CT and MRI assessment of symptomatic organized pancreatic fluid collections and pancreatic duct disruption: an interreader variability study using the revised Atlanta classification 2012

Ayesha Kamal, Vikesh Singh, Venkata S. Akshintala, Satomi Kawamoto, Salina Tsai, Maera Haider, Elliot K Fishman, Ihab R Kamel, Atif Zaheer

Research output: Contribution to journalArticle

Abstract

Purpose: Compare CT and MRI for fluid/debris component estimate and pancreatic duct (PD) communication with organized pancreatic fluid collections in acute pancreatitis. Evaluate fat density globules on CT as marker for debris. Methods: 29 Patients with 46 collections with CECT and MRI performed ≥4 weeks of symptom onset assessed for necrotizing pancreatitis, estimated percentage of fluid volume and PD involvement by two radiologists on separate occasions. T2WI used as standard for estimated percentage of fluid volume. Presence of fat globules and fluid attenuation on CT was recorded. Spearman rank correlation and kappa statistics were used to assess the correlation between imaging techniques and interreader agreement, respectively. Results: Necrotizing pancreatitis seen on CT in 27 (93%, κ 0.119) vs. 20 (69%, κ 0.748) patients on MRI. CT identified 42 WON and 4 pseudocysts vs. 34 WON, and 12 pseudocysts on MRI. Higher interreader agreement for percentage fluid volume on MRI (κ = 0.55) vs. CT (κ = 0.196). Accuracy of CT in evaluation of percentage fluid volume was 65% using T2WI MRI used as standard. Fat globules identified on CT in 13(65%) out of 20 collections containing 75% fluid (p = 0.0001). PD involvement confidently excluded on CT in 68% collections vs. 93% on MRI. Conclusion: MRI demonstrates higher reproducibility for fluid to debris component estimation. Fat globules on CT were frequently seen in organized pancreatic fluid collections with large amount of debris. PD disruption more confidently excluded on MRI. This information may be helpful for pre-procedure planning.

Original languageEnglish (US)
Pages (from-to)1608-1616
Number of pages9
JournalAbdominal Imaging
Volume40
Issue number6
DOIs
StatePublished - Nov 26 2014

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Pancreatic Ducts
Fats
Pancreatitis
Communication

Keywords

  • MRI
  • Multi-detector computed tomography
  • Organized pancreatic fluid collections
  • Pancreatitis
  • Revised Atlanta classification 2012

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

@article{abb44c93441149f9a4d5a9d98a1351e8,
title = "CT and MRI assessment of symptomatic organized pancreatic fluid collections and pancreatic duct disruption: an interreader variability study using the revised Atlanta classification 2012",
abstract = "Purpose: Compare CT and MRI for fluid/debris component estimate and pancreatic duct (PD) communication with organized pancreatic fluid collections in acute pancreatitis. Evaluate fat density globules on CT as marker for debris. Methods: 29 Patients with 46 collections with CECT and MRI performed ≥4 weeks of symptom onset assessed for necrotizing pancreatitis, estimated percentage of fluid volume and PD involvement by two radiologists on separate occasions. T2WI used as standard for estimated percentage of fluid volume. Presence of fat globules and fluid attenuation on CT was recorded. Spearman rank correlation and kappa statistics were used to assess the correlation between imaging techniques and interreader agreement, respectively. Results: Necrotizing pancreatitis seen on CT in 27 (93{\%}, κ 0.119) vs. 20 (69{\%}, κ 0.748) patients on MRI. CT identified 42 WON and 4 pseudocysts vs. 34 WON, and 12 pseudocysts on MRI. Higher interreader agreement for percentage fluid volume on MRI (κ = 0.55) vs. CT (κ = 0.196). Accuracy of CT in evaluation of percentage fluid volume was 65{\%} using T2WI MRI used as standard. Fat globules identified on CT in 13(65{\%}) out of 20 collections containing 75{\%} fluid (p = 0.0001). PD involvement confidently excluded on CT in 68{\%} collections vs. 93{\%} on MRI. Conclusion: MRI demonstrates higher reproducibility for fluid to debris component estimation. Fat globules on CT were frequently seen in organized pancreatic fluid collections with large amount of debris. PD disruption more confidently excluded on MRI. This information may be helpful for pre-procedure planning.",
keywords = "MRI, Multi-detector computed tomography, Organized pancreatic fluid collections, Pancreatitis, Revised Atlanta classification 2012",
author = "Ayesha Kamal and Vikesh Singh and Akshintala, {Venkata S.} and Satomi Kawamoto and Salina Tsai and Maera Haider and Fishman, {Elliot K} and Kamel, {Ihab R} and Atif Zaheer",
year = "2014",
month = "11",
day = "26",
doi = "10.1007/s00261-014-0303-x",
language = "English (US)",
volume = "40",
pages = "1608--1616",
journal = "Abdominal Imaging",
issn = "0942-8925",
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number = "6",

}

TY - JOUR

T1 - CT and MRI assessment of symptomatic organized pancreatic fluid collections and pancreatic duct disruption

T2 - an interreader variability study using the revised Atlanta classification 2012

AU - Kamal, Ayesha

AU - Singh, Vikesh

AU - Akshintala, Venkata S.

