Research Article
Quantitative CT Markers for Early Prediction of Severity in Acute Pancreatitis A Prospective Observational Study
Janakare AH*, Kulkarni AM, Indushree TV and Parthasarathy KR
Department of Radiodiagnosis SS Institute of Medical Sciences and Research Centre Davangere, Karnataka, India
*Corresponding author:Dr. Akshay H. Janakare, Department of Radiodiagnosis SS Institute of Medical Sciences and Research Centre Davangere, Karnataka, India. E-mail Id: akshayjanakare@gmail.com
Copyright: © 2026 Janakare AH, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information: Submission: 12/02/2026; Accepted: 08/04/2026; Published: 10/04/2026
Abstract
Objective: To evaluate quantitative CT markers in acute pancreatitis and identify the strongest predictor of severe disease and adverse outcomes.
Materials and Methods: This prospective observational study included 50 patients with clinically and biochemically confirmed acute pancreatitis who underwent contrast-enhanced CT (CECT) within 5–7 days after symptom onset (mean: 5 + 2 days). Quantitative parameters assessed were percentage pancreatic necrosis, extrapancreatic necrosis (EN) volume, peripancreatic fluid volume using 3D volumetry, and peripancreatic fat attenuation. Findings were correlated with the Revised Atlanta Classification and clinical outcomes.
Results: Severe acute pancreatitis was observed in 24% of patients. Extrapancreatic necrosis volume demonstrated the highest diagnostic accuracy for severe disease (area under the ROC curve [AUC] 0.89; cutoff >120 mL), outperforming pancreatic necrosis percentage and other quantitative markers..
Conclusion: Extrapancreatic necrosis volume is the most reliable quantitative CT marker for predicting severe acute pancreatitis and adverse clinical outcomes.
Materials and Methods: This prospective observational study included 50 patients with clinically and biochemically confirmed acute pancreatitis who underwent contrast-enhanced CT (CECT) within 5–7 days after symptom onset (mean: 5 + 2 days). Quantitative parameters assessed were percentage pancreatic necrosis, extrapancreatic necrosis (EN) volume, peripancreatic fluid volume using 3D volumetry, and peripancreatic fat attenuation. Findings were correlated with the Revised Atlanta Classification and clinical outcomes.
Results: Severe acute pancreatitis was observed in 24% of patients. Extrapancreatic necrosis volume demonstrated the highest diagnostic accuracy for severe disease (area under the ROC curve [AUC] 0.89; cutoff >120 mL), outperforming pancreatic necrosis percentage and other quantitative markers..
Conclusion: Extrapancreatic necrosis volume is the most reliable quantitative CT marker for predicting severe acute pancreatitis and adverse clinical outcomes.
Keywords:Acute pancreatitis; Quantitative CT; Extrapancreatic necrosis; Severity prediction