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Volume 16
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Review

Diagnostic Imaging of Pancreatic and Biliary Involvement in IgG4-Related Disease: Key Imaging Features, Diagnostic Criteria and Differential Diagnosis

by
Javier Miguez González
1,2,*,
Rafael Oliveira Caiafa
1,
Marc Valls Mellado
1,
Marta López Gómez
3,4,
Pilar Lozano Arranz
1,
Francesc Calaf Forn
1,
Alona Thomas Martínez
1,
Laura Pelegrí Martínez
1,
Cristina Pallàs Guardiola
1,
Lorena Ivonne Sarati Nieto
1,
Ingrid Carolina Durán Palacios
1,
Angélica María Herrera Pulido
1,
Sergio González Martínez
5 and
Jordi Català Forteza
1
1
Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, 08970 Sant Joan Despí, Barcelona, Spain
2
Department of Medicine, Universitat de Barcelona (UB), 08036 Barcelona, Spain
3
Department of Rheumatology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, 08970 Sant Joan Despí, Barcelona, Spain
4
Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
5
Hepatobiliopancreatic Unit, Department of General and Digestive Surgery, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, 08970 Sant Joan Despí, Barcelona, Spain
*
Author to whom correspondence should be addressed.
Diagnostics 2026, 16(12), 1806; https://doi.org/10.3390/diagnostics16121806
Submission received: 22 April 2026 / Revised: 3 June 2026 / Accepted: 5 June 2026 / Published: 11 June 2026
(This article belongs to the Special Issue Diagnostic Imaging in Gastrointestinal and Liver Diseases)
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Abstract

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder characterised by elevated serum levels of IgG4 and multiorgan damage. Its diagnosis is challenging and requires a careful integration of clinical, radiological, serological and histological data. Pancreatic and biliary involvement is one of the most common manifestations of IgG4-RD, presenting as type 1 autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-SC), two entities that often occur synchronously and may mimic malignancy in the form of pancreatic ductal adenocarcinoma (PDAC) and cholangiocarcinoma, respectively. The main objective of this article is to illustrate the key imaging features of AIP and IgG4-SC on computed tomography (CT) and magnetic resonance imaging (MRI), providing a comprehensive review of their current diagnostic criteria and discussing their differential diagnosis with other benign and malignant conditions.
Keywords: autoimmune pancreatitis; IgG4-related sclerosing cholangitis; IgG4-related disease; diagnostic criteria; differential diagnosis; pancreatic ductal adenocarcinoma; cholangiocarcinoma; magnetic resonance imaging; computed tomography autoimmune pancreatitis; IgG4-related sclerosing cholangitis; IgG4-related disease; diagnostic criteria; differential diagnosis; pancreatic ductal adenocarcinoma; cholangiocarcinoma; magnetic resonance imaging; computed tomography
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MDPI and ACS Style

Miguez González, J.; Oliveira Caiafa, R.; Valls Mellado, M.; López Gómez, M.; Lozano Arranz, P.; Calaf Forn, F.; Thomas Martínez, A.; Pelegrí Martínez, L.; Pallàs Guardiola, C.; Sarati Nieto, L.I.; et al. Diagnostic Imaging of Pancreatic and Biliary Involvement in IgG4-Related Disease: Key Imaging Features, Diagnostic Criteria and Differential Diagnosis. Diagnostics 2026, 16, 1806. https://doi.org/10.3390/diagnostics16121806

AMA Style

Miguez González J, Oliveira Caiafa R, Valls Mellado M, López Gómez M, Lozano Arranz P, Calaf Forn F, Thomas Martínez A, Pelegrí Martínez L, Pallàs Guardiola C, Sarati Nieto LI, et al. Diagnostic Imaging of Pancreatic and Biliary Involvement in IgG4-Related Disease: Key Imaging Features, Diagnostic Criteria and Differential Diagnosis. Diagnostics. 2026; 16(12):1806. https://doi.org/10.3390/diagnostics16121806

Chicago/Turabian Style

Miguez González, Javier, Rafael Oliveira Caiafa, Marc Valls Mellado, Marta López Gómez, Pilar Lozano Arranz, Francesc Calaf Forn, Alona Thomas Martínez, Laura Pelegrí Martínez, Cristina Pallàs Guardiola, Lorena Ivonne Sarati Nieto, and et al. 2026. "Diagnostic Imaging of Pancreatic and Biliary Involvement in IgG4-Related Disease: Key Imaging Features, Diagnostic Criteria and Differential Diagnosis" Diagnostics 16, no. 12: 1806. https://doi.org/10.3390/diagnostics16121806

APA Style

Miguez González, J., Oliveira Caiafa, R., Valls Mellado, M., López Gómez, M., Lozano Arranz, P., Calaf Forn, F., Thomas Martínez, A., Pelegrí Martínez, L., Pallàs Guardiola, C., Sarati Nieto, L. I., Durán Palacios, I. C., Herrera Pulido, A. M., González Martínez, S., & Català Forteza, J. (2026). Diagnostic Imaging of Pancreatic and Biliary Involvement in IgG4-Related Disease: Key Imaging Features, Diagnostic Criteria and Differential Diagnosis. Diagnostics, 16(12), 1806. https://doi.org/10.3390/diagnostics16121806

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