Relationship between pancreatic morphological changes and diabetes in autoimmune pancreatitis: Multimodal medical imaging assessment has important potential.

Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis with clinical symptoms of obstructive jaundice and abdominal discomfort; this condition is caused by autoimmunity and marked by pancreatic fibrosis and dysfunction. Previous studies have revealed a close relationship between early pancreatic atrophy and the incidence rate of diabetes in type 1 AIP patients receiving steroid treatment. Shimada performed a long-term follow-up study and reported that the pancreatic volume (PV) of these patients initially exponentially decreased but then slowly decreased, which was considered to be an important factor related to diabetes; moreover, serum IgG4 levels were positively correlated with PV during follow-up. In this letter, regarding the original study presented by Shimada , we present our insights and discuss how multimodal medical imaging and artificial intelligence can be used to better assess the relationship between pancreatic morphological changes and diabetes in patients with AIP.