title: Evaluation of the degree of pancreatic fatty infiltration by area-based assessment of CT images: comparison with histopathology-based and CT attenuation index-based assessments.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the degree of fatty infiltration (FI) of the pancreas using area-based assessment on computed tomography (CT) (CT area-based assessment) in its correlation and agreement/concordance with histopathology-based assessment. Furthermore, we examined whether CT area-based assessment was better than CT attenuation index-based assessment.
  
  
  METHODS
  We retrospectively evaluated the degree of FI of the pancreas in 37 pancreatic cancer patients who had undergone preoperative CT and pancreaticoduodenectomy. The degree of FI of the pancreas was examined by histopathology-based assessment using surgical resection samples, and CT area-based and CT attenuation index-based assessments.
  
  
  RESULTS
  Mean values of pancreatic FI measured by area-based assessment on unenhanced CT and by histopathology-based assessments were 14.4 ± 23.2 % (range 0-77.7 %) and 16.2 ± 17.4 % (range 0.2-60.2 %), respectively. Area-based assessment on unenhanced CT showed higher correlation and concordance with histopathology-based assessment, demonstrating a Spearman correlation coefficient of 0.78 (P < 0.0001) and a Kendall's tau-b coefficient of 0.69 (P < 0.0001). For CT attenuation index-based assessment, the corresponding values were -0.66 (P < 0.0001) and -0.39 (P = 0.008), respectively.
  
  
  CONCLUSIONS
  To order/categorize subjects according to the degree of FI of the pancreas, CT area-based assessment is suggested to be better than CT attenuation index-based assessment.
authors: Division of Cancer Development System, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.|Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Mika
authors: M
authors: Hori
authors: Radiology Consultation Section, Department of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Hiroaki
authors: H
authors: Onaya
authors: Division of Molecular Pathology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Nobuyoshi
authors: N
authors: Hiraoka
authors: Epidemiology and Prevention Group, Center of Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Taiki
authors: T
authors: Yamaji
authors: Radiology Consultation Section, Department of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Hideaki
authors: H
authors: Kobayashi
authors: Central Animal Division, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Mami
authors: M
authors: Takahashi
authors: Division of Carcinogenesis and Cancer Prevention, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Michihiro
authors: M
authors: Mutoh
authors: Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Kazuaki
authors: K
authors: Shimada
authors: National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. hnakagam@ncc.go.jp.
authors: Hitoshi
authors: H
authors: Nakagama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography; Fatty infiltration; Histopathology; Pancreas; Pancreatic cancer