T1 Signal Intensity Ratio of the Pancreas as an Imaging Biomarker for the Staging of Chronic Pancreatitis

Authors

Temel Tirkes
Anil K Dasyam
Zarine K Shah
Evan L Fogel
Santhi Swaroop Vege
Liang Li
Shuang Li
Stephanie T Chang
Carlos A Farinas
Joseph R Grajo
Kareem Mawad
Naoki Takahashi
Sudhakar K Venkatesh
Ashley Wachsman
William E Fisher
Christopher E Forsmark
Phil A Hart
Stephen J Pandol
Walter G Park
Stephen K Van Den Eeden
Yunlong Yang
Mark Topazian
Dana K Andersen
Jose Serrano
Darwin L Conwell
Dhiraj Yadav
Consortium for the Study of Chronic Pancreatitis, Diabetes, Pancreatic Cancer (CPDPC)

Publication Date

10-1-2022

Journal

Abdominal Radiology

DOI

10.1007/s00261-022-03611-4

PMID

35857066

PMCID

PMC10020893

PubMedCentral® Posted Date

10-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Acute Disease, Biomarkers, Humans, Magnetic Resonance Imaging, Pancreas, Pancreatitis, Chronic, Prospective Studies, T1 score, Mechanistic Stages of Chronic Pancreatitis, MRI

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.