Quantitative MRI of Chronic Pancreatitis: Results From a Multi-Institutional Prospective Study, Magnetic Resonance Imaging as a Non-Invasive Method for Assessment of Pancreatic Fibrosis (MINIMAP)

Authors

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 S Vege
Phil A Hart
Mark Topazian
Dana K Andersen
Evan L Fogel
Consortium for the Study of Chronic Pancreatitis, Diabetes, Pancreatic Cancer (CPDPC)

Publication Date

11-1-2022

Journal

Abdominal Radiology

DOI

10.1007/s00261-022-03654-7

PMID

36038644

PMCID

PMC9423890

PubMedCentral® Posted Date

8-29-2022

PubMedCentral® Full Text Version

Post-print

Abstract

Purpose: To determine if quantitative MRI techniques can be helpful to evaluate chronic pancreatitis (CP) in a setting of multi-institutional study.

Methods: This study included a subgroup of participants (n = 101) enrolled in the Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies (PROCEED) study (NCT03099850) from February 2019 to May 2021. MRI was performed on 1.5 T using Siemens and GE scanners at seven clinical centers across the USA. Quantitative MRI parameters of the pancreas included T1 relaxation time, extracellular volume (ECV) fraction, apparent diffusion coefficient (ADC), and fat signal fraction. We report the diagnostic performance and mean values within the control (n = 50) and CP (n = 51) groups. The T1, ECV and fat signal fraction were combined to generate the quantitative MRI score (Q-MRI).

Results: There was significantly higher T1 relaxation time; mean 669 ms (± 171) vs. 593 ms (± 82) (p = 0.006), ECV fraction; 40.2% (± 14.7) vs. 30.3% (± 11.9) (p < 0.001), and pancreatic fat signal fraction; 12.2% (± 5.5) vs. 8.2% (± 4.4) (p < 0.001) in the CP group compared to controls. The ADC was similar between groups (p = 0.45). The AUCs for the T1, ECV, and pancreatic fat signal fraction were 0.62, 0.72, and 0.73, respectively. The composite Q-MRI score improved the diagnostic performance (cross-validated AUC: 0.76).

Conclusion: Quantitative MR parameters evaluating the pancreatic parenchyma (T1, ECV fraction, and fat signal fraction) are helpful in the diagnosis of CP. A Q-MRI score that combines these three MR parameters improves diagnostic performance. Further studies are warranted with larger study populations including patients with acute and recurrent acute pancreatitis and longitudinal follow-ups.

Keywords

Acute Disease, Digestive System Abnormalities, Fibrosis, Humans, Magnetic Resonance Imaging, Pancreatitis, Chronic, Prospective Studies

Published Open-Access

yes

Recommended Citation

Tirkes, Temel; Yadav, Dhiraj; Conwell, Darwin L; et al., "Quantitative MRI of Chronic Pancreatitis: Results From a Multi-Institutional Prospective Study, Magnetic Resonance Imaging as a Non-Invasive Method for Assessment of Pancreatic Fibrosis (MINIMAP)" (2022). Faculty, Staff and Student Publications. 4718.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4718