研究者詳細 - 辻　喜久

論文 - 辻　喜久

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Optimal Treatment for Octogenarians With Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Retrospective Study.

Sohei Satoi, Tomohisa Yamamoto, Kazushige Uchida, Tsutomu Fujii, Toshifumi Kin, Satoshi Hirano, Keiji Hanada, Takao Itoi, Yoshiaki Murakami, Hisato Igarashi, Hidetoshi Eguchi, Tamotsu Kuroki, Yasuhiro Shimizu, Masaji Tani, Satoshi Tanno, Yoshihisa Tsuji, Yoshiki Hirooka, Atsushi Masamune, Toshio Shimokawa, Hiroki Yamaue, Kazuichi Okazaki

Pancreas 49 ( 6 ) 837 - 844 2020年07月 [国際誌]

OBJECTIVES: The objective of this study was to clarify the role of pancreatectomy for patients with resectable and borderline resectable pancreatic ductal adenocarcinoma aged 80 years or older using a nationwide audit by the Japan Pancreas Society. METHODS: Data were collected from 39 institutions from 2007 to 2014. The primary endpoint was overall survival, and secondary endpoints were surgical outcomes and predictive factors for prognosis. RESULTS: Data were obtained from 556 octogenarians who underwent pancreatectomy (n = 369, 66%), chemo(radio)therapy (n = 99, 18%), and palliative therapy (n = 88, 16%). Median survival times were 20.6, 18.6, and 8.8 months in each group, respectively. Even after propensity score matching, median survival time in the surgery group (22.8 months) was significantly higher than that in the chemotherapy group (18.5 months; hazard ratio, 0.64 [95% confidence interval, 0.44-0.93]; P = 0.020). Significant independent prognostic factors were body mass index, lymph node metastasis, and tumor diameter in the surgery group, and serum albumin level, American Society of Anesthesiologists classification, body mass index, modified Glasgow prognostic score, second-line chemotherapy, and tumor diameter in the chemotherapy group. CONCLUSIONS: Octogenarians with resectable/borderline resectable pancreatic ductal adenocarcinoma can be recommended for pancreatectomy according to mental and physical fitness for surgical procedures.

DOI PubMed

80歳以上高齢者膵癌に対する治療法日本膵臓学会アンケート調査

里井壯平, 山本智久, 内田一茂, 藤井努, 金俊文, 浅野賢道, 花田敬士, 糸井隆夫, 五十嵐久人, 江口英利, 黒木保, 清水泰博, 谷眞至, 丹野誠志, 辻喜久, 廣岡芳樹, 正宗淳, 下川敏雄, 山上裕機, 岡崎和一, 日本膵臓学会膵疾患臨床研究推進委員会

膵臓 ( (一社)日本膵臓学会 ) 35 ( 3 ) A104 - A104 2020年07月

Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy: A nationwide, cancer registry-based study from the Japan Pancreas Society.

Hiroyoshi Tsuchida, Tsutomu Fujii, Masamichi Mizuma, Sohei Satoi, Hisato Igarashi, Hidetoshi Eguchi, Tamotsu Kuroki, Yasuhiro Shimizu, Masaji Tani, Satoshi Tanno, Yoshihisa Tsuji, Yoshiki Hirooka, Atsushi Masamune, Kazuhiro Mizumoto, Takao Itoi, Shinichi Egawa, Yuzo Kodama, Shin Hamada, Michiaki Unno, Hiroki Yamaue, Kazuichi Okazaki

Surgery 166 ( 6 ) 997 - 1003 2019年12月 [査読有り] [国際誌]

BACKGROUND: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry-based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. METHODS: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. RESULTS: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14% vs 43%; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7% and 31.1% in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. CONCLUSION: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.

