Radiological parameters to predict pancreatic texture: Current evidence and future perspectives

Table 3 Summary of studies evaluating the role of magnetic resonance imaging abdomen signal intensity in assessing pancreatic texture

Ref.	Number of patients	Aim	Parameter studied	Results	Conclusion	Histological correlation
Winston et al[34], 1995	89	Correlation of pancreatic SI to predict the presence of pancreatic disease	PLSI	Accuracy -86%; PPV- 88	Pancreatic SI less than that of liver correlates highly with pancreatic disease, especially in younger patients	Not evaluated
Kim et al[16], 2009	43	Accuracy of non-enhanced fat-suppressed T1W MRI in predicting POPF	PLSI, PSSI	PLSI cut off −0.12097 (sensitivity -36%, specificity - 89%); PSSI cut off -0.29979 (sensitivity-79%, specificity-45%)	PLSI, PSSI significantly differed between POPF group and non POPF group, hence, can be useful in predicting POPF	Good
Watanabe et al[36], 2014	29	Efficacy of MRI in assessing degrees of pancreatic fibrosis and predicting POPF	PMSI in unenhanced T1W and T2 W images	Odds ratio of PMSI in T1 W for POPF was 21.3 in patients with an SI ratio of 1.41 and higher	T1W SI ratio and ADC measurements useful to detect advanced pancreatic fibrosis and occurrence of POPF	Good
Noda et al[35], 2016	29	Evaluate the noncontrast-enhanced MRI to grade pancreatic fibrosis and correlate with HbA1c values	PMSI on in- and opposed-phase T1W images	The pancreatic fibrosis grade and HbA1c value were negatively correlated with the SI ratio on opposed-phase T1W images	PMSI could be a potential biomarker for pancreatic fibrosis and elevated HbA1c values	Good
Yoon et al[37], 2016	165	Evaluate the multiparametric pancreatic MRI in the quantification of pancreatic fibrosis and determine relation with POPF	PMSI on in- and opposed-phase T1, IVIM DW imaging; Perfusion fraction (f)	Mean SI ratio for fibrosis; F0 – 1.51; F1 – 1.48; SI ratio cutoff for POPF - 1.40; Odds of developing POPF for a 1% increase in f were 1.17	Multiparametric MR imaging of the pancreas may quantify pancreatic steatosis and fibrosis, and f was significantly associated with POPF	Good
Fukada et al[38], 2022	117	Predictive ability of SI ratio on T1W MRI for POPF after distal pancreatectomy	PMSI on T1W	SI ratio cutoff for POPF - 1.37; Sensitivity- 96.3% Specificity- 52.0%	PMSI is a quantitative biomarker for pancreatic characteristics	Good

T1W: T1 weighted; T2W: T2 Weighted; MRI: Magnetic resonance imaging; POPF: Postoperative pancreatic fistula; PLSI: Pancreas-to-liver signal intensity ratio; PSSI: Pancreas-to-spleen signal intensity ratio; PMSI: Pancreas-to-muscle signal intensity ratio; SI: Signal intensity; IVIM: Intravoxel incoherent motion.