Imaging of the Pancreas in New-Onset Diabetes: A Prospective Pilot Study.
Imaging of the Pancreas in New-Onset Diabetes: A Prospective Pilot Study.
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DOI：
10.14309/ctg.0000000000000478
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发表时间：
2022-06-01
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
--
作者：
本研究的目的是评估横断面成像检测新发高血糖和糖尿病（NOD）患者胰腺癌（PDAC）的可行性。我们于2018年11月至2020年3月在综合卫生系统内进行了一项前瞻性试点研究。在参与建立NOD队列的前瞻性研究时，邀请年龄50-85岁、血糖参数新升高且无糖尿病史的患者完成3期对比增强计算机断层扫描胰腺方案扫描。确定了异常胰腺结果、偶发胰腺外结果和后续临床评价。基于胰管和实质的描述，评估了医疗中心之间临床报告的变异性。147名参与者中共有130名（88.4%）同意接受成像;完成了93次扫描（在COVID-19居家订单之前）。中位年龄为62.4岁（四分位距56.3-68.8），37.6%为女性;西班牙裔（39.8%）、白色（29.0%）、黑人（14.0%）和亚裔（13.3%）。诊断出1例（1.1%）PDAC（IV期），93例参与者中有12例（12.9%）有额外的胰腺发现：5例脂肪浸润，3例囊肿，2例萎缩，1例分裂和1例钙化。在52/93例（56%）独特患者中有57例胰腺外发现; 12/57例（21.1%）提示临床评价，诊断出2例其他恶性肿瘤（非小细胞肺和肾嗜酸细胞瘤）。来自1家参与医疗中心的报告更频繁地提供了胰腺实质和导管的描述（92.9% vs 18.4%），P < 0.0001。高比例的偶然发现和临床报告中的变异性是成功的基于NOD的PDAC早期检测策略所面临的挑战。
The aim of this study was to assess the feasibility of cross-sectional imaging for detection of pancreatic cancer (PDAC) in patients with new-onset hyperglycemia and diabetes (NOD). We conducted a prospective pilot study from November 2018 to March 2020 within an integrated health system. Patients aged 50–85 years with newly elevated glycemic parameters without a history of diabetes were invited to complete a 3-phase contrast-enhanced computed tomography pancreas protocol scan while participating in the Prospective Study to Establish a NOD Cohort. Abnormal pancreatic findings, incidental extrapancreatic findings, and subsequent clinical evaluation were identified. Variability in clinical reporting between medical centers based on descriptors of pancreatic duct and parenchyma was assessed. A total of 130 of 147 participants (88.4%) consented to imaging; 93 scans were completed (before COVID-19 stay-at-home order). The median age was 62.4 years (interquartile range 56.3–68.8), 37.6% women; Hispanic (39.8%), White (29.0%), Black (14.0%), and Asian (13.3%). One (1.1%) case of PDAC (stage IV) was diagnosed, 12 of 93 participants (12.9%) had additional pancreatic findings: 5 fatty infiltration, 3 cysts, 2 atrophy, 1 divisum, and 1 calcification. There were 57 extrapancreatic findings among 52 of 93 (56%) unique patients; 12 of 57 (21.1%) prompted clinical evaluation with 2 additional malignancies diagnosed (nonsmall cell lung and renal oncocytoma). Reports from 1 participating medical center more frequently provided description of pancreatic parenchyma and ducts (92.9% vs 18.4%), P < 0.0001. High proportion of incidental findings and variability in clinical reports are challenges to be addressed for a successful NOD-based early detection strategy for PDAC.
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影响因子：
19.7
作者：
Al-Hawary, Mahmoud M.;Francis, Isaac R.;Simeone, Diane M.
通讯作者：
Simeone, Diane M.
DOI：
10.1016/j.pan.2012.02.003
发表时间：
2012-03
期刊：
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
影响因子：
--
作者：
Aggarwal G;Rabe KG;Petersen GM;Chari ST
通讯作者：
Chari ST
影响因子：
4.5
作者：
Fabrega-Foster, Kelly;Kamel, Ihab R.;Carucci, Laura R.
通讯作者：
Carucci, Laura R.
影响因子：
12.6
作者：
Huang, Brian Z.;Pandol, Stephen J.;Setiawan, Veronica Wendy
通讯作者：
Setiawan, Veronica Wendy
影响因子：
3.6
作者：
Illes, Dora;Terzin, Viktoria;Czako, Laszlo
通讯作者：
Czako, Laszlo