DOI PubMed

重症度判定基準の改訂中間報告

廣田衛久, 竹山宜典, 池浦司, 糸井隆夫, 伊藤鉄英, 岩崎栄典, 堀部昌靖, 岸和田昌之, 北村勝哉, 阪上順一, 白井邦博, 鈴木裕, 竹中完, 辻喜久, 正宗淳, 真弓俊彦

膵臓 ( 日本膵臓学会 ) 34 ( 3 ) A108 - A108 2019年06月 [査読有り]

急性膵炎局所合併症の定義の再検討

辻喜久, 池浦司, 糸井隆夫, 岩崎栄典, 岸和田昌之, 北村勝哉, 阪上順一, 白井邦博, 鈴木裕, 竹中完, 廣田衛久, 正宗淳, 真弓俊彦, 堀部昌靖, 能登原憲司, 入江裕之, 蒲田敏文, 竹山宜典

膵臓 ( 日本膵臓学会 ) 34 ( 3 ) A109 - A110 2019年06月 [査読有り]

卒前卒後を通してのシームレスな評価表作成の経験

辻喜久, 伊藤俊之

医学教育 ( (一社)日本医学教育学会 ) 49 ( Suppl. ) 144 - 144 2018年07月 [査読有り]

Chemokine CXCL16 mediates acinar cell necrosis in cerulein induced acute pancreatitis in mice.

Yojiro Sakuma, Yuzo Kodama, Takaaki Eguchi, Norimitsu Uza, Yoshihisa Tsuji, Masahiro Shiokawa, Takahisa Maruno, Katsutoshi Kuriyama, Yoshihiro Nishikawa, Yuki Yamauchi, Motoyuki Tsuda, Tatsuki Ueda, Tomoaki Matsumori, Toshihiro Morita, Teruko Tomono, Nobuyuki Kakiuchi, Atsushi Mima, Yuko Sogabe, Saiko Marui, Takeshi Kuwada, Akihiko Okada, Tomohiro Watanabe, Hiroshi Nakase, Tsutomu Chiba, Hiroshi Seno

Scientific reports 8 ( 1 ) 8829 - 8829 2018年06月 [査読有り] [国際誌]

Severe acute pancreatitis is a lethal inflammatory disease frequently accompanied by pancreatic necrosis. We aimed to identify a key regulator in the development of pancreatic necrosis. A cytokine/chemokine array using sera from patients with acute pancreatitis (AP) revealed that serum CXCL16 levels were elevated according to the severity of pancreatitis. In a mouse model of AP, Cxcl16 expression was induced in pancreatic acini in the late phase with the development of pancreatic necrosis. Cxcl16-/- mice revealed similar sensitivity as wild-type (WT) mice to the onset of pancreatitis, but better resisted development of acinar cell necrosis with attenuated neutrophil infiltration. A cytokine array and immunohistochemistry revealed lower expression of Ccl9, a neutrophil chemoattractant, in the pancreatic acini of Cxcl16-/- mice than WT mice. Ccl9 mRNA expression was induced by stimulation with Cxcl16 protein in pancreatic acinar cells in vitro, suggesting a Cxcl16/Ccl9 cascade. Neutralizing antibody against Cxcl16 ameliorated pancreatic injury in the mouse AP model with decreased Ccl9 expression and less neutrophil accumulation. In conclusion, Cxcl16 expressed in pancreatic acini contributes to the development of acinar cell necrosis through the induction of Ccl9 and subsequent neutrophil infiltration. CXCL16 could be a new therapeutic target in AP.

DOI PubMed

Erratum to: Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis.

Yoshihisa Tsuji, Naoki Takahashi, Hiroyoshi Isoda, Koji Koizumi, Sho Koyasu, Miho Sekimoto, Yuichi Imanaka, Shujiro Yazumi, Masanori Asada, Yoshihiro Nishikawa, Hiroshi Yamamoto, Osamu Kikuchi, Tsukasa Yoshida, Tetsuro Inokuma, Shinji Katsushima, Naoki Esaka, Akihiro Okano, Chiharu Kawanami, Nobuyuki Kakiuchi, Masahiro Shiokawa, Yuzo Kodama, Ichiro Moriyama, Takafumi Kajitani, Yoshikazu Kinoshita, Tsutomu Chiba

Journal of gastroenterology 52 ( 10 ) 1147 - 1148 2017年10月 [査読有り] [国内誌]

DOI PubMed

Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis.

