Prediction of pancreatic atrophy after steroid therapy using equilibrium‐phase contrast computed tomography imaging in autoimmune pancreatitis. Issue 4 (10th March 2020)

• Record Type: Journal Article
• Authors: Yamada, Yasutaka; Masuda, Atsuhiro; Sofue, Keitaro; Ueshima, Eisuke; Shiomi, Hideyuki; Sakai, Arata; Kobayashi, Takashi; Ikegawa, Takuya; Tanaka, Shunta; Nakano, Ryota; Tanaka, Takeshi; Kakihara, Maya; Ashina, Shigeto; Tsujimae, Masahiro; Yamakawa, Kohei; Abe, Shohei; Gonda, Masanori; Masuda, Shigeto; Inomata, Noriko; Kutsumi, Hiromu; Itoh, Tomoo; Murakami, Takamichi; Kodama, Yuzo
• Is Part Of: JGH open. Volume 4:Issue 4(2020)
• Page Start: 677
• Page End: 683
• Publication Date: 2020-03-10
• Subjects: autoimmune pancreatitis -- diabetes mellitus -- equilibrium‐phase images -- pancreatic atrophy
• DOI: 10.1002/jgh3.12316
• Languages: English
• ISSNs: 2397-9070

Abstract

Abstract: Background and Aims: Imaging tools for predicting pancreatic atrophy after steroid therapy in autoimmune pancreatitis (AIP) have not been established. As delayed equilibrium‐phase contrast enhancement in computed tomography (CE‐CT) may reflect interstitial fibrosis, we evaluated the ability of equilibrium‐phase CT imaging for predicting pancreatic atrophy. Methods: Forty‐six steroid‐treated AIP patients who underwent contrast‐enhanced CT at our university hospital were included in this retrospective study. CT attenuation (Hounsfield units [HU]) values in noncontrast images (NC) and equilibrium‐phase images (EP) and the differences in HU values between NC and EP images (SUB) were measured. Pancreatic volume was measured in CE‐CT before (Volpre ) and after (Volpost ) steroid therapy. The volume reduction rate was calculated. The relationships of CT values with pancreatic atrophy, Volpost, volume reduction rate, and diabetes exacerbation were investigated. Results: CT values in the EP and SUB images before steroid therapy were associated with pancreatic atrophy after steroid therapy (atrophy vs nonatrophy 114.5 ± 12.8 vs 99.5 ± 11.1, P = 0.0002; 70.9 ± 14.72 vs 57.2 ± 13.1, P = 0.003, respectively), but CT values in NC images were not ( P = 0.42). CT values in EP and SUB images before steroid therapy were correlated with Volpost (EP images r = −0.70, P = 0.002; SUB images r = −0.68, P = 0.03) and volume reduction rate after steroid therapy (EP images: r = −0.55, P < 0.0001; SUB images r = −0.45, P = 0.002). Diabetes exacerbation was associated with higher EP and SUB values ( P = 0.009 and P = 0.04, respectively). Conclusion: Equilibrium‐phase contrast CT imaging may facilitate prediction of pancreatic atrophy after steroid therapy in AIP. Abstract : Pancreatic atrophy is often observed after steroid therapy for AIP and is associated with exacerbation of diabetes. However, it has not been possible to predict pancreatic atrophy before the start of therapy. This time, we have found a method to predict pancreatic atrophy using CT values, and we introduce it here.