Computed tomography derived morphomics in the prediction of long-term outcomes in acute pancreatitis

doi:10.4329/wjr.118613

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World Journal of Radiology

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1949-8470

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

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Radiol. Jul 28, 2026; 18(7): 118613
Published online Jul 28, 2026. doi: 10.4329/wjr.118613

Table 1 Baseline patient demographics and pancreatitis aetiology

Baseline characteristics	All patients (n = 72)	Men (n = 46)	Women (n = 26)
Age (years)	56.0 ± 18.8	55.6 ± 18.8	56.7 ± 19.2
Modified Glasgow Imrie severity score	2 [2]	2 [2]	1.5 [2]
Aetiology
Alcohol	18 (25.0)	13 (28.3)	5 (19.2)
Gallstones	28 (38.9)	14 (30.4)	14 (53.9)
Idiopathic	23 (31.9)	16 (34.8)	7 (26.9)
Other	3 (4.2)	3 (6.5)	0 (0.0)

Data are presented as mean ± SD, median [interquartile range], or n (%).

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Table 2 Morphomic variables

Baseline morphomics	All patients (n = 72)	Men (n = 46)	Women (n = 26)	P value
Wall muscle area (cm²)	126 ± 30.7	137 ± 30.4	105 ± 17.7	< 0.001
Wall muscle density (HU)	27.8 ± 13.3	30.1 ± 12.4	23.8 ± 14.2	0.039
Psoas muscle area (cm²)	9.35 ± 3.87	11.1 ± 3.35	6.23 ± 2.52	< 0.001
Psoas muscle density (HU)	44.5 ± 12.0	44.8 ± 11.7	44.0 ± 12.8	0.784
Subcutaneous fat area (cm²)	233 ± 137	191 ± 97	309 ± 165	< 0.001
Subcutaneous fat density (HU)	-95.2 ± 11.5	-93.1 ± 13.2	-98.8 ± 6.15	0.055
Visceral fat area (cm²)	205 ± 106	230 ± 115	162 ± 69.1	0.008
Visceral fat density (HU)	-77.2 ± 14.0	-78.5 ± 15.3	-74.8 ± 11.2	0.053

Data are presented as mean ± SD. The Mann-Whitney U test was used for data that were not normally distributed, whereas Student’s t-test was used for data that followed a normal distribution.

HU: Hounsfield units.

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Table 3 Correlation analysis between morphomic variables and modified Glasgow Imrie severity score

Variable	mGIS score (0-7)
Variable	Pearson’s r	P value
Wall muscle area (cm²)	-0.190	0.875
Wall muscle density (HU)	-0.480	< 0.001
Psoas muscle area (cm²)	-0.153	0.199
Psoas muscle density (HU)	-0.465	< 0.001
Subcutaneous fat area (cm²)	0.079	0.509
Subcutaneous fat density (HU)	0.050	0.675
Visceral fat area (cm²)	0.239	0.043
Visceral fat density (HU)	-0.127	0.290

Pearson’s correlation coefficient was used for univariate analysis.

HU: Hounsfield units; mGIS: Modified Glasgow Imrie severity.

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Table 4 Association between morphomic variables and survival or recurrence

Variable	Survival (30-day)		Survival (10-year)		Recurrence
	MD	P value	MD	P value	MD	P value
WM area (cm²)	-1.398	0.905	9.73	0.145	0.793	0.931
WM density (HU)	14.401	0.003	13.82	< 0.001	7.936	0.009
PM area (cm²)	1.927	0.153	2.14	0.033	1.117	0.366
PM density (HU)	10.469	0.010	9.52	< 0.001	6.366	0.014
SCF area (cm²)	65.279	0.033	38.04	0.216	-58.451	0.037
SCF density (HU)	-8.240	0.059	-3.33	0.125	-0.100	0.951
VF area (cm²)	0.673	0.986	-2.86	0.833	-42.016	0.056
VF density (HU)	-0.895	0.762	-3.00	0.393	3.686	0.347

Values were generated using the Mann-Whitney U test.

HU: Hounsfield units; MD: Mean difference; PM: Psoas muscle; SCF: Subcutaneous fat; VF: Visceral fat; WM: Wall muscle.

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Table 5 Multivariate logistic regression in predicting death and recurrence

Variable	Death (30-day)		Recurrence
Variable	Estimate¹	P value	Estimate¹	P value
Wall muscle density (HU)	-0.44137	0.019	-0.08008	0.283
Psoas muscle density (HU)	0.00581	0.957	0.11924	0.134
Subcutaneous fat area (cm²)	-0.06031	0.018	-0.00642	0.119
Age (years)	-0.10983	0.096	-0.01033	0.635
Sex (male-female)	2.23529	0.310	1.35976	0.149
Pancreatitis subtype (NP-AIOP)	0.44864	0.814	1.03349	0.184
mGIS score (0-7)	0.53263	0.447	-0.39655	0.230

¹The estimate represents the log odds of death vs survival and recurrence vs no recurrence.

AIOP: Acute interstitial oedematous pancreatitis; HU: Hounsfield units; mGIS: Modified Glasgow Imrie severity; NP: Necrotising pancreatitis.

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Table 6 Multivariate logistic regression in predicting all-cause mortality over 10 years

Variable	Multivariate
Variable	Estimate¹	P value
Wall muscle density (HU)	-0.21702	0.004
Psoas muscle density (HU)	0.07638	0.222
Psoas muscle area (cm²)	-0.15725	0.266
Subcutaneous fat area (cm²)	-0.01374	0.038
Age (years)	-0.00200	0.947
Sex (male-female)	1.07564	0.328
Pancreatitis subtype (NP-AIOP)	-0.77738	0.455
mGIS score (0-7)	0.25253	0.458

¹The estimate represents the log odds of death vs survival in the multivariate analysis.

AIOP: Acute interstitial oedematous pancreatitis; HU: Hounsfield units; mGIS: Modified Glasgow Imrie severity; NP: Necrotising pancreatitis.

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Table 7 Morphomic analysis by pancreatitis aetiology

Variable	Alcohol (n = 18)	Gallstones (n = 28)	Idiopathic (n = 23)	Other (n = 3)	P value
Subcutaneous fat area (cm²)	157 [120]	262 [122]	184 [145]	184 [205]	0.004
Wall muscle density (HU)	34.4 [13.0]	27.0 [9.4]	29.1 [20.1]	38.3 [7.3]	0.043
Psoas muscle density (HU)	47.0 [12.2]	44.9 [12.7]	44.9 [12.8]	52.3 [3.3]	0.368

Data are presented as median [interquartile range].

Group comparisons were performed using the Kruskal-Wallis test.

HU: Hounsfield units.

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Citation: Shet S, O’Shea OC, De Kock LGA, Kakish E, Lee RJ, Ni Chleirigh N, O’Broin E, Ryan DJ, Maher MM. Computed tomography derived morphomics in the prediction of long-term outcomes in acute pancreatitis. World J Radiol 2026; 18(7): 118613
URL: https://www.wjgnet.com/1949-8470/full/v18/i7/118613.htm
DOI: https://dx.doi.org/10.4329/wjr.118613

Shet S, O’Shea OC, De Kock LGA, Kakish E, Lee RJ, Ni Chleirigh N, O’Broin E, Ryan DJ, Maher MM. Computed tomography derived morphomics in the prediction of long-term outcomes in acute pancreatitis. World J Radiol 2026; 18(7): 118613 [DOI: 10.4329/wjr.118613]

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