Hu JX, Zhao CF, Wang SL, Tu XY, Huang WB, Chen JN, Xie Y, Chen CR. Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence. World J Gastroenterol 2023; 29(37): 5268-5291 [PMID: 37899784 DOI: 10.3748/wjg.v29.i37.5268]
Corresponding Author of This Article
Cun-Rong Chen, MD, PhD, Chief Physician, Doctor, Professor, Department of Critical Care Medicine, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou 350001, Fujian Province, China. chcr789@139.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 7, 2023; 29(37): 5268-5291 Published online Oct 7, 2023. doi: 10.3748/wjg.v29.i37.5268
Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence
Jian-Xiong Hu, Intensive Care Unit, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
Cheng-Fei Zhao, School of Pharmacy and Medical Technology, Putian University, Putian 351100, Fujian Province, China
Cheng-Fei Zhao, Key Laboratory of Pharmaceutical Analysis and Laboratory Medicine, Putian University, Putian 351100, Fujian Province, China
Shu-Ling Wang, Xiao-Yan Tu, Wei-Bin Huang, Jun-Nian Chen, Cun-Rong Chen, Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
Ying Xie, School of Mechanical, Electrical and Information Engineering, Putian University, Putian 351100, Fujian Province, China
Author contributions: Hu JX and Zhao CF wrote this paper and contributed equally to this work; Chen CR designed this paper; Wang SL and Tu XY checked and proofread this paper; Huang WB, Chen JN, and Xie Y searched related literature and information for this paper; all authors have read and approved the final manuscript.
Supported byFujian Provincial Health Technology Project, No. 2020GGA079; Natural Science Foundation of Fujian Province, No. 2021J011380; and National Natural Science Foundation of China, No. 62276146.
Conflict-of-interest statement: All the authors in this article declare there are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cun-Rong Chen, MD, PhD, Chief Physician, Doctor, Professor, Department of Critical Care Medicine, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou 350001, Fujian Province, China. chcr789@139.com
Received: May 1, 2023 Peer-review started: May 1, 2023 First decision: July 9, 2023 Revised: July 31, 2023 Accepted: September 14, 2023 Article in press: September 14, 2023 Published online: October 7, 2023 Processing time: 147 Days and 1.5 Hours
Abstract
Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease of the pancreas, with clinical management determined by the severity of the disease. Diagnosis, severity prediction, and prognosis assessment of AP typically involve the use of imaging technologies, such as computed tomography, magnetic resonance imaging, and ultrasound, and scoring systems, including Ranson, Acute Physiology and Chronic Health Evaluation II, and Bedside Index for Severity in AP scores. Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications. Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild, moderate, or severe categories, guiding treatment decisions, such as intensive care unit admission, early enteral feeding, and antibiotic use. Despite the central role of imaging technologies and scoring systems in AP management, these methods have limitations in terms of accuracy, reproducibility, practicality and economics. Recent advancements of artificial intelligence (AI) provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data. AI algorithms can analyze large amounts of clinical and imaging data, identify scoring system patterns, and predict the clinical course of disease. AI-based models have shown promising results in predicting the severity and mortality of AP, but further validation and standardization are required before widespread clinical application. In addition, understanding the correlation between these three technologies will aid in developing new methods that can accurately, sensitively, and specifically be used in the diagnosis, severity prediction, and prognosis assessment of AP through complementary advantages.
Core Tip: In this review, we comprehensively analyzed, discussed, and summarized the latest progress in the diagnosis, severity prediction, and prognosis assessment of acute pancreatitis from the aspects of imaging technologies, scoring systems, and artificial intelligence. This review provided comprehensive guidance and suggestions with clinical value for the diagnosis and treatment of acute pancreatitis.