Journal of gastroenterology 52 ( 10 ) 1130 - 1139 2017年10月 [査読有り] [国内誌]

BACKGROUND: Perfusion CT can diagnose pancreatic necrosis in early stage of severe acute pancreatitis, accurately. However, no study to date has examined whether early diagnosis of pancreatic necrosis is useful in predicting persistent organ failure (POF). METHODS: We performed a multi-center prospective observational cohort study to investigate whether perfusion CT can predict the development of POF in the early stage of AP, based on early diagnosis of the development of pancreatic necrosis (PN). From 2009 to 2012, we examined patients showing potential early signs of severe AP (n = 78) on admission. Diagnoses for the development of PN were made prospectively by on-site physicians on the admission based on perfusion CT (diagnosis 1). Blinded retrospective reviews were performed by radiologists A and B, having 8 and 13 years of experience as radiologists (diagnosis 2 and 3), respectively. Positive diagnosis for the development of PN were assumed equivalent to positive predictions for the development of POF. We then calculated the area under the curve (AUC) of the receiver operating characteristic for POF predictions. RESULTS: Fourteen (17.9%) and 23 patients (29.5%) developed PN and POF, respectively. For diagnoses 1, 2, and 3, AUCs for POF predictions were 74, 68, and 73, respectively. CONCLUSIONS: Perfusion CT diagnoses pancreatic necrosis and on that basis predicts the development of POF; http://www.umin.ac.jp/ctr/index-j.htm,UMIN000001926 .

DOI PubMed

自作アプリケーションを用いたOSCE評価環境の構築の有用性

服部哲久, 辻喜久, 山木照子, 伊藤俊之

医学教育 ( (一社)日本医学教育学会 ) 48 ( Suppl. ) 154 - 154 2017年08月 [査読有り]

佐久間洋二朗, 児玉裕三, 宇座徳光, 辻喜久, 塩川雅広, 渡邉智裕, 仲瀬裕志, 千葉勉, 妹尾浩

膵臓 ( 日本膵臓学会 ) 32 ( 3 ) 339 - 339 2017年05月 [査読有り]

Pathogenicity of IgG in patients with IgG4-related disease.

Masahiro Shiokawa, Yuzo Kodama, Katsutoshi Kuriyama, Kenichi Yoshimura, Teruko Tomono, Toshihiro Morita, Nobuyuki Kakiuchi, Tomoaki Matsumori, Atsushi Mima, Yoshihiro Nishikawa, Tatsuki Ueda, Motoyuki Tsuda, Yuki Yamauchi, Ryuki Minami, Yojiro Sakuma, Yuji Ota, Takahisa Maruno, Akira Kurita, Yugo Sawai, Yoshihisa Tsuji, Norimitsu Uza, Kazuyoshi Matsumura, Tomohiro Watanabe, Kenji Notohara, Tatsuaki Tsuruyama, Hiroshi Seno, Tsutomu Chiba

Gut 65 ( 8 ) 1322 - 32 2016年08月 [査読有り] [国際誌]

