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PRELIMINARY STUDY RESULTS OF PANCREATIC FIBROSIS ASSESSMENT BY MULTIDETECTOR COMPUTED TOMOGRAPHY

Igor Khatkov 1,2, Konstantin Lesko 1, Dmitry S. Bordin 3,4,5, Elena Dubtsova 1, Nikolay Karnaukhov 1, Nadezhda Makarenko 1, Irina Savina 1, Mariia Kiriukova 1, Diana Salimgereeva 1, Ludmila Vinokurova 1

Affiliations

1 The A.S. Loginov Moscow Clinical Scientific Center of the Moscow Health Department, Moscow, Russian Federation

2 A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Fed

3 A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation

4 Tver State Medical University, Tver, Russian Federation

5 The A.S. Loginov Moscow Clinical Scientific C

Summary

AI Generated

Multidetector computed tomography enhancement characteristics correlate with pancreatic fibrosis grade and morphological signs of chronic pancreatitis, offering potential for non-invasive fibrosis assessment.

Unenhanced pancreatic density values were significantly lower in patients with moderate and severe pancreatic fibrosis compared to mild fibrosis, and differed significantly based on intralobular fibrosis grade.
Contrast enhancement ratio values were significantly higher in patients with severe pancreatic fibrosis and differed significantly between groups divided by perilobular fibrosis grade.
Patients with pancreatic inflammation signs had significantly lower unenhanced pancreas density (33.1±11 HU) than those without inflammation (40.8±5.9 HU, p=0.01), and similar differences were seen with pancreatic duct epithelium metaplasia.
Normalized contrast enhancement ratios during venous phase showed significant differences related to pancreatic duct epithelium metaplasia (p=0.02), morphological signs of inflammation (p=0.017), and perilobular fibrosis grade (p=0.04).
The study analyzed contrast-enhanced 128-row MDCT data from patients who underwent pancreatic surgery for benign and malignant tumors as well as advanced chronic pancreatitis, with fibrosis graded by experienced pathologists using the Klöppel and Maillet scoring system.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Pancreatic fibrosis is a major histological feature of chronic pancreatitis (CP) as well as affects a course of vast spectrum of pancreatic disorders. Therefore, pancreatic fibrosis early diagnosis gives an invaluable opportunity to be a part of the strategy for preventing disease progression. So, it makes non-invasive pancreatic fibrosis evaluation techniques research perspective.

Aims & Methods

We aimed to clarify relationships between pancreatic fibrosis grade and results of multidetector computed tomography (MDCT). Results of contrast-enhanced 128-row MDCT from 43 patients who underwent surgery from April to December 2022 due to benign and malignant pancreatic tumors as well as advanced CP, mean age 56.8±14 (25-84) were analyzed. We calculated normalized contrast enhancement ratio during the pancreatic (PP)and venous phases (VP), as well as contrast enhancement ratio between VP and non-contrast MDCT Morphological signs of CP as well as pancreatic fibrosis grade were assessed by experienced pathologists according to Klöppel & Maillet’s scoring system [1] for the evaluation of the extent of fibrosis in CP.

Results

We received significant intergroup differences between mean values of normalized contrast enhancement ratios during PV and pancreatic duct epithelium metaplasia (p=0.02) and within morphological signs of pancreatic inflammation (p=0.017). There were differences in mean values of normalized contrast enhancement ratios during PV in groups divided by perilobular fibrosis grade (p=0.04). Unenhanced pancreas density value significantly differed in patients with pancreatic inflammation signs (33.1±11HU) and pancreatic duct epithelium metaplasia (33.1±8.1 HU) than in patients without both phenomena (40.8±5.9HU and 41.2±9.5HU, respectively), with p=0.01 and p=0.001, respectively. We revealed significant intergroup differences in unenhanced pancreas density value depending on intralobular fibrosis grade. Enhancement ratio values were also significantly different in groups divided by perilobular fibrosis grade (p=0.024).

Conclusion

Morphological signs of CP and pancreatic fibrosis like pancreatic tissue inflammation and pancreatic duct epithelium metaplasia as well as pancreatic peri- and intralobular fibrosis grade affect MDCT pancreas enhancement characteristics. It could be useful for noninvasive pancreatic fibrosis diagnosis and prognosis.

References

1. Esposito I, Hruban RH, Verbeke C, et al. Guidelines on the histopathology of chronic pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and the European Pancreatic Club. Pancreatology. 2020;20(4):586-593. doi:10.1016/j.pan.2020.04.009

Disclosure

This study was conducted within the healthcare research project “Assessment of pancreatic fibrosis as a prognostic factor for its diseases course” funded by Autonomous non-profit organization "Moscow Center for Innovative Technologies in Healthcare" administered by the Moscow Healthcare Department.

Conference

UEG Week Copenhagen 2023

Topics

Pancreas

Submission format

Abstract

Session

Acute and chronic pancreatitis (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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