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Pancreas Imaging of Children with Type 1 Diabetes Reveals New Patterns and Correlations with Pancreatic Functions
Olivier G Pollé1,2, Antoine Delfosse1,2, Nicolas Michoux3
1Pôle PEDI, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.
Insights
New-onset type 1 diabetes (T1D) in children shows decreased pancreas volume (PV) and atrophy, with MRI predicting pancreatic function. Longitudinal MRI analysis enhances understanding of T1D progression.
Area of Science:
- Endocrinology
- Medical Imaging
- Pediatrics
Background:
- Type 1 diabetes (T1D) is an autoimmune disease affecting the pancreas.
- Understanding the pancreatic changes in new-onset T1D is crucial for disease management.
Purpose of the Study:
- To longitudinally characterize the pancreas in pediatric patients with new-onset T1D using MRI.
- To investigate correlations between MRI parameters and pancreatic function markers during the first year postdiagnosis.
Main Methods:
- Thirty-one pediatric patients with new-onset T1D and 29 controls underwent multiparametric MRI.
- Pancreas volume (PV) and subregion parameters were analyzed.
- Correlations with C-peptide, trypsinogen, and glucose homeostasis markers were assessed.
Main Results:
- Patients with new-onset T1D showed a significant decrease in PV (-45%) compared to controls.
- PV parameters correlated with C-peptide and trypsinogen levels.
- MRI parameters predicted pancreatic function and glucose homeostasis.
Conclusions:
- Multiparametric MRI provides insights into pancreatic changes in new-onset T1D.
- Longitudinal MRI analysis aids in understanding T1D heterogeneity and evolution.
Objective:
To perform a longitudinal characterization of the pancreas in patients with new-onset T1D and investigate the correlations between magnetic resonance imaging (MRI) parameters and pancreatic functions during the first year postdiagnosis.
Methods:
Thirty-one pediatric patients with new-onset T1D and 29 retrospective age-, body mass index-, and sex-matched controls were included in the study. Following hypotheses were investigated: (H1) the value of pancreas volume (PV) parameters in T1D and in controls, (H2) the association between MRI parameters and markers of pancreatic functions, (H3) the ability of MRI parameters to predict glucose homeostasis, (H4) the longitudinal evolution of MRI parameters and glucose homeostasis, per-organ (whole pancreas) and per-subregion (head, body, and tail).
Results:
Patients with new-onset T1D demonstrated a significant decrease of PV at diagnosis compared to controls (-45%), with prepubertal patients having increased pancreas atrophy (+25%) (H1). PV parameters were correlated with C-peptide, and trypsinogen (PVTail and PVHead, respectively). Biparametric regression models including MRI parameters predicted pancreas functions during the first year postdiagnosis (H3). Longitudinal evolution of PV parameters at 1 year postdiagnosis was correlated with PV at diagnosis (R = -0.72) but not with markers of glucose homeostasis (H4).
Conclusion:
Our study shows that longitudinal analysis of pancreases of children with T1D using multiparametric MRI improve the understanding of T1D heterogeneity both in the context of its onset and its evolution.
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