OBJECTIVE: The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI. METHODS: MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained. RESULTS: Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024). CONCLUSION: A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.
OBJECTIVE: The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitispatients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI. METHODS: MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained. RESULTS: Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024). CONCLUSION: A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.
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Authors: Michael C Young; Jake R Theis; James S Hodges; Ty B Dunn; Timothy L Pruett; Srinath Chinnakotla; Sidney P Walker; Martin L Freeman; Guru Trikudanathan; Mustafa Arain; Paul R Robertson; Joshua J Wilhelm; Sarah J Schwarzenberg; Barbara Bland; Gregory J Beilman; Melena D Bellin Journal: Pancreas Date: 2016-08 Impact factor: 3.327
Authors: R Lundberg; G J Beilman; T B Dunn; T L Pruett; S C Chinnakotla; D M Radosevich; R P Robertson; P Ptacek; A N Balamurugan; J J Wilhelm; B J Hering; D E R Sutherland; A Moran; M D Bellin Journal: Am J Transplant Date: 2013-08-07 Impact factor: 8.086