Dual-Phase CT of Autoimmune Pancreatitis: A Multireader Study
The purpose of this study was to identify findings that aid in differentiating autoimmune pancreatitis from pancreatic carcinoma using dual-phase CT. Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently e...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2008-02, Vol.190 (2), p.280-286 |
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| container_title | American journal of roentgenology (1976) |
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| creator | Takahashi, Naoki Fletcher, Joel G Fidler, Jeff L Hough, David M Kawashima, Akira Chari, Suresh T |
| description | The purpose of this study was to identify findings that aid in differentiating autoimmune pancreatitis from pancreatic carcinoma using dual-phase CT.
Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently evaluated by three radiologists for enhancement of the pancreas; the presence of a capsule-like rim, peripancreatic strands, and pancreatic calcifications; pancreatic duct or bile duct changes; and renal involvement. The frequency of CT characteristics was compared between autoimmune pancreatitis and carcinoma. Interobserver agreement for the three reviewers for the assessment of CT characteristics was evaluated using kappa statistics.
Diffusely decreased enhancement of the pancreas (autoimmune pancreatitis vs carcinoma: 28% vs 3%; p = 0.02, kappa = 0.33-0.75), capsule-like rim (40% vs 9%; p = 0.009, kappa = 0.42-0.66), peripancreatic strands (60% vs 27%; p = 0.02, kappa = 0.45-0.54), pancreatic calcifications (32% vs 9%; p = 0.04, kappa = 0.14-0.47), bile duct wall enhancement (52% vs 6%; p = 0.0001, kappa = 0.28-0.47), and renal involvement (28% vs 0%; p = 0.002, kappa = 0.32-0.74) were more frequent in patients with autoimmune pancreatitis. Pancreatic duct dilation (24% vs 67%; p = 0.001, kappa = 0.65-0.73) and abrupt cutoff (16% vs 55%; p = 0.003, kappa = 0.60-0.65) were more frequent in patients with carcinoma.
Diffusely decreased enhancement of the pancreas, a capsule-like rim, bile duct enhancement, and renal involvement are useful signs of autoimmune pancreatitis. |
| doi_str_mv | 10.2214/AJR.07.2309 |
| format | Article |
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Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently evaluated by three radiologists for enhancement of the pancreas; the presence of a capsule-like rim, peripancreatic strands, and pancreatic calcifications; pancreatic duct or bile duct changes; and renal involvement. The frequency of CT characteristics was compared between autoimmune pancreatitis and carcinoma. Interobserver agreement for the three reviewers for the assessment of CT characteristics was evaluated using kappa statistics.
Diffusely decreased enhancement of the pancreas (autoimmune pancreatitis vs carcinoma: 28% vs 3%; p = 0.02, kappa = 0.33-0.75), capsule-like rim (40% vs 9%; p = 0.009, kappa = 0.42-0.66), peripancreatic strands (60% vs 27%; p = 0.02, kappa = 0.45-0.54), pancreatic calcifications (32% vs 9%; p = 0.04, kappa = 0.14-0.47), bile duct wall enhancement (52% vs 6%; p = 0.0001, kappa = 0.28-0.47), and renal involvement (28% vs 0%; p = 0.002, kappa = 0.32-0.74) were more frequent in patients with autoimmune pancreatitis. Pancreatic duct dilation (24% vs 67%; p = 0.001, kappa = 0.65-0.73) and abrupt cutoff (16% vs 55%; p = 0.003, kappa = 0.60-0.65) were more frequent in patients with carcinoma.
