Fat-modified computed tomography severity index (CTSI) is a better predictor of severity and outcome in patients with acute pancreatitis compared with modified CTSI

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ID: 261913
2020
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Abstract
The amount of intra-abdominal fat on CT correlates positively with the severity of acute pancreatitis (AP). The objective of the study was to evaluate a fat-modified CT severity index (FMCTSI) and compare its performance with MCTSI. For this retrospective study, 99 patients with AP who underwent contrast-enhanced CT between 3 and 7 days after pain onset were divided into a training cohort (n = 75) and a validation cohort (n = 24). MCTSI was calculated. The total adipose tissue (TAT), visceral adipose tissue (VAT), and total to visceral fat ratio (TVFR) were computed using semi-automatic software. These parameters were given a score of 1–3. FMCTSI was calculated by adding the fat score to MCTSI. Concordance for diagnosing the severity of AP was assessed. Areas under receiver operating characteristic curves (AUC) for predicting clinical outcomes were compared between FMCTSI and MCTSI. The diagnostic performance of the FMCTSI in the validation cohort was also evaluated. In the training cohort, our proposed FMCTSI performed better than MCTSI for all the outcome parameters. The highest concordance for the severity of AP was achieved for VAT-MCTSI. For all outcome parameters, the highest AUC was seen for TVFR-MCTSI. In the validation cohort, the FMCTSI achieved diagnostic performance similar to the training cohort with the highest AUC for TVFR-MCTSI. FMCTSI is a better CT index than MCTSI for predicting the severity and clinical outcomes of AP. Among the various FMCTSI parameters, TVFR-MCTSI is the best performer.
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gupta2020abdominalfat-modified Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Pankaj Gupta;Saurabh Dawra;Karamvir Chandel;Jayanta Samanta;Harshal Mandavdhare;Vishal Sharma;Saroj Kant Sinha;Usha Dutta;Rakesh Kochhar;Pankaj Gupta;Saurabh Dawra;Karamvir Chandel;Jayanta Samanta;Harshal Mandavdhare;Vishal Sharma;Saroj Kant Sinha;Usha Dutta;Rakesh Kochhar;
Journal abdominal radiology
Year 2020
DOI
doi:10.1007/s00261-020-02473-y
URL
https://link.springer.com/article/10.1007/s00261-020-02473-y
Keywords
hepatology gastroenterology imaging / radiology

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