A pilot study of radiologic measures of abdominal adiposity: weighty contributors to early pancreatic carcinogenesis worth evaluating?

Jennifer B. Permuth, Jung W. Choi, Dung Tsa Chen, Kun Jiang, Gina DeNicola, Jian Nong Li, Domenico Coppola, Barbara A. Centeno, Anthony Magliocco, Yoganand Balagurunathan, Nipun Merchant, Jose G. Trevino, Daniel Jeong

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Intra-abdominal fat is a risk factor for pancreatic cancer (PC), but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms (IPMNs). Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology. Methods: In a cohort of 34 surgically-resected, pathologically-confirmed IPMNs (17 benign; 17 malignant) with preoperative abdominal computed tomography (CT) images, we calculated body mass index (BMI) and four radiologic measures of obesity: total abdominal fat (TAF) area, visceral fat area (VFA), subcutaneous fat area (SFA), and visceral to subcutaneous fat ratio (V/S). Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics. Results: Mean BMI for individuals with malignant IPMNs (28.9 kg/m2) was higher than mean BMI for those with benign IPMNs (25.8 kg/m2) (P=0.045). Mean VFA was higher for patients with malignant IPMNs (199.3 cm2) compared to benign IPMNs (120.4 cm2), P=0.092. V/S was significantly higher (P=0.013) for patients with malignant versus benign IPMNs (1.25 vs. 0.69 cm2), especially among females. The accuracy, sensitivity, specificity, and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74%, 71%, 76%, 75%, and 72%, respectively. Conclusions: Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology, acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI. Further investigation of gender-specific associations in larger, prospective IPMN cohorts is warranted to validate and expand upon these observations.

Original languageEnglish (US)
Pages (from-to)66-73
Number of pages8
JournalCancer Biology and Medicine
Volume14
Issue number1
DOIs
StatePublished - Mar 1 2017

Fingerprint

Adiposity
Carcinogenesis
Intra-Abdominal Fat
Neoplasms
Body Mass Index
Abdominal Obesity
Subcutaneous Fat
Pathology
Pancreatic Neoplasms
Abdominal Fat
Obesity
Tomography
Sensitivity and Specificity

Keywords

  • Abdominal obesity
  • Computed tomography
  • Pancreatic cancer
  • Pre-malignant lesions

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A pilot study of radiologic measures of abdominal adiposity : weighty contributors to early pancreatic carcinogenesis worth evaluating? / Permuth, Jennifer B.; Choi, Jung W.; Chen, Dung Tsa; Jiang, Kun; DeNicola, Gina; Li, Jian Nong; Coppola, Domenico; Centeno, Barbara A.; Magliocco, Anthony; Balagurunathan, Yoganand; Merchant, Nipun; Trevino, Jose G.; Jeong, Daniel.

In: Cancer Biology and Medicine, Vol. 14, No. 1, 01.03.2017, p. 66-73.

Research output: Contribution to journalArticle

Permuth, JB, Choi, JW, Chen, DT, Jiang, K, DeNicola, G, Li, JN, Coppola, D, Centeno, BA, Magliocco, A, Balagurunathan, Y, Merchant, N, Trevino, JG & Jeong, D 2017, 'A pilot study of radiologic measures of abdominal adiposity: weighty contributors to early pancreatic carcinogenesis worth evaluating?', Cancer Biology and Medicine, vol. 14, no. 1, pp. 66-73. https://doi.org/10.20892/j.issn.2095-3941.2017.0006
Permuth, Jennifer B. ; Choi, Jung W. ; Chen, Dung Tsa ; Jiang, Kun ; DeNicola, Gina ; Li, Jian Nong ; Coppola, Domenico ; Centeno, Barbara A. ; Magliocco, Anthony ; Balagurunathan, Yoganand ; Merchant, Nipun ; Trevino, Jose G. ; Jeong, Daniel. / A pilot study of radiologic measures of abdominal adiposity : weighty contributors to early pancreatic carcinogenesis worth evaluating?. In: Cancer Biology and Medicine. 2017 ; Vol. 14, No. 1. pp. 66-73.
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abstract = "Objective: Intra-abdominal fat is a risk factor for pancreatic cancer (PC), but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms (IPMNs). Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology. Methods: In a cohort of 34 surgically-resected, pathologically-confirmed IPMNs (17 benign; 17 malignant) with preoperative abdominal computed tomography (CT) images, we calculated body mass index (BMI) and four radiologic measures of obesity: total abdominal fat (TAF) area, visceral fat area (VFA), subcutaneous fat area (SFA), and visceral to subcutaneous fat ratio (V/S). Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics. Results: Mean BMI for individuals with malignant IPMNs (28.9 kg/m2) was higher than mean BMI for those with benign IPMNs (25.8 kg/m2) (P=0.045). Mean VFA was higher for patients with malignant IPMNs (199.3 cm2) compared to benign IPMNs (120.4 cm2), P=0.092. V/S was significantly higher (P=0.013) for patients with malignant versus benign IPMNs (1.25 vs. 0.69 cm2), especially among females. The accuracy, sensitivity, specificity, and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74{\%}, 71{\%}, 76{\%}, 75{\%}, and 72{\%}, respectively. Conclusions: Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology, acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI. Further investigation of gender-specific associations in larger, prospective IPMN cohorts is warranted to validate and expand upon these observations.",
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T1 - A pilot study of radiologic measures of abdominal adiposity

