{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:13:10Z","timestamp":1788235990936,"version":"build-2803163510"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019084","name":"Kobe University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019084","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Diabetol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitor (ICI)-induced diabetes is a rare endocrine immune-related adverse event, and long-term pancreatic magnetic resonance imaging (MRI) findings after disease onset have not been well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>An individual developed abrupt hyperglycemia during pembrolizumab therapy for recurrent renal cell carcinoma and subsequently required insulin therapy. Serum C-peptide rapidly declined to below the detection threshold, whereas pancreatic enzyme levels remained within normal limits throughout follow-up. MRI performed 1 day after diagnosis demonstrated diffuse high signal intensity on diffusion-weighted imaging (DWI) and reduced apparent diffusion coefficient (ADC) values throughout the pancreas. Serial imaging over 25 months showed progressive pancreatic atrophy, whereas the DWI\/ADC features persisted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case provides a new descriptive longitudinal radiological observation of persistent diffusion-related pancreatic MRI findings and progressive pancreatic atrophy after the onset of ICI-induced diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00592-026-02683-8","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:41:16Z","timestamp":1779792076000},"page":"1509-1513","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term imaging characteristics of the pancreas related to diabetes induced by immune checkpoint inhibitor therapy"],"prefix":"10.1007","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8018-3718","authenticated-orcid":false,"given":"Seiji","family":"Tomofuji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7996-232X","authenticated-orcid":false,"given":"Shin","family":"Urai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8062-4379","authenticated-orcid":false,"given":"Kei","family":"Yoshino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7421-2714","authenticated-orcid":false,"given":"Hironori","family":"Bando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-4155","authenticated-orcid":false,"given":"Yushi","family":"Hirota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"2683_CR1","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1038\/s41574-024-01077-6","volume":"21","author":"S Iwama","year":"2025","unstructured":"Iwama S, Kobayashi T, Arima H (2025) Management, biomarkers and prognosis in people developing endocrinopathies associated with immune checkpoint inhibitors. Nat Rev Endocrinol 21:289\u2013300. https:\/\/doi.org\/10.1038\/s41574-024-01077-6","journal-title":"Nat Rev Endocrinol"},{"key":"2683_CR2","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/jdi.14362","volume":"16","author":"F Kamitani","year":"2025","unstructured":"Kamitani F, Nishioka Y, Koizumi M et al (2025) Immune checkpoint inhibitor-related type 1 diabetes incidence, risk, and survival association. J Diabetes Investig 16:334\u2013342. https:\/\/doi.org\/10.1111\/jdi.14362","journal-title":"J Diabetes Investig"},{"key":"2683_CR3","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s00592-018-1234-8","volume":"56","author":"L Marchand","year":"2019","unstructured":"Marchand L, Thivolet A, Dalle S et al (2019) Diabetes mellitus induced by PD-1 and PD-L1 inhibitors: description of pancreatic endocrine and exocrine phenotype. Acta Diabetol 56:441\u2013448. https:\/\/doi.org\/10.1007\/s00592-018-1234-8","journal-title":"Acta Diabetol"},{"key":"2683_CR4","doi-asserted-by":"publisher","DOI":"10.1172\/JCI192938","author":"L Wu","year":"2025","unstructured":"Wu L, Wentworth JM, Liddle C et al (2025) Pancreatic volume and immune biomarkers predict checkpoint inhibitor-associated autoimmune diabetes in humans. J Clin Invest. https:\/\/doi.org\/10.1172\/JCI192938","journal-title":"J Clin Invest"},{"key":"2683_CR5","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1148\/radiol.14130778","volume":"274","author":"M Barral","year":"2015","unstructured":"Barral M, Taouli B, Guiu B et al (2015) Diffusion-weighted MR imaging of the pancreas: current status and recommendations. Radiology 274:45\u201363. https:\/\/doi.org\/10.1148\/radiol.14130778","journal-title":"Radiology"},{"key":"2683_CR6","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s13340-018-0355-1","volume":"9","author":"A Tokunaga","year":"2018","unstructured":"Tokunaga A, Imagawa A, Nishio H et al (2018) Diffusion-weighted magnetic resonance imaging in the pancreas of fulminant type 1 diabetes. Diabetol Int 9:257\u2013265. https:\/\/doi.org\/10.1007\/s13340-018-0355-1","journal-title":"Diabetol Int"},{"key":"2683_CR7","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1007\/s42000-025-00629-3","volume":"24","author":"M Suzuki","year":"2025","unstructured":"Suzuki M, Hirota Y, Urai S et al (2025) Immune checkpoint inhibitor-related diabetes mellitus associated with high signal intensity in diffusion-weighted magnetic resonance imaging of the pancreas at an early clinical stage. Horm (Athens) 24:569\u2013574. https:\/\/doi.org\/10.1007\/s42000-025-00629-3","journal-title":"Horm (Athens)"}],"container-title":["Acta Diabetologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00592-026-02683-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00592-026-02683-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00592-026-02683-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:14:48Z","timestamp":1788232488000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00592-026-02683-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":7,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["2683"],"URL":"https:\/\/doi.org\/10.1007\/s00592-026-02683-8","relation":{},"ISSN":["1432-5233"],"issn-type":[{"value":"1432-5233","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"25 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Yushi Hirota has received lecture fees from Eli Lilly Japan K.K., Sanofi, Terumo Corp., Sumitomo Pharma Co. Ltd., Novo Nordisk Pharma Ltd., and Abbott Japan LLC; research support from Sumitomo Pharma Co. Ltd., Kyowa Kirin Co. Ltd., and Medtronic Japan Co. Ltd.; and research expenses (including contracted research, joint research, and clinical trials) from Nippon Boehringer Ingelheim Co. Ltd. All remaining authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent, expressly permitting journal submission and publication, was obtained in accordance with institutional policy.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}