title: MRI prediction of islet yield for autologous transplantation after total pancreatectomy for chronic pancreatitis.
abstract: OBJECTIVE
  The relationship between magnetic resonance imaging (MRI), histopathology, and islet yield was examined for chronic pancreatitis patients undergoing total pancreatectomy and autologous islet cell transplant (TP-AIT) to determine if the yield can be predicted by pre-operative MRI.
  
  
  METHODS
  MRI sequences and histopathology were scored and compared for patients from whom ≤2,500 islet equivalents/kg were obtained with those from whom >2,500 islet equivalents/kg were obtained.
  
  
  RESULTS
  Twenty patients, 14 female, mean age 40.20 ± 12.5 years, (range 19-63) underwent MRI before TP-AIT; mean 3,724 ± 891 islet equivalents/kg body weight, median 2,970, (range 76-17,770) were procured. There was no correlation between islet cell numbers and pancreas weight, HgbA1c, or c-peptide. The most common MRI sequence abnormality was the delayed interstitial phase, 14/18 (78 %). The other common MRI sequence abnormalities were, precontrast T1W 3D GRE sequence, 13/19 (68 %), and the arterial perfusion phase, 11/18 (61 %). The pancreatic duct was dilated in 10/20 (50 %). Parenchymal atrophy was noted in 10/20 (50 %). Median scores for individual MRI sequences were greater in patients with an islet cell yield of ≤2,500 islet equivalents/kg; for the delayed interstitial phase the difference was significant (median 2.5, range 1-3 versus median 0.5, range 0-3, P = 0.034). Histologically the most common feature was fibrosis, (17/17, 100 %); the score for fibrosis was greater for patients with an islet cell yield of ≤2,500 islet equivalents/kg (median 6.0, range 5-7 versus median 4.0, range 3-7, P = 0.024).
  
  
  CONCLUSIONS
  A diminished islet yield may be predicted on the basis of the delayed interstitial phase MRI sequence.
authors.affiliation: Department of Surgery, College of Medicine, University of Arizona, 1501 N. Campbell Avenue, PO Box 245066, Tucson, AZ 85724, USA. khalid.m.khan@medstar.net
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Khan
authors.forename: Chirag S
authors.initials: CS
authors.lastname: Desai
authors.forename: Bobby
authors.initials: B
authors.lastname: Kalb
authors.forename: Charmi
authors.initials: C
authors.lastname: Patel
authors.forename: Brianna M
authors.initials: BM
authors.lastname: Grigsby
authors.forename: Tun
authors.initials: T
authors.lastname: Jie
authors.forename: Rainer W G
authors.initials: RW
authors.lastname: Gruessner
authors.forename: Horacio
authors.initials: H
authors.lastname: Rodriguez-Rilo
mesh_terms: D000328:Adult; D002096:C-Peptide / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016381:Islets of Langerhans Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010179:Pancreas / Q000473:pathology*; D010180:Pancreatectomy; D050500:Pancreatitis, Chronic / Q000097:blood / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D002096:C-Peptide; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human