OBJECTIVE: IgG4-related disease (IgG4-RD) is a systemic disease characterised by elevated serum IgG4 and IgG4-positive lymphoplasmacytic infiltration in the affected tissues. The pathogenic role of IgGs, including IgG4, in patients with IgG4-RD, however, is unknown. DESIGN: We examined the pathogenic activity of circulating IgGs in patients with IgG4-RD by injecting their IgGs into neonatal male Balb/c mice. Binding of patient IgGs to pancreatic tissue was also analysed in an ex vivo mouse organ culture model and in tissue samples from patients with autoimmune pancreatitis (AIP). RESULTS: Subcutaneous injection of patient IgG, but not control IgG, resulted in pancreatic and salivary gland injuries. Pancreatic injury was also induced by injecting patient IgG1 or IgG4, with more destructive changes induced by IgG1 than by IgG4. The potent pathogenic activity of patient IgG1 was significantly inhibited by simultaneous injection of patient IgG4. Binding of patient IgG, especially IgG1 and IgG4, to pancreatic tissue was confirmed in both the mouse model and AIP tissue samples. CONCLUSIONS: IgG1 and IgG4 from patients with IgG4-RD have pathogenic activities through binding affected tissues in neonatal mice.

DOI PubMed

Evaluation of Tumor-associated Stroma and Its Relationship with Tumor Hypoxia Using Dynamic Contrast-enhanced CT and (18)F Misonidazole PET in Murine Tumor Models.

Sho Koyasu, Yoshihisa Tsuji, Hiroshi Harada, Yuji Nakamoto, Tomomi Nobashi, Hiroyuki Kimura, Kohei Sano, Koji Koizumi, Masatsugu Hamaji, Kaori Togashi

Radiology 278 ( 3 ) 734 - 41 2016年03月 [査読有り] [国際誌]

PURPOSE: To determine the relationship between the fractional interstitial volume (Fis), as calculated at dynamic contrast material-enhanced (DCE) computed tomography (CT), and tumor-associated stroma and to analyze its spatial relationship with tumor hypoxia in several xenograft tumor models. MATERIALS AND METHODS: All animal experiments were approved by the animal research committee. Mice with three different xenograft tumors (U251, CFPAC-1, and BxPC-3; n = 6, n = 8, and n = 6, respectively) underwent DCE CT then hypoxia imaging with fluorine 18 ((18)F) fluoromisonidazole (FMISO) positron emission tomography (PET) within 24 hours. Immunohistochemical analysis was performed in harvested tumors to detect hypoxia markers and to quantify microvascular and stromal density. Two DCE CT parameters (amount of interstitial space associated with the amount of stroma [Fis] and flow velocity [Fv]) were identified and quantitatively validated by using immunohistochemistry. FMISO uptake within the tumor was also assessed in relation to DCE CT parameters. Imaging and immunohistochemical parameters were assessed by using the Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni correction, and Pearson correlation coefficient. RESULTS: Almost no α-smooth muscle actin-positive cells were found in the U251 xenograft, while abundant stroma was found in the entire BxPC-3 xenograft and in the periphery of the CFPAC-1 xenograft. Quantitative analysis showed a significant correlation (R = 0.83, P < .0001) between Fis and stromal density. FMISO uptake had a negative correlation with Fis (R = -0.58, P < .0001) and Fv (R = -0.53, P < .0001). CONCLUSION: DCE CT can be used to quantify parameters associated with tumor-associated stroma. Tumor hypoxia was Complementarily localized in tumor-associated stroma in these models.

DOI PubMed

Acute Pancreatitis-Progress and Challenges: A Report on an International Symposium.

Elham Afghani, Stephen J Pandol, Tooru Shimosegawa, Robert Sutton, Bechien U Wu, Santhi Swaroop Vege, Fred Gorelick, Morihisa Hirota, John Windsor, Simon K Lo, Martin L Freeman, Markus M Lerch, Yoshihisa Tsuji, Gil Y Melmed, Wahid Wassef, Julia Mayerle

Pancreas 44 ( 8 ) 1195 - 210 2015年11月 [査読有り] [国際誌]

An international symposium entitled "Acute pancreatitis: progress and challenges" was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives.

DOI PubMed

Activation-Induced Cytidine Deaminase Contributes to Pancreatic Tumorigenesis by Inducing Tumor-Related Gene Mutations.

