Department of Radiology & Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd. Suite 0663, Indianapolis, IN, 46202, USA.
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Abdom Radiol (NY). 2022 Oct;47(10):3507-3519. doi: 10.1007/s00261-022-03611-4. Epub 2022 Jul 20.
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.
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.
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.
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.
本研究旨在通过一项大型多中心前瞻性研究，验证 T1 SIR（T1 评分）作为 CP 分期的影像学生物标志物的有效性。
本前瞻性研究纳入了 2017 年 6 月至 2021 年 12 月期间，9 个临床中心的 820 名 PROCEED 研究参与者。各机构的放射科医生采用标准化方法测量胰腺和参照器官（脾、椎旁肌、肝）的 T1 信号强度，由此得出各自的 T1 评分。根据参与者的临床病史、MRCP 和 CT 结果，将其分为慢性胰腺炎的 7 个机制阶段（MSCP 0-6）。
有慢性腹痛的参与者的胰腺-脾脏 T1 评分平均值为 1.30，有急性或复发性胰腺炎的参与者为 1.22，明确 CP 的参与者为 1.03。调整协变量后，我们观察到随着 MSCP 从 0 级到 6 级，胰腺-脾脏 T1 评分呈线性、渐进性下降。胰腺-脾脏 T1 评分的平均值分别为 1.34（MSCP 0）、1.27（MSCP 1）、1.21（MSCP 2）、1.16（MSCP 3）、1.18（MSCP 4）、1.12（MSCP 5）和 1.05（MSCP 6）（p<0.0001）。胰腺-肝脏和胰腺-肌肉 T1 评分的线性趋势较弱，置信区间较宽。
通过 SIR 计算得出的胰腺-脾脏 T1 评分与慢性胰腺炎的进展呈负线性相关。它有望成为评估临床研究和实践中疾病严重程度的实用影像学生物标志物。
