Midtveisevaluering - Ingrid Kvåle Nordaas
Midtveisevaluering for ph.d.-graden ved Universitetet i Bergen for kandidat Ingrid Kvåle Nordaas
Ingrid Kvåle Nordaas er tilknyttet Klinisk institutt 1. Veiledere er Trond Engjom, Georg Gjorgji Dimcevski, Odd Helge Gilja og Spiros Kotopulis.
Diagnostic imaging in chronic pancreatitis
Chronic pancreatitis (CP) is a progressive, inflammatory disease of the pancreas, and can lead to endocrine and exocrine pancreatic insufficiency. Patients often present with nonspecific symptoms such as upper abdominal pain, and both biochemistry and imaging can be negative. Hence, establishing the CP diagnosis may be challenging, and international guidelines recommend a diagnostic approach comprised of biochemistry, clinical presentation and a multimodal imaging.
The aim of this project is validation of pancreatic ultrasound and computed tomography (CT) for diagnosing CP, and validation of scoring systems used for diagnosing and determining the severity of the disease. The project is based on material from the Bergen Pancreas database and the Scandinavian Baltic Pancreatic Club (SBPC) database.
Pancreatic CT is commonly used for diagnosing CP, but despite this, the diagnostic accuracy of CT has not been re-evaluated during the past 20 years. The first paper evaluates interobserver agreement and diagnostic accuracy for pancreatic CT in 118 patients with suspected CP. Our results show that CT has a moderate sensitivity and high specificity for diagnosing CP. Furthermore, we found good interobserver agreement for the CP diagnosis between the two observers.
In the second paper, we will compare the diagnostic accuracy of pancreatic CT and ultrasound for diagnosing CP. Preliminary results show that CT and ultrasound yields similar, moderate accuracy for the CP diagnosis, indicating that both imaging modalities are good options as part of a primary diagnostic workup. The third paper will assess structural changes of the pancreas using M-ANNHEIM and Cambridge diagnostic scores for CP, and relate the scores to clinical variables.