Pancreatic MRI associated with pancreatic fibrosis and postoperative fistula: comparison between pancreatic cancer and non-pancreatic cancer tissue

Noda, Yoshifumi; Goshima, Satoshi; Suzui, Natsuko; T, Miyazaki; Kajita, Kimihiro; Kawada, Hiroshi; Kawai, Nobuyuki; Tanahashi, Yoshikatsu

doi:10.1016/j.crad.2019.02.013

Cited by 17 publications

(29 citation statements)

References 15 publications

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“…This is because normal pancreatic parenchyma exhibits relative hyperintensity on T1-weighted MRI, as pancreatic juice is rich in glycoproteins, and the endoplasmic reticulum within the pancreatic cells contributes to the T1 shortening effect; however, the signal intensity gradually decreases with progression of pancreatic atrophy, brosis, interstitial edema, or fat deposition [32,33]. Moreover, in another study [29], we reported that the frequency of POPF after pancreaticoduodenectomy was signi cantly higher in patients without PC than in those with PC and was inversely related to pancreatic brosis. Based on these ndings, we proposed that the pancreas-to-muscle SIR on fat-suppressed T1-weighted MRI might be a potential imaging biomarker for predicting POPF re ecting pancreatic brosis.…”

Section: Patient Clinical Outcomes After Dp For Pcmentioning

confidence: 95%

“…Previous studies have reported various risk factors for POPF after DP [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]; however, a clear consensus has not yet been established, with some reported risk factors for POPF being subjective and poorly reproducible. Previously, we studied the potential value of magnetic resonance imaging (MRI) in evaluating pancreatic properties [28,29] and reported that the pancreas-to-muscle signal intensity ratio (SIR) on T1-weighted MRI signi cantly correlated with pancreatic brosis, and that it may be a potential biomarker for predicting POPF.…”

Section: Introductionmentioning

confidence: 99%

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Significance of Preoperative Pancreatic MRI Findings in Predicting Factors for Postoperative Pancreatic Fistula after Distal Pancreatectomy for Pancreatic Cancer: A Retrospective Study

Fukada

Murase

Higashi

et al. 2021

Preprint

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Background: Postoperative pancreatic fistula (POPF) is the most serious complication of distal pancreatectomy (DP). For patients with pancreatic cancer (PC), POPF can have a negative effect on both short- and long-term prognoses. This study aimed to identify clinical outcomes of POPF after DP for PC and predictive factors for POPF.Methods: This retrospective, single-institution study comprised 48 patients with PC who underwent open DP (excluding simultaneous resection of other organs and other pancreatic diseases) between January 2010 and December 2020 at the Gifu University Hospital. We statistically analyzed patient-, pancreas-, cancer-, and surgery-related factors for predicting outcomes and risk factors for POPF. Results: According to the International Study Group of Pancreatic Fistula (ISGPF) definition and grading, 11 (22.9%) of 48 patients had POPF grades B and C. Among 22 related factors, POPF was significantly associated with pancreatic width (p = 0.04) and the pancreas-to-muscle signal intensity ratio (SIR) on T1-weighted magnetic resonance imaging (MRI, p = 0.02) in univariate analysis. In multivariate analysis, both pancreatic width (≥23 mm, odds ratio [OR] 9.37; 95% confidence interval [CI] 1.22–202.40; p = 0.03) and SIR on T1-weighted MRI (≥1.37, OR 17.10; 95% CI 2.38–359.04; p = 0.003) were identified as independent predictive factors for POPF. Conclusion: Pancreatic width and pancreas-to-muscle SIR on T1-weighted MRI significantly correlated with POPF after DP for PC. These parameters may be potential imaging biomarkers for predicting POPF in pancreatic surgery.

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Section: Patient Clinical Outcomes After Dp For Pcmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Significance of Preoperative Pancreatic MRI Findings in Predicting Factors for Postoperative Pancreatic Fistula after Distal Pancreatectomy for Pancreatic Cancer: A Retrospective Study

Fukada

Murase

Higashi

et al. 2021

Preprint

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“…For VFA-T 1 mapping, both 2D and 3D data were acquired with a fast spoiled gradient echo (FSPGR) method using flip angles of 2,5,8,12,15,18,22, and 26°. The 2D data matched the FOV, matrix, and slices as the MRF acquisition.…”

