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Correlation of quantitative pancreatic T₁ value and HbA1c value in subjects with normal and impaired glucose

Yoshifumi Noda¹, Satoshi Goshima¹, Yusuke Tsuji²

¹Department of Radiology, Gifu University, Gifu, Japan.

Journal of Magnetic Resonance Imaging : JMRI

|November 16, 2018

Abstract

Background:

Signal intensity on T₁ -weighted images (T₁ WI) is associated with pancreatic fibrosis and HbA1c levels.

Purpose:

To evaluate the feasibility of the pancreatic T₁ value for assessment of subjects with normal and impaired glucose tolerance (IGT).

Study Type:

A prospective single-institution study.

Population:

In all, 95 consecutive patients with a known or suspected pancreatic disease.

Field Strength/Sequences:

3T/fast pancreatic T₁ mapping using a modified Look-Locker sequence.

Assessment:

Following the American Diabetes Association criteria, patients were classified into three groups, as follows: no-diabetes subject, HbA1c < 5.7%; prediabetes, 5.7% ≤ HbA1c < 6.5%; and type 2 diabetes mellitus (T2DM), HbA1c ≥ 6.5%. Pancreatic T₁ value and signal intensity ratio (SIR = SI_pancreas /SI_muscle ) using T₁ WI were compared with the HbA1c values.

Statistical Tests:

Quantitative data were assessed with one-way analysis of variance, Fisher's and Mann-Whitney U tests, and receiver-operating characteristic analysis.

Results:

The pancreatic T₁ value was significantly longer in T2DM than in no-diabetes and prediabetes subjects (P < 0.05) and was significantly longer in prediabetes than in no-diabetes subjects (P < 0.05). The mean pancreatic T₁ value was significantly lower in the low-value group (HbA1c < 5.7%) (906.3 msec) compared with the high-value group (HbA1c ≥ 6.5%) (993.8 msec) (P < 0.0001). SIR on T₁ WI was significantly higher in the low-value group compared with the high-value group (P = 0.029). The sensitivities, specificities, and area under the receiver-operating characteristic curve (AUCs) for differentiating the low- and high-value groups were 74.1%, 83.8%, and 0.82 in the pancreatic T₁ values and 77.8%, 54.4%, and 0.63 in SIR on T₁ WI, respectively. The specificity (P < 0.0001) and AUC (P = 0.0020) were significantly higher in the pancreatic T₁ values than in SIR on T₁ WI.

Data Conclusion:

Pancreatic T₁ value has the potential of being an imaging biomarker for the assessment of IGT.

Level Of Evidence:

2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:711-718.

Keywords:

abdomen diabetes mellitus glucose intolerance magnetic resonance imaging pancreas

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