{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:04:39Z","timestamp":1753869879349,"version":"3.41.2"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","award":["K08CA250418"],"award-info":[{"award-number":["K08CA250418"]}],"id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Acute pancreatitis (AP) due to chemotherapy\u2010induced pancreatic injury is a common side effect of treatment for acute lymphoblastic leukemia (ALL), the most common childhood malignancy. The American College of Radiology recommends ultrasound (US) for initial imaging of AP in all populations to assess for ductal obstruction. However, US may be insensitive to diagnose and assess chemotherapy\u2010associated AP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Materials<\/jats:title><jats:p>The institutional review board approved this retrospective study. Patients with ALL and AP were identified from protocol databases, using Common Terminology Criteria for Adverse Events (CTCAE) version 3. Chemotherapy dosing, amylase\/lipase levels, clinical symptoms, and US\/computed tomography (CT) reports within 10\u00a0days of diagnosis were recorded. All CT images were reviewed for revised Atlanta classification and CT severity index (CTSI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010nine patients, aged 2\u201021\u00a0years, experienced 88 episodes of AP, undergoing 98 US and 44 CT. Seventy\u2010two events (82%) occurred within 30\u00a0days of asparaginase administration. Sixty\u2010nine episodes (78%) were initially diagnosed by the presence of abdominal pain and pancreatic enzyme elevation. Overall sensitivities for AP detection were 47% using US and 98% for CT. US sensitivity was greatest in CTCAE grade 4 (86%) and necrotizing pancreatitis (67%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most cases of AP in children with ALL can be diagnosed with clinical history and labs. US has limited sensitivity in detecting pancreatitis in this population. Imaging to diagnose AP in this patient population could be limited to clinically equivocal cases.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28730","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T06:12:01Z","timestamp":1603865521000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ultrasound has limited diagnostic utility in children with acute lymphoblastic leukemia developing pancreatitis"],"prefix":"10.1002","volume":"68","author":[{"given":"Rebecca","family":"Richardson","sequence":"first","affiliation":[{"name":"Department of Radiology, Johns Hopkins School of Medicine  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1953-4486","authenticated-orcid":false,"given":"Cara E.","family":"Morin","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles A.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yian","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Jeha","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0605-7342","authenticated-orcid":false,"given":"Hiroto","family":"Inaba","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0303-5658","authenticated-orcid":false,"given":"Ching\u2010Hon","family":"Pui","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8113-8180","authenticated-orcid":false,"given":"Seth E.","family":"Karol","sequence":"additional","affiliation":[{"name":"Department of Oncology St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Beth","family":"McCarville","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, St Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.1002\/cam4.649"},{"doi-asserted-by":"publisher","key":"e_1_2_10_3_1","DOI":"10.1097\/MPH.0b013e3181b794e8"},{"doi-asserted-by":"publisher","key":"e_1_2_10_4_1","DOI":"10.1111\/bjh.12016"},{"doi-asserted-by":"publisher","key":"e_1_2_10_5_1","DOI":"10.1016\/S1470-2045(17)30424-2"},{"doi-asserted-by":"publisher","key":"e_1_2_10_6_1","DOI":"10.1136\/gutjnl-2012-302779"},{"doi-asserted-by":"publisher","key":"e_1_2_10_7_1","DOI":"10.1097\/MPG.0b013e31824f1516"},{"doi-asserted-by":"publisher","key":"e_1_2_10_8_1","DOI":"10.1097\/RUQ.0000000000000099"},{"doi-asserted-by":"publisher","key":"e_1_2_10_9_1","DOI":"10.1007\/s00247-018-4190-0"},{"doi-asserted-by":"publisher","key":"e_1_2_10_10_1","DOI":"10.1148\/rg.2016150097"},{"doi-asserted-by":"publisher","key":"e_1_2_10_11_1","DOI":"10.1148\/radiology.174.2.2296641"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.28730","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.28730","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.28730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T10:35:23Z","timestamp":1693737323000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.28730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/pbc.28730"],"URL":"https:\/\/doi.org\/10.1002\/pbc.28730","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"type":"print","value":"1545-5009"},{"type":"electronic","value":"1545-5017"}],"subject":[],"published":{"date-parts":[[2020,10,27]]},"assertion":[{"value":"2020-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e28730"}}