Radiological parameters to predict pancreatic texture: Current evidence and future perspectives

Area of Science:

• Radiology
• Gastroenterology
• Surgical Oncology

Background:

• Minimally invasive pancreatic surgery necessitates preoperative risk stratification for postoperative pancreatic fistula.
• Pancreatic duct diameter is routinely assessed, but pancreatic texture evaluation remains underutilized for fistula risk prediction.
• Pancreatic texture, influenced by fibrosis and fat fraction, is key to predicting outcomes.

Purpose of the Study:

• To review current evidence on imaging modalities for pancreatic texture assessment.
• To highlight the potential of advanced imaging in predicting pancreatic fistula risk.
• To emphasize the role of texture analysis in early chronic pancreatitis diagnosis.

Main Methods:

• Review of literature on various imaging techniques (CT, EUS, MRI, elastography) for pancreatic texture evaluation.
• Discussion of qualitative and quantitative assessment parameters (fibrosis, fat fraction).
• Exploration of elastography as an emerging tool for texture analysis.

Main Results:

• Pancreatic duct diameter is a known factor, but pancreatic texture is an important, less-utilized predictor of pancreatic fistula.
• Elastography shows promise for assessing pancreatic texture, complementing CT, EUS, and MRI.
• Early diagnosis of chronic pancreatitis via texture assessment may improve surgical outcomes.

Conclusions:

• Standardizing non-invasive tools for pancreatic texture assessment requires multidisciplinary investigation and radiologic-pathologic correlation.
• Accurate pancreatic texture assessment can improve preoperative risk stratification and guide perioperative management.
• Further research is needed to establish the definitive role of these imaging tools in clinical practice.