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Pancreatitis DFP

Welcome to our page. The mission of Pancreatitis DFP is to educate, disseminate, and advance the role of imaging in the diagnosis and management of patients with pancreatitis.

 

RESOURCES

 

Twitter: @PancreatitisDFP

 

Educational Materials:

 

 

 

DFP MEMBERS

 

SAR Members:

  1. Temel Tirkes, MD, FACR; Associate Professor of Radiology and Imaging Sciences
  2. Bhavik N. Patel, MD, MBA; Assistant Professor of Radiology; Stanford University
  3. Atif Zaheer, MD; Associate Professor of Radiology; Johns Hopkins University
  4. Kumar Sandrasegaran, MD; Professor of Radiology; Mayo Clinic, Scottsdale
  5. Desiree E. Morgan, MD; Professor of Radiology; University of Alabama Medical School
  6. Frank Miller, MD; Professor of Radiology; Northwestern University
  7. R. Brooke Jeffrey, MD; Professor of Radiology; Stanford University
  8. Fatih Akisik, MD; Professor of Clinical Radiology; Indiana University
  9. Dushyant Sahani, MD; Professor of Radiology; Washington University
  10. Peter Poullos, MD; Clinical Associate Professor of Radiology; Stanford University Medical Center
  11. Pardeep Mittal, MD; Associate Professor of Radiology; Emory University
  12. Jordan K Swensson, MD; Assistant Professor of Clinical Radiology; Indiana University
  13. Anil K Dasyam, MD; Associate Professor of Radiology; University of Pittsburgh Medical Center
  14. Abraham Fourie Bezuidenhout, MD; BIDMC - HMFP Radiology

CONSULTANTS:

  1. Dhiraj Yadav, MD; Professor of Medicine; University of Pittsburgh Medical Center; yadavd@upmc.edu
  2. Darwin L Conwell, MD; Professor of Medicine, Ohio State University; darwin.conwell@osumc.edu
  3. Walter Park, MD; Associate Professor of Medicine, Stanford; wgpark@stanford.edu

LEADERSHIP PLAN:

 

Chair

 

Temel Tirkes, MD, FACR

Associate Professor of Radiology and Imaging Sciences

Indiana University School of Medicine

atirkes@iu.edu

 

DFP GOALS (2020-2023)

  1. Creating educational materials on pancreatitis and online disseminating via the DFP website.
  2. Investigate possible imaging biomarkers that can be used for severity and monitoring the course of chronic pancreatitis during investigational therapies
  3. Create a consensus on indications of secretin for MRCP
  4. Determine the association between the pancreatic size/volume with chronic pancreatitis and T2DM.

Project 1:

  • Create educational materials on pancreatitis to be presented on the DFP website.
    • Lead: Abraham Bezuidenhout, MD
    • Rationale: There is a need for a collection of most up to date teaching materials for trainees in radiology. We are aiming to disseminate the most up to date information via online material
    • Deliverables: Teaching materials on pancreatitis
    • Timeline: 1 year

     

Project 2:

  • Investigate possible imaging biomarkers that can be used for severity and monitoring the course of chronic pancreatitis during investigational therapies
    • Lead: Temel Tirkes, MD
    • Consultants: Dhiraj Yadav, MD; Darwin L Conwell, MD
    • Rationale: Characteristic features of CP may be absent on standard imaging studies. Preliminary data suggest that quantitative features on MRI not currently used in clinical practice (T1 relaxation time, extracellular volume fraction, T1-weighted gradient-echo signal intensity ratio, diffusion-weighted imaging) can be useful for the diagnosis of CP. However, limited data exist in healthy subjects or those with CP.
    • One of the objectives yet to be completed by the pancreas radiologists is to detect and quantify pancreatic fibrosis. In this multi-institutional study, we aim to show that MRI can serve as a valuable non- invasive biomarker to identify and grade CP. The NIDDK funded this multi-institutional study (MINIMAP; PMID: 31089778). We will combine the results from the primary and secondary endpoints to generate a composite scoring system to be used in clinical practice as well as clinical trials.
    • Timeline: 3 years

     

Project 3:

  • Secretin Enhanced MRCP: When & How

    This is an invited expert panel review invitation from incoming AJR GI Section Editor, Dr. Miller. 

