natural Science Foundation of Shanghai Science and Technology Innovation Action Plan (21ZR1478500, 21Y11910300), Clinical Research Plan of SHDC (SHDC2020CR4073), and 234 Platform Discipline Consolidation Foundation Project (2019YPT001, 2020YPT001).

Author information

Authors and Affiliations

  1. Department of Radiology, Changhai Hospital, Naval Medical University, Changhai Road 168, Shanghai, 200434, China

    Hao Zhang, Yinghao Meng, Qi Li, Jieyu Yu, Fang Liu, Xu Fang, Jing Li, Xiaochen Feng, Jian Zhou, Mengmeng Zhu, Na Li, Jianping Lu, Chengwei Shao & Yun Bian

  2. Department of Radiology, No. 971 Hospital of Navy, Qingdao, 266071, Shandong, China

    Yinghao Meng

Authors
  1. Hao Zhang
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  2. Yinghao Meng
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  11. Na Li
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Corresponding authors

Correspondence to Chengwei Shao or Yun Bian.

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Guarantor

The scientific guarantor of this publication is Yun Bian.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

A professor of Biostatistics (Dr Pin Wu, PhD) was consulted for specialist advice.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained by the Changhai Hospital.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Cite this article

Zhang, H., Meng, Y., Li, Q. et al. Two nomograms for differentiating mass-forming chronic pancreatitis from pancreatic ductal adenocarcinoma in patients with chronic pancreatitis. Eur Radiol 32, 6336–6347 (2022). https://doi.org/10.1007/s00330-022-08698-3

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  • DOI: https://doi.org/10.1007/s00330-022-08698-3

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