• Journal of Veterinary Clinics
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• 제27권6호
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• pp.686-692
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• 2010

Computed tomography (CT) is considered as gold standard in evaluating pancreatitis in human, but there have been only a few studies in veterinary field. Balthazar CT severity index (CTSI) used to assess the severity of acute necrotizing pancreatitis in human could be applicable to dogs, because the severity of acute pancreatitis depends on the area of pancreatic necrosis in dogs more than in human. In this study, 25 adult, clinically healthy beagle dogs were used. CT examinations was performed in normal pancreas, positive control group and acute necrotizing pancreatitis induced by autologous bile injection. Balthazar CTSI was applied to canine acute necrotizing pancreatitis in contrastenhanced CT image and compared with the result of histopathologic examination. The Hounsfield unit (HU) of normal canine pancreas was $52.44{\pm}4.58$ and the density was significantly decreased in acute necrotizing pancreatitis (P < .05). In contrast-enhanced CT examination, pancreatic density was decreased significantly and this area was compatible to pancreatic necrosis. Balthazar CTSI showed positive correlation with histopathologic evaluation with a sensitivity of 100% and a specificity of 88.89%. Balthazar CTSI can be applied to evaluate the severity of acute necrotizing pancreatitis in dogs.

• Journal of the Korean Society of Radiology
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• 제81권6호
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• pp.1436-1447
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• 2020

Purpose To investigate the clinical and CT features at admission to predict the progression to necrotizing pancreatitis (NP) in patients initially diagnosed with interstitial edematous pancreatitis (IEP). Materials and Methods Patients with IEP who underwent contrast-enhanced CT at admission and follow-up CT (< 14 days) were included (n = 178). Two radiologists performed a consensus review of follow-up CT scans and diagnosed the type of acute pancreatitis as IEP or NP. Laboratory findings at admission were recorded. Clinical, CT, and laboratory findings were compared between the IEP-IEP group and IEP-NP group using the chi-square test and the t-test. Multivariate analysis was also performed. Results There were 112 and 66 patients in the IEP-IEP and the IEP-NP groups, respectively. The proportion of patients with alcohol etiology was significantly larger in the IEP-NP group. Among the CT findings, the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were more frequently observed in the IEP-NP group. Among the laboratory variables, serum C-reactive protein levels and white blood cell counts were significantly higher in the IEP-NP group. Multivariate analysis revealed that the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were significant findings distinguishing the two groups. Conclusion CT findings, such as the presence of peripancreatic fluid and heterogeneous pancreatic parenchymal enhancement, may be helpful in predicting the progression to NP in patients initially diagnosed with IEP.

• Journal of Digestive Cancer Research
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• 제1권1호
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• pp.43-47
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• 2013

There have been very few reports related to pancreatic cancer developing in the remnant pancreas after a resection for pancreatic cancer. We report two cases of repeated pancreatectomy for second primary pancreatic cancer. A 58-year-old man with a 2.3 cm sized low attenuated pancreatic tail mass on abdomen CT scan, received a distal pancreatectomy (adenosquamous carcinoma, stage IIB) and adjuvant chemoradiotherapy. A follow-up abdomen CT scan revealed a 2.0 cm sized pancreatic head mass in the remnant pancreas at 35 months after the distal pancreatectomy. He received a pancreaticoduodenectomy and diagnosed as ductal adenocarcinoma (stage IIA). Another 62-year-old female was declared pancreatic head mass on a regular health examination. An abdomen CT scan revealed a 3.6 cm sized mixed solid and cystic mass. She received a pylorus-preserving pancreaticoduodenectomy (ductal adenocarcinoma, stage IB) and adjuvant chemoradiation therapy. At 20 months after the resection, a 1.8 cm sized ill-defined low attenuated mass developing in the tail of remnant pancreas was detected on a follow-up abdomen CT scan. The patient received a distal pancreatectomy and diagnosed as ductal adenocarcinoma (stage IIA).

• The Journal of the Korea Contents Association
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• 제17권10호
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• pp.567-575
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• 2017

In this study, when diagnosis pancreatic cancer by dual time point PET/CT, we propose SUVm 2.52 as the threshold value for performing the dual time point PET/CT exam. The hypothesis of normal distribution was adopted through data conversion of 60 pancreatic diseases. The proposed SUVm2.52 boundary value showed a significance level that could be applied to both 120 and 180 minutes of delay time scan for pancreatic cancer determination (p<0.05). C-value variation shows that delay time 2 hour test is more useful than delay time 3 hour test. When the SUVm 2.52 is set to the boundary value and the double-time point PET/CT exam is performed, the probability of distinguishing cancer from inflammation in the delayed image is 95%. When the delayed test is performed with the proposed boundary value SUVm 2.52, Compared with general PET / CT scans, it is thought that it may be helpful to distinguish pancreatic cancer.