    • Lead: Jordan Swensson, MD
    • Consultant: Darwin L Conwell, MD
    • Rationale Consensus among the radiologists about indications and imaging techniques for secretin. Address issues around when secretin is necessary and which patients will benefit. How to prescribe and perform secretin enhanced MRCP?
    • Timeline: 1 year

     

Project 4:

  • Determine the association between the pancreatic volume and size with chronic pancreatitis and type 2 DM.
    • Lead: Temel Tirkes, MD
    • Consultant: Dhiraj Yadav, MD
    • Rationale: There is no sufficient data on pancreatic volume and diameter in patients with chronic pancreatitis and type 2 diabetes. We aim to investigate the correlation of pancreatic size and volume with chronic pancreatitis and type 2 diabetes.
    • Timeline: 3 years

 

PANCREATITIS DFP PUBLICATIONS

 

Reporting Standards

 

Reporting of acute pancreatitis by radiologists-time for a systematic change with structured reporting template. 

Khurana A, Nelson LW, Myers CB, et al. Abdom Radiol (NY). 2020;45(5):1277-1289. https://doi.org/10.1148/radiol.2018181353

 

Reporting Standards for Chronic Pancreatitis by Using CT, MRI, and MR Cholangiopancreatography: The Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer. 

Tirkes T, Shah ZK, Takahashi N, et al. Radiology. 2019;290(1):207-215.

https://doi.org/10.1148/radiol.2018181353

 

Abdominal Radiology

Volume 45, issue 5, May 2020

Special Section on Pancreatitis

 

MRI in acute pancreatitis.

Sandrasegaran, K., Heller, M.T., Panda, A. et al.  Abdom Radiol45, 1232–1242 (2020). https://doi.org/10.1007/s00261-019-02141-w

 

Advanced imaging techniques for chronic pancreatitis. 

Parakh, A., Tirkes, T. Abdom Radiol 45, 1420–1438 (2020). https://doi.org/10.1007/s00261-019-02191-0

 

Emerging imaging techniques for acute pancreatitis. 

Ghandili, S., Shayesteh, S., Fouladi, D.F. et al.  Abdom Radiol 45, 1299–1307 (2020). https://doi.org/10.1007/s00261-019-02192-z

 

Acute pancreatitis: an update on the revised Atlanta classification. 

Colvin, S.D., Smith, E.N., Morgan, D.E. et al.  Abdom Radiol 45, 1222–1231 (2020). https://doi.org/10.1007/s00261-019-02214-w

 

CT imaging, classification, and complications of acute pancreatitis. 

Fung, C., Svystun, O., Fouladi, D.F. et al.  Abdom Radiol 45, 1243–1252 (2020). https://doi.org/10.1007/s00261-019-02236-4

 

Utility of ultrasound in acute pancreatitis.

Burrowes, D.P., Choi, H.H., Rodgers, S.K. et al.  Abdom Radiol 45, 1253–1264 (2020). https://doi.org/10.1007/s00261-019-02364-x

 

Traumatic pancreatitis. 

Sharbidre, K.G., Galgano, S.J. & Morgan, D.E. Abdom Radiol 45, 1265–1276 (2020). https://doi.org/10.1007/s00261-019-02241-7

 

Initial experience with 3D CT cinematic rendering of acute pancreatitis and associated complications. 

Rowe, S.P., Chu, L.C. & Fishman, E.K. Abdom Radiol 45, 1290–1298 (2020). https://doi.org/10.1007/s00261-019-02310-x

 

Endoscopic intervention in pancreatitis: perspectives from a gastroenterologist.

