Quantification of Pancreas Surface Lobularity on CT: A Feasibility Study in the Normal Pancreas

Korean J Radiol. 2021 Aug;22(8):1300-1309. doi: 10.3348/kjr.2020.1049. Epub 2021 Apr 23.

Abstract

Objective: To assess the feasibility and reproducibility of pancreatic surface lobularity (PSL) quantification derived from abdominal computed tomography (CT) in a population of patients free from pancreatic disease.

Materials and methods: This retrospective study included 265 patients free from pancreatic disease who underwent contrast-enhanced abdominal CT between 2017 and 2019. A maximum of 11 individual PSL measurements were performed by two abdominal radiologists (head [5 measurements], body, and tail [3 measurements each]) using dedicated software. The influence of age, body mass index (BMI), and sex on PSL was assessed using the Pearson correlation and repeated measurements. Inter-reader agreement was assessed using the intraclass correlation coefficient (ICC) and Bland Altman (BA) plots.

Results: CT images of 15 (6%) patients could not be analyzed. A total of 2750 measurements were performed in the remaining 250 patients (143 male [57%], mean age 45 years [range, 18-91]), and 2237 (81%) values were obtained in the head 951/1250 (76%), body 609/750 (81%), and tail 677/750 (90%). The mean ± standard deviation PSL was 6.53 ± 1.37. The mean PSL was significantly higher in male than in female (6.89 ± 1.30 vs. 6.06 ± 1.31, respectively, p < 0.001). PSL gradually increased with age (r = 0.32, p < 0.001) and BMI (r = 0.32, p < 0.001). Inter-reader agreement was excellent (ICC 0.82 [95% confidence interval 0.72-0.85], with a BA bias of 0.30 and 95% limits of agreement of -1.29 and 1.89).

Conclusion: CT-based PSL quantification is feasible with a high success rate and inter-reader agreement in subjects free from pancreatic disease. Significant variations were observed according to sex, age, and BMI. This study provides a reference for future studies.

Keywords: Anatomy; Pancreatic lobule; Quantitative.

MeSH terms

  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas* / diagnostic imaging
  • Reproducibility of Results
  • Retrospective Studies
  • Tomography, X-Ray Computed*