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Purpose <p>This study aimed to assess whether the pancreatic extracellular volume (ECV) fraction on multiphasic contrast-enhanced computed tomography (CE-CT) can estimate histological pancreatic fibrosis and predict clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD).</p> Methods <p>This single-center retrospective study included 106 patients who underwent multiphasic CE-CT and PD. ECV fractions were calculated based on absolute enhancements of the pancreas and aorta between the pre-contrast and equilibrium-phase images, followed by a comparison between different fibrosis grades. Multivariate logistic regression analyses were used to evaluate the association between the risk of CR-POPF development and perioperative factors.</p> Results <p>Of 106 patients, 45 (42.5%) developed POPF (biochemical leak, <i>n</i> = 8; grades B and C, <i>n</i> = 37). The ECV fraction (median, 40.1%; range, 20.0–87.7%) showed a moderate positive correlation with pancreatic fibrosis grade (<i>r</i> = 0.549, <i>P</i> &lt; 0.001). In the multivariate analysis, the ECV fraction (&lt; 40%; odds ratio, 10.1; 95% confidence interval, 3.32–36.3; <i>P</i> &lt; 0.001) was identified as the only independent risk factor for CR-POPF. The area under the receiver operating characteristic curve was 0.824 for the correlation between ECV fraction and CR-POPF prediction, with a cutoff value of 40.9%.</p> Conclusion <p>The pancreatic ECV fraction provides quantitative information for assessing pancreatic fibrosis and predicting CR-POPF after PD.</p>

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Pancreatic extracellular volume fraction on multiphasic contrast-enhanced computed tomography for predicting pancreatic fistula after pancreatoduodenectomy

  • 期刊论文

  • 发表日期：

    2025年12月5日

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  • Hayato Abe,
  • Yukiyasu Okamura,
  • Nao Yoshida,
  • Yusuke Mitsuka,
  • Osamu Aramaki,
  • Kenichiro Tago,
  • Masahiro Okada,
  • Noriyuki Nakano,
  • Shinobu Masuda,
  • Seiichi Udagawa

摘要

Purpose

This study aimed to assess whether the pancreatic extracellular volume (ECV) fraction on multiphasic contrast-enhanced computed tomography (CE-CT) can estimate histological pancreatic fibrosis and predict clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD).

Methods

This single-center retrospective study included 106 patients who underwent multiphasic CE-CT and PD. ECV fractions were calculated based on absolute enhancements of the pancreas and aorta between the pre-contrast and equilibrium-phase images, followed by a comparison between different fibrosis grades. Multivariate logistic regression analyses were used to evaluate the association between the risk of CR-POPF development and perioperative factors.

Results

Of 106 patients, 45 (42.5%) developed POPF (biochemical leak, n = 8; grades B and C, n = 37). The ECV fraction (median, 40.1%; range, 20.0–87.7%) showed a moderate positive correlation with pancreatic fibrosis grade (r = 0.549, P < 0.001). In the multivariate analysis, the ECV fraction (< 40%; odds ratio, 10.1; 95% confidence interval, 3.32–36.3; P < 0.001) was identified as the only independent risk factor for CR-POPF. The area under the receiver operating characteristic curve was 0.824 for the correlation between ECV fraction and CR-POPF prediction, with a cutoff value of 40.9%.

Conclusion

The pancreatic ECV fraction provides quantitative information for assessing pancreatic fibrosis and predicting CR-POPF after PD.