Gurakar, M., Faghih, M. & Singh, V.K. Abdom Radiol 45, 1308–1315 (2020). https://doi.org/10.1007/s00261-019-02314-7

 

Pancreatitis in the developmentally anomalous pancreas. 

Wood, C.G., Lopes Vendrami, C., Craig, E. et al.  Abdom Radiol 45, 1316–1323 (2020). https://doi.org/10.1007/s00261-019-02197-8

 

Pancreatitis and PDAC: association and differentiation. 

Elsherif, S.B., Virarkar, M., Javadi, S. et al.  Abdom Radiol 45, 1324–1337 (2020). https://doi.org/10.1007/s00261-019-02292-w

 

Imaging guidelines for acute pancreatitis: when and when not to image. 

Rocha, A.P.C., Schawkat, K. & Mortele, K.J. Abdom Radiol 45, 1338–1349 (2020). https://doi.org/10.1007/s00261-019-02319-2

 

Fat-modified computed tomography severity index (CTSI) is a better predictor of severity and outcome in patients with acute pancreatitis compared with modified CTSI. 

Gupta, P., Dawra, S., Chandel, K. et al.  Abdom Radiol 45, 1350–1358 (2020). https://doi.org/10.1007/s00261-020-02473-y

 

Autoimmune pancreatitis: an update. 

Khandelwal, A., Inoue, D. & Takahashi, N. Abdom Radiol 45, 1359–1370 (2020). https://doi.org/10.1007/s00261-019-02275-x

 

Differentiation of focal autoimmune pancreatitis from pancreatic ductal adenocarcinoma. 

Lopes Vendrami, C., Shin, J.S., Hammond, N.A. et al.  Abdom Radiol 45, 1371–1386 (2020). https://doi.org/10.1007/s00261-019-02210-0

 

Endoscopic and surgical treatment options for chronic pancreatitis: an imaging perspective. 

Shanbhogue, K., Pourvaziri, A., Jeyaraj, S.K. et al.  Abdom Radiol 45, 1397–1409 (2020). https://doi.org/10.1007/s00261-019-02249-z

 

Optimum imaging of chronic pancreatitis. 

Zamboni, G.A., Ambrosetti, M.C., Pezzullo, M. et al.  Abdom Radiol 45, 1410–1419 (2020). https://doi.org/10.1007/s00261-020-02492-9

 

Groove pancreatitis: a clinical and imaging overview. 

Patel, B.N., Brooke Jeffrey, R., Olcott, E.W. et al.  Abdom Radiol 45, 1439–1446 (2020). https://doi.org/10.1007/s00261-019-02239-1

 

Cross-sectional imaging-based severity scoring of chronic pancreatitis: why it is necessary and how it can be done. 

Dasyam, A.K., Shah, Z.K., Tirkes, T. et al.  Abdom Radiol 45, 1447–1457 (2020). https://doi.org/10.1007/s00261-019-02218-6

 

Value of multidisciplinary collaboration in acute and chronic pancreatitis. 

Haj-Mirzaian, A., Patel, B.N., Fishman, E.K. et al.  Abdom Radiol 45, 1458–1467 (2020). https://doi.org/10.1007/s00261-019-02320-9

 

Inter-observer variability of radiologists for Cambridge classification of chronic pancreatitis using CT and MRCP: results from a large multi-center study. 

Tirkes, T., Shah, Z.K., Takahashi, N. et al.  Abdom Radiol 45, 1481–1487 (2020). https://doi.org/10.1007/s00261-020-02521-7

 

Impact of age on the diagnostic performance of pancreatic ductal diameters in detecting chronic pancreatitis. 

Frøkjær, J.B., Olesen, S.S., Drewes, A.M. et al.  Abdom Radiol 45, 1488–1494 (2020). https://doi.org/10.1007/s00261-020-02522-6

 

Ultrasonography in characterizing collections in acute pancreatitis. 