Yugo Sawai, Yuzo Kodama, Takahiro Shimizu, Yuji Ota, Takahisa Maruno, Yuji Eso, Akira Kurita, Masahiro Shiokawa, Yoshihisa Tsuji, Norimitsu Uza, Yuko Matsumoto, Toshihiko Masui, Shinji Uemoto, Hiroyuki Marusawa, Tsutomu Chiba

Cancer research 75 ( 16 ) 3292 - 301 2015年08月 [査読有り] [国際誌]

Pancreatic ductal adenocarcinoma (PDAC) develops via an accumulation of various gene mutations. The mechanism underlying the mutations in PDAC development, however, is not fully understood. Recent insight into the close association between the mutation pattern of various cancers and specific mutagens led us to investigate the possible involvement of activation-induced cytidine deaminase (AID), a DNA editing enzyme, in pancreatic tumorigenesis. Our immunohistochemical findings revealed AID protein expression in human acinar ductal metaplasia, pancreatic intraepithelial neoplasia, and PDAC. Both the amount and intensity of the AID protein expression increased with the progression from precancerous to cancerous lesions in human PDAC tissues. To further assess the significance of ectopic epithelial AID expression in pancreatic tumorigenesis, we analyzed the phenotype of AID transgenic (AID Tg) mice. Consistent with our hypothesis that AID is involved in the mechanism of the mutations underlying pancreatic tumorigenesis, we found precancerous lesions developing in the pancreas of AID Tg mice. Using deep sequencing, we also detected Kras and c-Myc mutations in our analysis of the whole pancreas of AID Tg mice. In addition, Sanger sequencing confirmed the presence of Kras, c-Myc, and Smad4 mutations, with the typical mutational footprint of AID in precancerous lesions in AID Tg mice separated by laser capture microdissection. Taken together, our findings suggest that AID contributes to the development of pancreatic precancerous lesions by inducing tumor-related gene mutations. Our new mouse model without intentional manipulation of specific tumor-related genes provides a powerful system for analyzing the mutations involved in PDAC.

DOI PubMed

【microbiome(腸内細菌)と肝胆膵領域の新世紀】膵臓とmicrobiome 良性膵疾患と腸内細菌

森田敏広, 児玉裕三, 大田悠司, 辻喜久, 渡邉智裕

肝・胆・膵 ( (株)アークメディア ) 70 ( 6 ) 895 - 900 2015年06月 [査読有り]

Usefulness of Adalimumab for Treating a Case of Intestinal Behçet's Disease With Trisomy 8 Myelodysplastic Syndrome.

Masamichi Kimura, Yoshihisa Tsuji, Masako Iwai, Masahiro Inagaki, Ali Madian, Takuya Yoshino, Minoru Matsuura, Hiroshi Nakase

Intestinal research 13 ( 2 ) 166 - 9 2015年04月 [査読有り] [国際誌]

Behçet's disease (BD) is a systemic vasculitis, while myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematologic disorders characterized by ineffective hematopoiesis. Some studies suggest a relationship between MDS and BD, especially intestinal BD, and trisomy 8 seems to play an important role in both diseases. There are several reports on patients with BD comorbid with MDS involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapies. Tumor necrosis factor (TNF)-α is strongly involved in the pathophysiology of several autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and BD. In addition, TNF-α plays an important role in the pathophysiology of MDS by inhibiting normal hematopoiesis and inducing the programmed cell death of normal total bone marrow cells and normal CD34+ cells. Recent clinical reports demonstrate the favorable effect of TNF-α antagonists in patients with refractory intestinal BD and in those with MDS. We present the case of a patient with intestinal BD and MDS involving trisomy 8 who was successfully treated with adalimumab.

DOI PubMed

Evaluation of intratumoral microenvironment with 18F-misonidazole PET and dynamic contrast enhanced CT in tumor-bearing mice models

Sho Koyasu, Yuji Nakamoto, Hiroshi Harada, Hiroyuki Kimura, Kohei Sano, Koji Koizumi, Yoshihisa Tsuji, Tomomi Nobashi, Kensuke Kurihara, Kaori Togashi

JOURNAL OF NUCLEAR MEDICINE ( SOC NUCLEAR MEDICINE INC ) 55 2014年05月 [査読有り]

Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience.