AU - Kawamoto, Satomi

AU - Tsai, Salina

AU - Haider, Maera

AU - Fishman, Elliot K

AU - Kamel, Ihab R

AU - Zaheer, Atif

PY - 2014/11/26

Y1 - 2014/11/26

N2 - Purpose: Compare CT and MRI for fluid/debris component estimate and pancreatic duct (PD) communication with organized pancreatic fluid collections in acute pancreatitis. Evaluate fat density globules on CT as marker for debris. Methods: 29 Patients with 46 collections with CECT and MRI performed ≥4 weeks of symptom onset assessed for necrotizing pancreatitis, estimated percentage of fluid volume and PD involvement by two radiologists on separate occasions. T2WI used as standard for estimated percentage of fluid volume. Presence of fat globules and fluid attenuation on CT was recorded. Spearman rank correlation and kappa statistics were used to assess the correlation between imaging techniques and interreader agreement, respectively. Results: Necrotizing pancreatitis seen on CT in 27 (93%, κ 0.119) vs. 20 (69%, κ 0.748) patients on MRI. CT identified 42 WON and 4 pseudocysts vs. 34 WON, and 12 pseudocysts on MRI. Higher interreader agreement for percentage fluid volume on MRI (κ = 0.55) vs. CT (κ = 0.196). Accuracy of CT in evaluation of percentage fluid volume was 65% using T2WI MRI used as standard. Fat globules identified on CT in 13(65%) out of 20 collections containing 75% fluid (p = 0.0001). PD involvement confidently excluded on CT in 68% collections vs. 93% on MRI. Conclusion: MRI demonstrates higher reproducibility for fluid to debris component estimation. Fat globules on CT were frequently seen in organized pancreatic fluid collections with large amount of debris. PD disruption more confidently excluded on MRI. This information may be helpful for pre-procedure planning.

AB - Purpose: Compare CT and MRI for fluid/debris component estimate and pancreatic duct (PD) communication with organized pancreatic fluid collections in acute pancreatitis. Evaluate fat density globules on CT as marker for debris. Methods: 29 Patients with 46 collections with CECT and MRI performed ≥4 weeks of symptom onset assessed for necrotizing pancreatitis, estimated percentage of fluid volume and PD involvement by two radiologists on separate occasions. T2WI used as standard for estimated percentage of fluid volume. Presence of fat globules and fluid attenuation on CT was recorded. Spearman rank correlation and kappa statistics were used to assess the correlation between imaging techniques and interreader agreement, respectively. Results: Necrotizing pancreatitis seen on CT in 27 (93%, κ 0.119) vs. 20 (69%, κ 0.748) patients on MRI. CT identified 42 WON and 4 pseudocysts vs. 34 WON, and 12 pseudocysts on MRI. Higher interreader agreement for percentage fluid volume on MRI (κ = 0.55) vs. CT (κ = 0.196). Accuracy of CT in evaluation of percentage fluid volume was 65% using T2WI MRI used as standard. Fat globules identified on CT in 13(65%) out of 20 collections containing 75% fluid (p = 0.0001). PD involvement confidently excluded on CT in 68% collections vs. 93% on MRI. Conclusion: MRI demonstrates higher reproducibility for fluid to debris component estimation. Fat globules on CT were frequently seen in organized pancreatic fluid collections with large amount of debris. PD disruption more confidently excluded on MRI. This information may be helpful for pre-procedure planning.

KW - MRI

KW - Multi-detector computed tomography

KW - Organized pancreatic fluid collections

KW - Pancreatitis

KW - Revised Atlanta classification 2012

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U2 - 10.1007/s00261-014-0303-x

DO - 10.1007/s00261-014-0303-x

M3 - Article

C2 - 25425489

AN - SCOPUS:84938989048

VL - 40

SP - 1608

EP - 1616

JO - Abdominal Imaging

JF - Abdominal Imaging

SN - 0942-8925

IS - 6

ER -