Temel Tirkes1, Anil K Dasyam2, Zarine K Shah3, Evan L Fogel4, Santhi Swaroop Vege5, Liang Li6, Shuang Li6, Stephanie T Chang7, Carlos A Farinas8, Joseph R Grajo9, Kareem Mawad10, Naoki Takahashi11, Sudhakar K Venkatesh11, Ashley Wachsman12, William E Fisher13, Christopher E Forsmark14, Phil A Hart15, Stephen J Pandol16, Walter G Park17, Stephen K Van Den Eeden18, Yunlong Yang6, Mark Topazian19, Dana K Andersen20, Jose Serrano20, Darwin L Conwell21, Dhiraj Yadav22. 1. Department of Radiology & Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd. Suite 0663, Indianapolis, IN, 46202, USA. atirkes@iupui.edu. 2. Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 3. Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 4. Lehman, Bucksot and Sherman Section of Pancreatobiliary Endoscopy, Indiana University School of Medicine, Indianapolis, IN, USA. 5. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. 6. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 7. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA. 8. Baylor College of Medicine, Radiology Department, TX, Houston, USA. 9. University of Florida College of Medicine, Gainesville, FL, USA. 10. The Permanente Medical Group, South San Francisco Medical Center, South San Francisco, CA, 94080, USA. 11. Department of Radiology, Mayo Clinic, Rochester, MN, USA. 12. Department of Radiology, Cedars-Sinai Medical Center, University of California in Los Angeles, Los Angeles, CA, USA. 13. Department of Surgery, Baylor College of Medicine, Houston, TX, USA. 14. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, 32610, USA. 15. Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 16. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 17. Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, USA. 18. Kaiser Permanente Division of Research, Oakland, CA, USA. 19. Mayo Clinic, Rochester, MN, USA. 20. Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. 21. Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA. 22. Department of Medicine, Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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.
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.
Authors: Jens Brøndum Frøkjær; Fatih Akisik; Ammad Farooq; Burcu Akpinar; Anil Dasyam; Asbjørn Mohr Drewes; Ingfrid S Haldorsen; Giovanni Morana; John P Neoptolemos; Søren Schou Olesen; Maria Chiara Petrone; Andrea Sheel; Tooru Shimosoegawa; David C Whitcomb Journal: Pancreatology Date: 2018-08-28 Impact factor: 3.996
Authors: Timothy B Gardner; Douglas G Adler; Chris E Forsmark; Bryan G Sauer; Jason R Taylor; David C Whitcomb Journal: Am J Gastroenterol Date: 2020-03 Impact factor: 10.864
Authors: Darwin L Conwell; Linda S Lee; Dhiraj Yadav; Daniel S Longnecker; Frank H Miller; Koenraad J Mortele; Michael J Levy; Richard Kwon; John G Lieb; Tyler Stevens; Phillip P Toskes; Timothy B Gardner; Andres Gelrud; Bechien U Wu; Christopher E Forsmark; Santhi S Vege Journal: Pancreas Date: 2014-11 Impact factor: 3.327
Authors: Vinicius P V Alves; Samuel Brady; Nadeen Abu Ata; Yinan Li; Joseph MacLean; Bin Zhang; Susan E Sharp; Andrew T Trout Journal: AJR Am J Roentgenol Date: 2022-09-21 Impact factor: 6.582
Authors: Temel Tirkes; Zarine K Shah; Naoki Takahashi; Joseph R Grajo; Stephanie T Chang; Ashley M Wachsman; Kareem Mawad; Carlos A Farinas; Liang Li; Savitri N Appana; Darwin L Conwell; Dhiraj Yadav; Anil K Dasyam Journal: Abdom Radiol (NY) Date: 2020-05
Authors: Temel Tirkes; Zarine K Shah; Naoki Takahashi; Joseph R Grajo; Stephanie T Chang; Sudhakar K Venkatesh; Darwin L Conwell; Evan L Fogel; Walter Park; Mark Topazian; Dhiraj Yadav; Anil K Dasyam Journal: Radiology Date: 2018-10-16 Impact factor: 29.146