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CT- and MRI-Based Assessment of Body Composition and Pancreatic Fibrosis Reveals High Incidence of Clinically Significant Metabolic Changes That Affect the Quality of Life and Treatment Outcomes of Patients with Chronic Pancreatitis and Pancreatic Cancer

1
Department of Radiology, Lithuanian University of Health Sciences, Kaunas 50161, Lithuania
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Department of Radiology, Aalborg University Hospital, Aalborg 9000, Denmark
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Department of Clinical Medicine, Aalborg University, Aalborg 9000, Denmark
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Department of Veterinary Pathobiology, Lithuanian University of Health Sciences, Kaunas 44307, Lithuania
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Department of Surgery, Lithuanian University of Health Sciences, Kaunas 50161, Lithuania
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School of Medicine, Nazarbayev University, Nur-Sultan 010000, Kazakhstan
7
Institute for Digestive System Research, Lithuanian University of Health Sciences, Kaunas 44307, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(10), 649; https://doi.org/10.3390/medicina55100649
Received: 7 August 2019 / Revised: 23 September 2019 / Accepted: 26 September 2019 / Published: 27 September 2019
Background and Objectives: Both chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) may lead to cachexia, sarcopenia, and osteoporosis due to different mechanisms. Neither patient gender, age, nor body weight are good predictors of these metabolic changes having a significant negative impact on the quality of life (QOL) and treatment outcomes. The aim of this study was to evaluate radiological changes in body composition and to compare them with manifestations of exocrine and endocrine pancreatic insufficiency, body mass, and QOL among patients with CP and PDAC. Materials and Methods: Prospectively collected data of 100 patients with diagnosed CP or PDAC were used for analysis. All patients underwent dual-energy X-ray absorptiometry (DXA), computed tomography (CT), and magnetic resonance imaging (MRI). The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) was used to assess QOL. Diabetes and changes in fecal elastase-1 were also assessed. Results: There was no significant difference in skeletal muscle mass (SMM) among patients with CP and PDAC (p = 0.85). Significantly more underweight patients had low SMM (p = 0.002). Patients with CP had more pronounced pancreatic fibrosis (PF) (p < 0.001). Data showed a significant relationship between a high degree of PF and occurrence of diabetes (p = 0.006) and low fecal elastase-1 levels (p = 0.013). A statistically significant lower QOL was determined in patients with PF ≥ 50% and in the CP group. Conclusions: Sarcopenia and osteoporosis/osteopenia are highly prevalent among patients with chronic pancreatitis and pancreatic cancer, and CT- and MRI-based assessment of body composition and pancreatic fibrosis could be a potentially useful tool for routine detection of these significant metabolic changes. View Full-Text
Keywords: pancreas; sarcopenia; CT; MRI; DXA; osteoporosis/osteopenia; quality of life pancreas; sarcopenia; CT; MRI; DXA; osteoporosis/osteopenia; quality of life
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Bieliuniene, E.; Brøndum Frøkjær, J.; Pockevicius, A.; Kemesiene, J.; Lukosevicius, S.; Basevicius, A.; Atstupenaite, V.; Barauskas, G.; Ignatavicius, P.; Gulbinas, A.; Dambrauskas, Z. CT- and MRI-Based Assessment of Body Composition and Pancreatic Fibrosis Reveals High Incidence of Clinically Significant Metabolic Changes That Affect the Quality of Life and Treatment Outcomes of Patients with Chronic Pancreatitis and Pancreatic Cancer. Medicina 2019, 55, 649.

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