T2 - weighty contributors to early pancreatic carcinogenesis worth evaluating?

AU - Permuth, Jennifer B.

AU - Choi, Jung W.

AU - Chen, Dung Tsa

AU - Jiang, Kun

AU - DeNicola, Gina

AU - Li, Jian Nong

AU - Coppola, Domenico

AU - Centeno, Barbara A.

AU - Magliocco, Anthony

AU - Balagurunathan, Yoganand

AU - Merchant, Nipun

AU - Trevino, Jose G.

AU - Jeong, Daniel

PY - 2017/3/1

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N2 - Objective: Intra-abdominal fat is a risk factor for pancreatic cancer (PC), but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms (IPMNs). Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology. Methods: In a cohort of 34 surgically-resected, pathologically-confirmed IPMNs (17 benign; 17 malignant) with preoperative abdominal computed tomography (CT) images, we calculated body mass index (BMI) and four radiologic measures of obesity: total abdominal fat (TAF) area, visceral fat area (VFA), subcutaneous fat area (SFA), and visceral to subcutaneous fat ratio (V/S). Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics. Results: Mean BMI for individuals with malignant IPMNs (28.9 kg/m2) was higher than mean BMI for those with benign IPMNs (25.8 kg/m2) (P=0.045). Mean VFA was higher for patients with malignant IPMNs (199.3 cm2) compared to benign IPMNs (120.4 cm2), P=0.092. V/S was significantly higher (P=0.013) for patients with malignant versus benign IPMNs (1.25 vs. 0.69 cm2), especially among females. The accuracy, sensitivity, specificity, and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74%, 71%, 76%, 75%, and 72%, respectively. Conclusions: Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology, acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI. Further investigation of gender-specific associations in larger, prospective IPMN cohorts is warranted to validate and expand upon these observations.

AB - Objective: Intra-abdominal fat is a risk factor for pancreatic cancer (PC), but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms (IPMNs). Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology. Methods: In a cohort of 34 surgically-resected, pathologically-confirmed IPMNs (17 benign; 17 malignant) with preoperative abdominal computed tomography (CT) images, we calculated body mass index (BMI) and four radiologic measures of obesity: total abdominal fat (TAF) area, visceral fat area (VFA), subcutaneous fat area (SFA), and visceral to subcutaneous fat ratio (V/S). Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics. Results: Mean BMI for individuals with malignant IPMNs (28.9 kg/m2) was higher than mean BMI for those with benign IPMNs (25.8 kg/m2) (P=0.045). Mean VFA was higher for patients with malignant IPMNs (199.3 cm2) compared to benign IPMNs (120.4 cm2), P=0.092. V/S was significantly higher (P=0.013) for patients with malignant versus benign IPMNs (1.25 vs. 0.69 cm2), especially among females. The accuracy, sensitivity, specificity, and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74%, 71%, 76%, 75%, and 72%, respectively. Conclusions: Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology, acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI. Further investigation of gender-specific associations in larger, prospective IPMN cohorts is warranted to validate and expand upon these observations.

KW - Abdominal obesity

KW - Computed tomography

KW - Pancreatic cancer

KW - Pre-malignant lesions

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