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Replacing secretin-enhanced MRCP with MRI radiomics model based on a fully automated pancreas segmentation for assessing pancreatic exocrine function in chronic pancreatitis

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

Abstract

Objectives

To develop and validate a radiomics nomogram based on a fully automated pancreas segmentation to assess pancreatic exocrine function. Furthermore, we aimed to compare the performance of the radiomics nomogram with the pancreatic flow output rate (PFR) and conclude on the replacement of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) by the radiomics nomogram for pancreatic exocrine function assessment.

Methods

All participants underwent S-MRCP between April 2011 and December 2014 in this retrospective study. PFR was quantified using S-MRCP. Participants were divided into normal and pancreatic exocrine insufficiency (PEI) groups using the cut-off of 200 µg/L of fecal elastase-1. Two prediction models were developed including the clinical and non-enhanced T1-weighted imaging radiomics model. A multivariate logistic regression analysis was conducted to develop the prediction models. The models’ performances were determined based on their discrimination, calibration, and clinical utility.

Results

A total of 159 participants (mean age \(\pm\) standard deviation, 45 years \(\pm\) 14;119 men) included 85 normal and 74 PEI. All the participants were divided into a training set comprising 119 consecutive patients and an independent validation set comprising 40 consecutive patients. The radiomics score was an independent risk factor for PEI (odds ratio = 11.69; p < 0.001). In the validation set, the radiomics nomogram exhibited the highest performance (AUC, 0.92) in PEI prediction, whereas the clinical nomogram and PFR had AUCs of 0.79 and 0.78, respectively.

Conclusion

The radiomics nomogram accurately predicted pancreatic exocrine function and outperformed pancreatic flow output rate on S-MRCP in patients with chronic pancreatitis.

Key Points

• The clinical nomogram exhibited moderate performance in diagnosing pancreatic exocrine insufficiency.

• The radiomics score was an independent risk factor for pancreatic exocrine insufficiency, and every point rise in the rad-score was associated with an 11.69-fold increase in pancreatic exocrine insufficiency risk.

• The radiomics nomogram accurately predicted pancreatic exocrine function and outperformed the clinical model and pancreatic flow output rate quantified by secretin-enhanced magnetic resonance cholangiopancreatography on MRI in patients with chronic pancreatitis.

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Abbreviations

CP:

Chronic pancreatitis

PEI:

Pancreatic exocrine insufficiency

PFT:

Pancreatic exocrine function test

FE-1:

Fecal elastase-1

ELISA:

Enzyme-linked immunosorbent assay

S-MRCP:

Secretin-enhanced magnetic resonance cholangiopancreatography

PFR:

Pancreatic flow output rate

MPD:

Main pancreatic duct

BPD:

Branch pancreatic duct

SIR:

Signal intensity ratio

Rad-score:

Radiomics score

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Funding

This work was supported in part by the National Science Foundation for Scientists of China (81871352, 82171915, and 82171930, 82202126, 82271972), The Natural Science Foundation of Shanghai Science and Technology Innovation Action Plan (21ZR1478500, 21Y11910300), Clinical Research Plan of SHDC (SHDC2020CR4073, SHDC2022CRD028), and 234 Platform Discipline Consolidation Foundation Project (2019YPT001, 2020YPT001).

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Authors and Affiliations

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

    Yun Bian, Jian Zhou, Mengmeng Zhu, Jieyu Yu, Haiyan Zhao, Xu Fang, Fang Liu, Tiegong Wang, Jing Li, Li Wang, Jianping Lu & Chengwei Shao

Authors
  1. Yun Bian
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  2. Jian Zhou
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  3. Mengmeng Zhu
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  10. Li Wang
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Corresponding author

Correspondence to Chengwei Shao.

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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 (Prof.Cheng 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 center institution

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Bian, Y., Zhou, J., Zhu, M. et al. Replacing secretin-enhanced MRCP with MRI radiomics model based on a fully automated pancreas segmentation for assessing pancreatic exocrine function in chronic pancreatitis. Eur Radiol 33, 3580–3591 (2023). https://doi.org/10.1007/s00330-023-09448-9

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