Madhusudhan, K.S., Srivastava, D.N. Abdom Radiol 45, 1495–1496 (2020). https://doi.org/10.1007/s00261-020-02494-7

Role of extrapancreatic necrosis volume in determining early prognosis in patients with acute pancreatitis. 

Çakar, İ., Keven, A., Eseroğlu, E. et al.  Abdom Radiol 45, 1507–1516 (2020). https://doi.org/10.1007/s00261-019-02188-9

 

Radiation dose from computed tomography in patients with acute pancreatitis: an audit from a tertiary care referral hospital. 

Gupta, P., Jain, R., Koshi, S. et al.  Abdom Radiol 45, 1517–1523 (2020). https://doi.org/10.1007/s00261-020-02408-7

 

Diagnostic accuracy of unenhanced CT texture analysis to differentiate mass-forming pancreatitis from pancreatic ductal adenocarcinoma.

Ren, S., Zhao, R., Zhang, J. et al.  Abdom Radiol 45, 1524–1533 (2020). https://doi.org/10.1007/s00261-020-02506-6

 

The augmented role of pancreatic imaging in the era of endoscopic necrosectomy: an illustrative and pictorial review. 

Kapoor, H., Issa, M., Winkler, M.A. et al.  Abdom Radiol 45, 1534–1549 (2020). https://doi.org/10.1007/s00261-019-02093-1

 

New, Informing or Interesting Publications

 

Normal T1 relaxometry and extracellular volume of the pancreas in subjects with no pancreas disease: correlation with age and gender. 

Tirkes T, Mitchell JR, Li L, Zhao X, Lin C. Abdom Radiol (NY). 2019;44(9):3133-3138. doi:10.1007/s00261-019-02071-7

Evaluation of variable flip angle, MOLLI, SASHA, and IR-SNAPSHOT pulse sequences for T1 relaxometry and extracellular volume imaging of the pancreas and liver. 

Tirkes T, Zhao X, Lin C, et al. MAGMA. 2019;32(5):559-566. doi:10.1007/s10334-019-00762-2

 

Quantitative MR Evaluation of Chronic Pancreatitis: Extracellular Volume Fraction and MR Relaxometry. 

Tirkes T, Lin C, Cui E, et al. AJR Am J Roentgenol. 2018;210(3):533-542. doi:10.2214/AJR.17.18606

 

T1 mapping for diagnosis of mild chronic pancreatitis. 

Tirkes T, Lin C, Fogel EL, Sherman SS, Wang Q, Sandrasegaran K. J Magn Reson Imaging. 2017;45(4):1171-1176. doi:10.1002/jmri.25428

 

Secretin-enhanced MR cholangiopancreatography: spectrum of findings. 

Tirkes T, Sandrasegaran K, Sanyal R, et al. Radiographics. 2013;33(7):1889-1906. doi:10.1148/rg.337125014

 

MRCP in patient care: a prospective survey of gastroenterologists. 

Akisik MF, Jennings SG, Aisen AM, et al. AJR Am J Roentgenol. 2013;201(3):573-577. doi:10.2214/AJR.12.9900

 

Association of Pancreatic Steatosis With Chronic Pancreatitis, Obesity, and Type 2 Diabetes Mellitus. 

Tirkes T, Jeon CY, Li L, et al. Pancreas. 2019;48(3):420-426. doi:10.1097/MPA.0000000000001252

 

PROPOSED CONTRIBUTIONS TO SAR EDUCATION PROGRAM:

  • Review article and/or workshop at the SAR on guidelines for appropriate imaging for pancreatitis (i.e., modality, protocols standards, frequency)
  • Scientific paper(s) on imaging predictors of severity of pancreatitis and outcomes
  • Series of workshops and plenary at the SAR focused on imaged based classification of pancreatitis, the role of imaging in diagnosis and management of all forms of pancreatitis, the role of percutaneous interventions in pancreatitis associated fluid collections, and management update of all forms of pancreatitis (surgical and medical perspective)

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