To introduce and validate the İstanbul Morphometric Pancreatic Atrophy Classification (IM-PAC), a four-tier morphometric grading system based on CT and MRI measurements, emphasizing its potential to improve clinical correlation and longitudinal follow-up in patients with chronic pancreatitis (CP).
Significant association between increasing IM-PAC grade and severity of ductal abnormalities (Spearman ρ = 0.52, p < 0.001) and MRI-defined fibrosis (ρ = 0.48, p < 0.001).
Excellent inter-observer agreement for thickness measurements (ICC = 0.89) and substantial agreement for ordinal grading (weighted κ = 0.81 for ductal, 0.78 for fibrosis), supporting the reliability of the IM-PAC classification.
Interpretation:
IM-PAC provides a reproducible and clinically relevant framework for quantifying pancreatic atrophy, integrating severity-based CP grading, which may enhance patient management and treatment strategies.
Limitations:
Single-center study may limit generalizability; further multicenter studies are needed to validate findings.
Retrospective design may introduce selection bias, potentially affecting the robustness of the conclusions.
Conclusion:
IM-PAC offers a standardized morphometric classification for pancreatic atrophy that enhances clinical correlation and facilitates longitudinal follow-up, addressing the need for objective assessment in clinical practice.
by Fatih Öner Kaya, Esra Ümmühan Mermi, Alev Öztürk Günaldı, Haydar Kaan Karataş, Uğur Can Demir, Pınar Mert, Hüseyin Öztürk, Şule Sena Mazlum, Çağdaş Enginoğlu