Diffusely decreased enhancement of the pancreas, a capsule-like rim, bile duct enhancement, and renal involvement are useful signs of autoimmune pancreatitis.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.07.2309</identifier><identifier>PMID: 18212210</identifier><identifier>CODEN: AAJRDX</identifier><language>eng</language><publisher>Leesburg, VA: Am Roentgen Ray Soc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Autoimmune Diseases - diagnostic imaging ; Biological and medical sciences ; Carcinoma - diagnostic imaging ; Diagnosis, Differential ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Observer Variation ; Other diseases. Semiology ; Pancreas - diagnostic imaging ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatitis - diagnostic imaging ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods</subject><ispartof>American journal of roentgenology (1976), 2008-02, Vol.190 (2), p.280-286</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-b023883025dfb43070b6a3d7086dabdef1bb12002ce7ca33db98b866afadf5153</citedby><cites>FETCH-LOGICAL-c445t-b023883025dfb43070b6a3d7086dabdef1bb12002ce7ca33db98b866afadf5153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,4121,27928,27929</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20110204$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18212210$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takahashi, Naoki</creatorcontrib><creatorcontrib>Fletcher, Joel G</creatorcontrib><creatorcontrib>Fidler, Jeff L</creatorcontrib><creatorcontrib>Hough, David M</creatorcontrib><creatorcontrib>Kawashima, Akira</creatorcontrib><creatorcontrib>Chari, Suresh T</creatorcontrib><title>Dual-Phase CT of Autoimmune Pancreatitis: A Multireader Study</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>The purpose of this study was to identify findings that aid in differentiating autoimmune pancreatitis from pancreatic carcinoma using dual-phase CT.
Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently evaluated by three radiologists for enhancement of the pancreas; the presence of a capsule-like rim, peripancreatic strands, and pancreatic calcifications; pancreatic duct or bile duct changes; and renal involvement. The frequency of CT characteristics was compared between autoimmune pancreatitis and carcinoma. Interobserver agreement for the three reviewers for the assessment of CT characteristics was evaluated using kappa statistics.
Diffusely decreased enhancement of the pancreas (autoimmune pancreatitis vs carcinoma: 28% vs 3%; p = 0.02, kappa = 0.33-0.75), capsule-like rim (40% vs 9%; p = 0.009, kappa = 0.42-0.66), peripancreatic strands (60% vs 27%; p = 0.02, kappa = 0.45-0.54), pancreatic calcifications (32% vs 9%; p = 0.04, kappa = 0.14-0.47), bile duct wall enhancement (52% vs 6%; p = 0.0001, kappa = 0.28-0.47), and renal involvement (28% vs 0%; p = 0.002, kappa = 0.32-0.74) were more frequent in patients with autoimmune pancreatitis. Pancreatic duct dilation (24% vs 67%; p = 0.001, kappa = 0.65-0.73) and abrupt cutoff (16% vs 55%; p = 0.003, kappa = 0.60-0.65) were more frequent in patients with carcinoma.
Diffusely decreased enhancement of the pancreas, a capsule-like rim, bile duct enhancement, and renal involvement are useful signs of autoimmune pancreatitis.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Autoimmune Diseases - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Carcinoma - diagnostic imaging</subject><subject>Diagnosis, Differential</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Other diseases. Semiology</subject><subject>Pancreas - diagnostic imaging</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatitis - diagnostic imaging</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1Lw0AQhhdRbK2evEsuepHU2d18bAQPoX5TsWgFb8tudmMjSVN3E0L_vVsa7NHTwPDMO8MzCJ1iGBOCg6v0-W0M8ZhQSPbQEIdB5FMc4H00BBphnwH9HKAja78BIGZJfIgGmBHsZmGIbm5bUfqzhbDam8y9OvfStqmLqmqX2puJZWa0aIqmsNde6r20ZVO4htLGe29atT5GB7korT7p6wh93N_NJ4_-9PXhaZJO_SwIwsaXQChjFEiochlQiEFGgqoYWKSEVDrHUmICQDIdZ4JSJRMmWRSJXKg8xCEdoYtt7srUP622Da8Km-myFEtdt5bHbgHQgP4LEogYTYA58HILZqa21uicr0xRCbPmGPhGK3daOcR8o9XRZ31sKyutdmzv0QHnPSBsJsrcOHOF_eMIYAwEgt19i-Jr0TmX3FaiLF0s5l3X4cQt58S97BeFmoq8</recordid><startdate>20080201</startdate><enddate>20080201</enddate><creator>Takahashi, Naoki</creator><creator>Fletcher, Joel