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

Background

Signal intensity on T₁‐weighted images (T₁WI) 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 T₁WI 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 T₁WI 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 T₁WI, respectively. The specificity (P < 0.0001) and AUC (P = 0.0020) were significantly higher in the pancreatic T₁ values than in SIR on T₁WI.

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 2018.

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