Satoshi Yamada, Takuya Yoshino, Minoru Matsuura, Naoki Minami, Takahiko Toyonaga, Yusuke Honzawa, Yoshihisa Tsuji, Hiroshi Nakase

BMC gastroenterology 14 80 - 80 2014年04月 [査読有り] [国際誌]

BACKGROUND: The long-term efficacy of infliximab (IFX) for patients with refractory ulcerative colitis (UC) is unclear. The aim of this study was to assess the long-term outcomes of IFX treatment in patients with refractory UC. METHODS: Thirty-three patients with refractory UC who received IFX treatment at Kyoto University Hospital between 2003 and 2013 were retrospectively evaluated. IFX intensification was defined as a dose escalation (up to 10 mg/kg) and/or shorter intervals between infusions (every 4-6 weeks). RESULTS: Of the 33 patients who received scheduled infusions of IFX, 24 (72.7%) achieved clinical remission within 8 weeks after initiating IFX treatment. Of these 24 responders, 17 (70.8%) experienced a relapse of UC and required IFX intensification, and 16 (66.7%) eventually maintained clinical remission with IFX treatment, including IFX intensification. Of the 33 patients, 6 (18.2%) underwent colectomy during IFX treatment. Multivariate regression analysis showed that a serum C-reactive protein (CRP) concentration <5 mg/L two weeks after starting IFX was a predictor of a positive clinical response to IFX induction therapy. No severe adverse events occurred in UC patients treated with IFX. CONCLUSION: IFX intensification was necessary for long-term maintenance of remission and to prevent colectomy in patients with refractory UC.

DOI PubMed

Subtraction color map of contrast-enhanced and unenhanced CT for the prediction of pancreatic necrosis in early stage of acute pancreatitis.

Yoshihisa Tsuji, Naoki Takahashi, Joel G Fletcher, David M Hough, Brendan P McMenomy, David M Lewis, Santhi S Vege, Suresh T Chari, Cynthia H McCollough, Katharine L Grant, Ernst Klotz

AJR. American journal of roentgenology 202 ( 4 ) W349-56 2014年04月 [査読有り] [国際誌]

OBJECTIVE: The objective of our study was to evaluate the accuracy of subtraction color-map images created from contrast-enhanced CT (CECT) and unenhanced CT for the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. MATERIALS AND METHODS: Forty-eight patients underwent unenhanced CT and CECT within 72 hours from the onset of acute pancreatitis. Subtraction color-map images were created from unenhanced CT and CECT using a 3D nonrigid registration method. Three radiologists reviewed two image sets: CECT alone and subtraction color-map images in conjunction with CECT. Readers evaluated each image set for the presence of pancreatic necrosis. The reference standard for pancreatic necrosis was CT or MRI 1 week or more after the onset of acute pancreatitis. The performance of each image set for the prediction of pancreatic necrosis was calculated and compared using the McNemar test. RESULTS: Eleven of the 48 patients developed pancreatic necrosis. There were no technical failures creating the subtraction images. The sensitivity, specificity, and accuracy for predicting pancreatic necrosis with CECT were 64%, 97%, and 90%, respectively, for reader 1; 73%, 87%, and 83% for reader 2; and 73%, 87%, and 83% for reader 3. The sensitivity, specificity, and accuracy for predicting pancreatic necrosis with the subtraction color maps were 100%, 100%, and 100%, respectively, for reader 1; 100%, 95%, and 96% for reader 2; and 82%, 92%, and 90% for reader 3. Accuracy significantly improved with the addition of subtraction color maps compared with CECT alone for reader 1 (p = 0.03) and reader 2 (p = 0.02) but not for reader 3 (p = 0.37). CONCLUSION: A subtraction color map is accurate in the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis.

DOI PubMed

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