MRI prediction of islet yield for autologous transplantation after total pancreatectomy for chronic pancreatitis

Khalid M. Khan, Chirag S. Desai, Bobby T Kalb, Charmi Patel, Brianna M. Grigsby, Tun Jie, Rainer W G Gruessner, Horacio Rodriguez-Rilo

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI. Methods: MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained. Results: Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024). Conclusion: A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.

Original languageEnglish (US)
Pages (from-to)1116-1124
Number of pages9
JournalDigestive Diseases and Sciences
Volume58
Issue number4
DOIs
StatePublished - Apr 2013

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Pancreatectomy
Autologous Transplantation
Chronic Pancreatitis
Magnetic Resonance Imaging
Islets of Langerhans
Fibrosis
Transplants
Pancreatic Ducts
Atrophy
Pancreas
Perfusion
Cell Count
Body Weight
Weights and Measures
Peptides

Keywords

  • Autotransplantation
  • Delayed phase MRI
  • Pancreatic fibrosis

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

MRI prediction of islet yield for autologous transplantation after total pancreatectomy for chronic pancreatitis. / Khan, Khalid M.; Desai, Chirag S.; Kalb, Bobby T; Patel, Charmi; Grigsby, Brianna M.; Jie, Tun; Gruessner, Rainer W G; Rodriguez-Rilo, Horacio.

In: Digestive Diseases and Sciences, Vol. 58, No. 4, 04.2013, p. 1116-1124.

Research output: Contribution to journalArticle

Khan, Khalid M. ; Desai, Chirag S. ; Kalb, Bobby T ; Patel, Charmi ; Grigsby, Brianna M. ; Jie, Tun ; Gruessner, Rainer W G ; Rodriguez-Rilo, Horacio. / MRI prediction of islet yield for autologous transplantation after total pancreatectomy for chronic pancreatitis. In: Digestive Diseases and Sciences. 2013 ; Vol. 58, No. 4. pp. 1116-1124.
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abstract = "Objective: The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI. Methods: MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained. Results: Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 {\%}). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 {\%}), and the arterial perfusion phase, 11/18 (61 {\%}). The pancreatic duct was dilated in 10/20 (50 {\%}). Parenchymal atrophy was noted in 10/20 (50 {\%}). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 {\%}); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024). Conclusion: A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.",
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T1 - MRI prediction of islet yield for autologous transplantation after total pancreatectomy for chronic pancreatitis

AU - Khan, Khalid M.

AU - Desai, Chirag S.

AU - Kalb, Bobby T

AU - Patel, Charmi

AU - Grigsby, Brianna M.

AU - Jie, Tun

AU - Gruessner, Rainer W G

AU - Rodriguez-Rilo, Horacio

PY - 2013/4

Y1 - 2013/4

N2 - Objective: The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI. Methods: MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained. Results: Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024). Conclusion: A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.

AB - Objective: The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI. Methods: MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained. Results: Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024). Conclusion: A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.

KW - Autotransplantation

KW - Delayed phase MRI

KW - Pancreatic fibrosis

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