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

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

Research output: Contribution to journalArticlepeer-review

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: [Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)3162-3173
Number of pages12
JournalAbdominal Radiology
Volume48
Issue number10
DOIs
StatePublished - Oct 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Chronic pancreatitis
  • Enhancement
  • MRI
  • Size
  • T1
  • Volume

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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