Pancreatic volume change using three dimensional-computed tomography volumetry and its relationships with diabetes on long-term follow-up in autoimmune pancreatitis

doi:10.4329/wjr.v16.i11.644

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 16, Issue 11

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (3491)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-6) series, Tables (1-5) series.

Item

Count

PDF

148

HTML

1716

Figures (1-6)

378

Tables (1-5)

344

Sum=2586

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

652

Sum=742

Nov 28, 2024 (publication date) through Feb 16, 2026

Times Cited of This Article

Times Cited (2)

Journal Information of This Article

Publication Name

World Journal of Radiology

ISSN

1949-8470

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Radiol. Nov 28, 2024; 16(11): 644-656
Published online Nov 28, 2024. doi: 10.4329/wjr.v16.i11.644

Pancreatic volume change using three dimensional-computed tomography volumetry and its relationships with diabetes on long-term follow-up in autoimmune pancreatitis

Ryuichi Shimada, Yasunari Yamada, Kazuhisa Okamoto, Kazunari Murakami, Mitsuteru Motomura, Hajime Takaki, Kengo Fukuzawa, Yoshiki Asayama

Ryuichi Shimada, Yoshiki Asayama, Department of Radiology, Oita University Faculty of Medicine, Yufu 879-5593, Oita, Japan

Yasunari Yamada, Hajime Takaki, Department of Radiology, Oita Red Cross Hospital, Oita 870-0033, Oita, Japan

Kazuhisa Okamoto, Kazunari Murakami, Department of Gastroenterology, Oita University Faculty of Medicine, Yufu 879-5593, Oita, Japan

Mitsuteru Motomura, Department of Hepato-Biliary-Pancreatic Internal Medicine, Oita Red Cross Hospital, Oita 870-0033, Oita, Japan

Kengo Fukuzawa, Department of Surgery, Oita Red Cross Hospital, Oita 870-0033, Oita, Japan

Author contributions: Shimada R and Yamada Y designed and conducted the study; Shimada R wrote the paper; Yamada Y contributed to the analysis; Okamoto K and Motomura M provided clinical advice; Asayama Y, Murakami K, Fukuzawa K, and Takaki H supervised the study.

Institutional review board statement: The study was approved by the institutional review board in Oita University Faculty of Medicine and Oita Red Cross Hospital.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymized clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.

Data sharing statement: The data used to support the findings to this study are available from the corresponding author upon request.

Corresponding author: Ryuichi Shimada, MD, Assistant Professor, Department of Radiology, Oita University Faculty of Medicine, Yufu city, Hasamamachi, Idaigaoka1-1, Yufu 879-5593, Oita, Japan. rshimada@oita-u.ac.jp

Received: July 25, 2024
Revised: September 7, 2024
Accepted: September 23, 2024
Published online: November 28, 2024
Processing time: 124 Days and 20.3 Hours

Abstract

BACKGROUND

Several studies found that early pancreatic atrophy detected by computed tomography (CT) within 6 months was associated with a high incidence of diabetes in patients with type-1 autoimmune pancreatitis (AIP) receiving steroid therapy; however, no long-term follow-up studies have been performed.

AIM

To investigate pancreatic volume (PV) changes using three dimensional (3D)-CT volumetry and their relationship with IgG4 and diabetes in patients with AIP.

METHODS

This retrospective study included 33 patients with type-1 AIP receiving steroid therapy. Patients were divided into diffuse (D-type) and mass-forming type (M-type) AIP. PV was determined by semi-automated 3D-CT volumetry, and changes between initial and follow-up values were calculated. The relationship between PV and serum IgG4 levels was analyzed by Spearman’s rank correlation. The PV atrophy ratio compared with the presumed normal PV at the time of last follow-up CT and its relationship with diabetes were investigated.

RESULTS

There were 16 D-type and 17 M-type patients with long-term follow-up (mean, 95.8 months). The regression curve of mean relative PV change reduced exponentially and rapidly during the first 25 months and then more slowly in both groups. The overall cumulative pancreas re-enlargement rates at 1, 3, 5, 7 and 10 years were 6.1%, 12.2%, 29.2%, 47.5% and 55.0%, respectively. There was a moderate-to-very strong positive correlation (ρ ≥ 0.4) between PV and serum IgG4 levels in nine (9/13, 69.2%) patients. All 33 patients showed pancreatic atrophy (mean 59.3%) after long-term follow-up. Patients with D-type AIP had a significantly higher atrophy rate and higher incidence of diabetes than M-type patients (P < 0.05).

CONCLUSION

PV change initially reduced exponentially and then more slowly and is considered an important factor associated with diabetes. Serum IgG4 levels were positively correlated with PV during follow-up.

Keywords: Autoimmune pancreatitis; Computerized tomography volumetry; Follow-up study; IgG4; Diabetes

Core Tip: To the best of our knowledge, no previous studies have reported on pancreatic volume (PV) changes during long-term follow-up in patients with autoimmune pancreatitis (AIP). In this study, we investigated PV changes using computed tomography volumetry and examined their relationships with IgG4 and diabetes in patients with AIP with long-term follow-up. PV reduced exponentially and rapidly during the first 25 months and then more slowly. IgG4 levels were positively correlated with PV during long-term follow-up in most patients. Pancreatic atrophy occurred during long-term follow-up in all patients, and is considered an important factor associated with diabetes.