Section: Methodsmentioning

confidence: 99%

“…Thus far only some studies have reported on the value of quantitative MRI on the pancreas. In normal pancreas, T 1 values have been reported to reflect the amount of acinar protein, rough endoplasmic reticulum and fat infiltration [10][11][12][13] . T 1 maps were found to aid determining the presence and severity of acinar cell loss in the diagnosis and classification of chronic pancreatitis 10,11,14 .…”

mentioning

confidence: 99%

Magnetic resonance fingerprinting of the pancreas at 1.5 T and 3.0 T

Serrao

Kessler

Carmo

et al. 2020

Sci Rep

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Magnetic resonance imaging of the pancreas is increasingly used as an important diagnostic modality for characterisation of pancreatic lesions. Pancreatic MRI protocols are mostly qualitative due to time constraints and motion sensitivity. MR Fingerprinting is an innovative acquisition technique that provides qualitative data and quantitative parameter maps from a single free‐breathing acquisition with the potential to reduce exam times. This work investigates the feasibility of MRF parameter mapping for pancreatic imaging in the presence of free-breathing exam. Sixteen healthy participants were prospectively imaged using MRF framework. Regions-of-interest were drawn in multiple solid organs including the pancreas and T1 and T2 values determined. MRF T1 and T2 mapping was performed successfully in all participants (acquisition time:2.4–3.6 min). Mean pancreatic T1 values were 37–43% lower than those of the muscle, spleen, and kidney at both 1.5 and 3.0 T. For these organs, the mean pancreatic T2 values were nearly 40% at 1.5 T and < 12% at 3.0 T. The feasibility of MRF at 1.5 T and 3 T was demonstrated in the pancreas. By enabling fast and free-breathing quantitation, MRF has the potential to add value during the clinical characterisation and grading of pathological conditions, such as pancreatitis or cancer.

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“…Previously, we studied the potential value of preoperative MRI in evaluating pancreatic properties [33,34] and reported that the pancreas-to-muscle signal intensity ratio on T 1 -weighted MRI (SIR on T 1 -w MRI) signi cantly correlated with pancreatic brosis, and that it may be a potential biomarker for predicting POPF. The signal intensity of the pancreatic parenchyma on the portal vein and the paraspinal muscle was measured using fat-suppressed axial T 1 -weighted imaging (Figure 3).…”

Section: Perioperative Managementmentioning

confidence: 99%

Early predictive factors for postoperative pancreatic fistula after distal pancreatectomy for pancreatic cancer: A retrospective study

Fukada

Murase

Higashi

et al. 2022

Preprint

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Background: Postoperative pancreatic fistula (POPF) is the most serious complication of distal pancreatectomy (DP). When POPF occurs and becomes severe, it causes secondary complications and leads to a longer treatment period. Therefore, especially for pancreatic cancer (PC), POPF may have a negative impact on not only short-term outcomes, but also on postoperative treatment. This study aimed to identify early predictive factors of POPF after DP for PC.Methods: This retrospective, single-institution study comprised of 55 patients with PC who underwent DP (excluding simultaneous resection of other organs and other pancreatic diseases) between January 2010 and December 2021 at the Gifu University Hospital. We statistically analyzed pre-, intra-, and post-operative 23 factors to identify early predictive factors for POPF. Results: According to the definition and grading of the International Study Group of Pancreatic Fistula (ISGPF), 12 (21.8%) of 55 patients had POPF grades B and C. In the univariate analysis, POPF was significantly associated with the pancreas-to-muscle signal intensity ratio on T1-weighted magnetic resonance imaging (SIR on T1-w MRI), the drainage fluid amylase (D-Amy) level on postoperative day 3 (POD3), C-reactive protein (CRP) on POD3, and heart rate on POD3. In multivariate analysis, pancreas-to-muscle SIR on T1-w MRI (>1.37; odds ratio [OR] 17.08; 95% confidence interval [CI] 1.64 – 598.16; p = 0.02), D-Amy level on POD3 (>1200 U/L; OR 20.00; 95% CI 1.73 – 563.83; p = 0.02) and heart rate on POD3 (>100 bpm; OR 15.33; 95% CI 1.53 – 258.45; p = 0.02) were identified as independent early predictive factors for POPF. Conclusion: Preoperative pancreas-to-muscle SIR on T1-w MRI and postoperative D-Amy level and heart rate significantly correlated with POPF after DP for PC. Postoperative management based on these predictive factors may contribute to shortened hospital stay and smooth introduction to postoperative treatment.

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Pancreatic MRI associated with pancreatic fibrosis and postoperative fistula: comparison between pancreatic cancer and non-pancreatic cancer tissue

Cited by 17 publications

References 15 publications

Significance of Preoperative Pancreatic MRI Findings in Predicting Factors for Postoperative Pancreatic Fistula after Distal Pancreatectomy for Pancreatic Cancer: A Retrospective Study

Significance of Preoperative Pancreatic MRI Findings in Predicting Factors for Postoperative Pancreatic Fistula after Distal Pancreatectomy for Pancreatic Cancer: A Retrospective Study

Magnetic resonance fingerprinting of the pancreas at 1.5 T and 3.0 T

Early predictive factors for postoperative pancreatic fistula after distal pancreatectomy for pancreatic cancer: A retrospective study

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