• Journal of the Korean Society of Radiology
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• 제10권5호
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• pp.299-305
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• 2016

Despite of the development of medical equipments and technology. Pancreatic cancer has maked high false positive rate and low survival rate compared to other cancers. Therefore, early catch of pancreatic cancer is the only way to enhance the viability. It is important to find the exact location of the pancreas cancer in early stage. The method of optimum scan for early detection of pancreatic cancer on PET/CT exam is proposed. Examined the anatomical region that potentially can be missing from the supine position of ordinary pet/ct exam. The characteristics and usefulness of angle variation ($0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$) of patients scan position is analyzed. The proposed scan method (named JJ-projection) is bringing advantage of anatomical discrimination by separating stomach, liver, gallbladder duodenum and pancreas. ROC curve analysis is shows to advantage of the JJ-Projection method. The sensitivity has increased 4.6% than the supine delay scan method, the results sensitivity has increased from 91% to 95.2%. The specificity has increased from 75.1% to 84%. Compared with the results observed in cancer by biological biopsy, The accuracy has increased from 86.8% to 94.1%.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.194-203
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• 1999

Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

• Journal of the Korean Society of Radiology
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• 제13권2호
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• pp.305-311
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• 2019

In this study, present the most useful delay scan time by statistical analysis of SUVm data for 30 suspected pancreatic cancer patients. Two statistical analysis and a mathematical model was applied to the theoretical formula by glucose and insulin mechanics, and a mathematical model was created. Statistical analysis was performed via Metlab p/g. Optimal delay scan time was suggested by Metlab p/g for the change of SUV value over time.In this study, for diagnosis pancreatic cancer by dual time point PET/CT, propose optimal delay scan time 131.5 minuts. The proposed delay scan time showed statistical reliability applicable to the diagnosis of pancreatic cancer (p<0.05). Delayed scanning with the suggested delay scan time of 131.5 minutes is considered to be useful for the diagnosis of pancreatic cancer compared to general PET / CT scan.hen the delayed test is performed with the proposed delay scan time 131.5 minuts, Compared with general PET/CT scans.

• Clinical and Experimental Pediatrics
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• 제49권10호
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• pp.1111-1115
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• 2006

Hereditary pancreatitis is an autosomal dominant disease characterized by recurrent episodes of pancreatitis, often beginning in childhood, with a positive family history involving at least two other affected family members with no known other precipitating factors. Most forms of hereditary pancreatitis are caused by one of two common mutations, i.e., R122H in exon 3 and N29I in exon 2 of the cationic trypsinogen (CT) (PRSS1) gene, located on chromosome 7. The authors describe the case of a 15-year-old boy who had suffered from recurrent attacks of pancreatitis since age three. His mother and grandmother had chronic pancreatitis and diabetes mellitus. Mutation analysis was performed on the family due to the suspicion of hereditary pancreatitis. The CT gene was analyzed in DNA samples extracted from the peripheral blood of three family members, the mother, the proband, and the proband's sister. Two members of the family, the mother and the proband, were found to have a N29I mutation in the CT gene. The authors document the first family with hereditary pancreatitis associated with the N29I mutation in Korea.

• Journal of the Korean Society of Radiology
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• 제16권5호
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• pp.537-543
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• 2022

The purpose of this simulation study was to evaluate the possibility of pancreas detection through effective atomic number information using dual-energy computed tomography(CT). The effective atomic number of 10 tissue-equivalent materials were estimated through stoichiometric calibration. For stoichiometric calibration, HU values at low-energy (80 kV) and high-energy (140 kV) for 10 tissue-equivalent materials were used. Based on this method, the effective atomic number image of the tissue-equivalent material was extracted through an iterative algorithm. According to the results, the attenuation ratio in accordance with the effective atomic number was estimated to have an R² value of 0.9999, and the effective atomic number of Pancreas, Water, Liver, Blood, Spongiosa, and Cortical bone was overall within 1% accuracy compared to the theoretical value. Conventional pancreatic cancer examination uses a contrast medium, so there is a possibility of potential side effects of the contrast medium. In order to solve this problem, it is thought that it will be possible to contribute to an accurate and safe examination by extracting the effective atomic number using dual-energy CT without contrast enhancement. Based on this study, future research will be conducted on the detection of pancreatic cancer using the HU value of pancreatic cancer based on clinical images.

• Journal of Biomedical Engineering Research
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• 제39권2호
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• pp.80-86
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• 2018

The aim of this study were to establish the clinical references and guidelines for the maximum standardized uptake ($SUV_{max}$) value of pancreatic cancer, pancreatitis, and normal pancreas in $^{18}F-FDG$ PET-CT examinations for pancreatic disease. For this purpose, we performed the statistical analysis on the descriptive statistics, percentiles and inter quartiles range (IQR), normal distribution, and using the probability density function for pancreatic cancer, pancreatitis, and normal pancreas. As a result, the clinical reference of $SUV_{max}$ for the pancreatic cancer, pancreatitis, and normal pancreas was more than 3.45, 1.91 to 2.62, and less than 1.91, respectively. Also, optimal cut-off value for applying the dual time point PET-CT examination was determined to be 2.62. The results of this study are summarized as follows: first, we suggests the clinical reference and guideline for the pancreatic cancer, pancreatitis, and normal pancreas, and second, suggests a scientific approach to improve diagnostic accuracy of pancreatic disease by deviating from an approximate experience approach.