G</creator><creator>Fidler, Jeff L</creator><creator>Hough, David M</creator><creator>Kawashima, Akira</creator><creator>Chari, Suresh T</creator><general>Am Roentgen Ray Soc</general><general>American Roentgen Ray Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20080201</creationdate><title>Dual-Phase CT of Autoimmune Pancreatitis: A Multireader Study</title><author>Takahashi, Naoki ; Fletcher, Joel G ; Fidler, Jeff L ; Hough, David M ; Kawashima, Akira ; Chari, Suresh T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-b023883025dfb43070b6a3d7086dabdef1bb12002ce7ca33db98b866afadf5153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Autoimmune Diseases - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Carcinoma - diagnostic imaging</topic><topic>Diagnosis, Differential</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Other diseases. Semiology</topic><topic>Pancreas - diagnostic imaging</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatitis - diagnostic imaging</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takahashi, Naoki</creatorcontrib><creatorcontrib>Fletcher, Joel G</creatorcontrib><creatorcontrib>Fidler, Jeff L</creatorcontrib><creatorcontrib>Hough, David M</creatorcontrib><creatorcontrib>Kawashima, Akira</creatorcontrib><creatorcontrib>Chari, Suresh T</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takahashi, Naoki</au><au>Fletcher, Joel G</au><au>Fidler, Jeff L</au><au>Hough, David M</au><au>Kawashima, Akira</au><au>Chari, Suresh T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dual-Phase CT of Autoimmune Pancreatitis: A Multireader Study</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2008-02-01</date><risdate>2008</risdate><volume>190</volume><issue>2</issue><spage>280</spage><epage>286</epage><pages>280-286</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><coden>AAJRDX</coden><abstract>The purpose of this study was to identify findings that aid in differentiating autoimmune pancreatitis from pancreatic carcinoma using dual-phase CT.
Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently evaluated by three radiologists for enhancement of the pancreas; the presence of a capsule-like rim, peripancreatic strands, and pancreatic calcifications; pancreatic duct or bile duct changes; and renal involvement. The frequency of CT characteristics was compared between autoimmune pancreatitis and carcinoma. Interobserver agreement for the three reviewers for the assessment of CT characteristics was evaluated using kappa statistics.
Diffusely decreased enhancement of the pancreas (autoimmune pancreatitis vs carcinoma: 28% vs 3%; p = 0.02, kappa = 0.33-0.75), capsule-like rim (40% vs 9%; p = 0.009, kappa = 0.42-0.66), peripancreatic strands (60% vs 27%; p = 0.02, kappa = 0.45-0.54), pancreatic calcifications (32% vs 9%; p = 0.04, kappa = 0.14-0.47), bile duct wall enhancement (52% vs 6%; p = 0.0001, kappa = 0.28-0.47), and renal involvement (28% vs 0%; p = 0.002, kappa = 0.32-0.74) were more frequent in patients with autoimmune pancreatitis. Pancreatic duct dilation (24% vs 67%; p = 0.001, kappa = 0.65-0.73) and abrupt cutoff (16% vs 55%; p = 0.003, kappa = 0.60-0.65) were more frequent in patients with carcinoma.
Diffusely decreased enhancement of the pancreas, a capsule-like rim, bile duct enhancement, and renal involvement are useful signs of autoimmune pancreatitis.</abstract><cop>Leesburg, VA</cop><pub>Am Roentgen Ray Soc</pub><pmid>18212210</pmid><doi>10.2214/AJR.07.2309</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Autoimmune Diseases - diagnostic imaging Biological and medical sciences Carcinoma - diagnostic imaging Diagnosis, Differential Gastroenterology. Liver. Pancreas. Abdomen Humans Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Observer Variation Other diseases. Semiology Pancreas - diagnostic imaging Pancreatic Neoplasms - diagnostic imaging Pancreatitis - diagnostic imaging Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed - methods |
| title | Dual-Phase CT of Autoimmune Pancreatitis: A Multireader Study |
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