Z Gastroenterol 2025; 63(08): e492-e493
DOI: 10.1055/s-0045-1810854
Abstracts | DGVS/DGAV
Kurzvorträge
KI und Bildgebung bei Pankreasraumforderung Freitag, 19. September 2025, 08:30 – 09:33, Seminarraum 6 + 7

Malignant transformation from IPMN to invasive IPMN and PDAC is characterized by distinct shifts in body composition – an AI-based body composition analysis

Authors

  • A Chernysheva

    1   Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • M Sieren

    2   Department of Interventional Radiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • J Schütte

    3   Section for Translational Surgical Oncology and Biobanking, Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • S Mogadas

    2   Department of Interventional Radiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • L Berkel

    4   Institute of Radiology and Nuclear Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • H Grasshoff

    5   Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • T Sauer

    3   Section for Translational Surgical Oncology and Biobanking, Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • K C Honselmann

    1   Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • U F Wellner

    1   Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • E Dazert

    6   Department of Hematology and Oncology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • N C von Bubnoff

    6   Department of Hematology and Oncology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • R Deck

    7   Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Deutschland

  • C Lill

    7   Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Deutschland

  • L Wagner

    7   Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Deutschland

  • T Keck

    1   Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • R Hosch

    8   Institute for Artificial Intelligence in Medicine, University Hospital Essen, Lübeck, Deutschland

  • F Nensa

    4   Institute of Radiology and Nuclear Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • T Gemoll

    3   Section for Translational Surgical Oncology and Biobanking, Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • R Klöckner

    2   Department of Interventional Radiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

  • L Bolm

    1   Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
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    Introduction: Intraductal papillary mucinous neoplasms (IPMN) are cystic lesions of the pancreas that may undergo malignant transformation. A comprehensive characterization of body composition has not been performed in patients with non-invasive IPMN as compared to invasive IPMN or pancreatic ductal adenocarcinoma (PDAC) yet.

    Patients and Methods: Patients with IPMN, invasive IPMN and PDAC were identified from our prospectively maintained institutional database. Analyzing patients’ routine CT scans at the time of diagnosis, body compartments were automatically segmented with a validated AI-based body composition algorithm (BCA), and body composition parameters including adipose tissue compartments, muscle and bone were quantified. Body composition measures were compared between patients with IPMN, invasive IPMN and PDAC.

    Results: A total of 181 patients were identified, 53 (29.3%) had IPMN, 16 (8.8%) had invasive IPMN, and 112 (61.9%) had PDAC. Median age was 68 (range 39-87) and 51.9% (n=94) of the patients were female. Mean BMI in all patients was 25.3 kg/m2, BMI values were comparable for patients with IPMN (24.6 kg/m2), invasive IPMN (24.7 kg/m2), and PDAC (25.5kg/m2). Comparing patients with IPMN and invasive IPMN, there was a trend for more pronounced visceral obesity (mean 0.31 vs. 0.33, p=0.055). In contrast, subcutaneous obesity was more common among IPMN patients (0.59 vs. 0.58, p=0.045). There was no difference regarding sarcopenia measures between the two groups. Patients with PDAC as opposed to IPMN had considerably higher rates of visceral obesity (0.68 vs. 0.59, p=0.015). In contrast, IPMN patients displayed higher rates of subcutaneous obesity than PDAC (0.58 vs. 0.56, p=0.013). There was a trend for more pronounced sarcopenia in PDAC patients as compared to IPMN (1.63 vs. 1.71, p=0.083). Comparing body composition parameters between PDAC and invasive IPMN, no statistically significant differences were detected for the adipose tissue, muscle and bone compartments.

    Conclusion: We performed the first analysis systematically by comparing objectively derived body composition measures between IPMN, invasive IPMN, and PDAC. IPMN as compared to malignant lesions was characterized by distinct body composition profiles. Invasive IPMN and even more so PDAC was associated with cancer body composition markers visceral obesity and sarcopenia. Body composition parameters may therefore be an important tool for early detection of malignancy in IPMN.


     

    Publication History

    Article published online:
    04 September 2025

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