Title: 18 F-FDG PET/CT metabolic parameters may have predictive value for relapse of type
1 autoimmune pancreatitis
Version: 1 Date: 11 Nov 2023
Reviewer's report:
A. Methods
a) Study subjects
1. This retrospective study analyzed patients not receiving maintenance steroid therapy or
had received maintenance therapy? As the exclusion criterias included patients not recieving
maintenance therapy, but the abstract method section stated that the aim of the current study is
to analyzed 51 patients who received 18F-FDG PET/CT prior to treatment and "did not receive
maintenance therapy after remission". The aim of the current study is not quite clear based on
the wording. Please clarify.
2. Please provide the  Institutional Review Board approval number for this retrospective study.
b) Followup
1. Why is relapse based on liver abnormalities only? (3rd sentence)
2. Please specify the duration and dosage of steroid used in this cohort, including initial induction
phase and maintenance phase.
3. Did these patients received additional therpy aside from steroid? i.e. immuonodulators etc.
4. Why are these patients discontinued glucocorticoids therapy? because of relapse?
c) Image analysis
1. Why both SUVmax threshold, 40% and 42% , were evaluated?
B. Results
1. Please provide a table showing all the  Univariable and multivariable analyses of the
association with relapse free survival.
B. Discussion
Fourth paragraph: "Our results suggest that AIP, which has a high tendency for recurrence, may
have a wider and denser range of inflammation; therefore, 18F-FDG metabolic and volumetric
parameters (TLG) may be larger, and the FDG uptake value of a single voxel (SUVmax and
SUVR) may be higher. However, the specific mechanism of action remains to be elucidated."
is not ambiguous, and not clear.
Others:
1. Please use the terms "relapsed group" and "non-relapsed group"  rather than relapse and non-
relapse group.
2. Table 1
a) what does "lose weight"mean?
b) as stated in the method section, only subjects with FDG PET done before treatment were
included in the current analysis, but this statement is contradictory to the heading of "initial
treatment" presented in the Table 1, whereas may patients had received immunotherapy and
steroid therapy?
3. Table 2
the authors mentioned in the manuscript that lymph nodes were also evaluated, but the
information was not presented in the current table.
4. Please provide two figure examples of FDG PET/CT  showing patient who relapsed and one
didn't.
Title: 18 F-FDG PET/CT metabolic parameters may have predictive value for relapse of type
1 autoimmune pancreatitis
Version: 1 Date: 11 Nov 2023
Reviewer's report:
A. Methods
a) Study subjects
1. This retrospective study analyzed patients not receiving maintenance steroid therapy or
had received maintenance therapy? As the exclusion criterias included patients not recieving
maintenance therapy, but the abstract method section stated that the aim of the current study is
to analyzed 51 patients who received 18F-FDG PET/CT prior to treatment and "did not receive
maintenance therapy after remission". The aim of the current study is not quite clear based on
the wording. Please clarify.
2. Please provide the  Institutional Review Board approval number for this retrospective study.
b) Followup
1. Why is relapse based on liver abnormalities only? (3rd sentence)
2. Please specify the duration and dosage of steroid used in this cohort, including initial induction
phase and maintenance phase.
3. Did these patients received additional therpy aside from steroid? i.e. immuonodulators etc.
4. Why are these patients discontinued glucocorticoids therapy? because of relapse?
c) Image analysis
1. Why both SUVmax threshold, 40% and 42% , were evaluated?
B. Results
1. Please provide a table showing all the  Univariable and multivariable analyses of the
association with relapse free survival.
B. Discussion
Fourth paragraph: "Our results suggest that AIP, which has a high tendency for recurrence, may
have a wider and denser range of inflammation; therefore, 18F-FDG metabolic and volumetric
parameters (TLG) may be larger, and the FDG uptake value of a single voxel (SUVmax and
SUVR) may be higher. However, the specific mechanism of action remains to be elucidated."
is not ambiguous, and not clear.
Others:
1. Please use the terms "relapsed group" and "non-relapsed group"  rather than relapse and non-
relapse group.
2. Table 1
a) what does "lose weight"mean?
b) as stated in the method section, only subjects with FDG PET done before treatment were
included in the current analysis, but this statement is contradictory to the heading of "initial
treatment" presented in the Table 1, whereas may patients had received immunotherapy and
steroid therapy?
3. Table 2
the authors mentioned in the manuscript that lymph nodes were also evaluated, but the
information was not presented in the current table.
4. Please provide two figure examples of FDG PET/CT  showing patient who relapsed and one
didn't.
Please review this paper.
user
Title: 18 F-FDG PET/CT metabolic parameters may have predictive value for relapse of type
1 autoimmune pancreatitis
Version: 1 Date: 11 Nov 2023
Reviewer's report:
A. Methods
a) Study subjects
1. This retrospective study analyzed patients not receiving maintenance steroid therapy or
had received maintenance therapy? As the exclusion criterias included patients not recieving
maintenance therapy, but the abstract method section stated that the aim of the current study is
to analyzed 51 patients who received 18F-FDG PET/CT prior to treatment and "did not receive
maintenance therapy after remission". The aim of the current study is not quite clear based on
the wording. Please clarify.
2. Please provide the  Institutional Review Board approval number for this retrospective study.
b) Followup
1. Why is relapse based on liver abnormalities only? (3rd sentence)
2. Please specify the duration and dosage of steroid used in this cohort, including initial induction
phase and maintenance phase.
3. Did these patients received additional therpy aside from steroid? i.e. immuonodulators etc.
4. Why are these patients discontinued glucocorticoids therapy? because of relapse?
c) Image analysis
1. Why both SUVmax threshold, 40% and 42% , were evaluated?
B. Results
1. Please provide a table showing all the  Univariable and multivariable analyses of the
association with relapse free survival.
B. Discussion
Fourth paragraph: "Our results suggest that AIP, which has a high tendency for recurrence, may
have a wider and denser range of inflammation; therefore, 18F-FDG metabolic and volumetric
parameters (TLG) may be larger, and the FDG uptake value of a single voxel (SUVmax and
SUVR) may be higher. However, the specific mechanism of action remains to be elucidated."
is not ambiguous, and not clear.
Others:
1. Please use the terms "relapsed group" and "non-relapsed group"  rather than relapse and non-
relapse group.
2. Table 1
a) what does "lose weight"mean?
b) as stated in the method section, only subjects with FDG PET done before treatment were
included in the current analysis, but this statement is contradictory to the heading of "initial
treatment" presented in the Table 1, whereas may patients had received immunotherapy and
steroid therapy?
3. Table 2
the authors mentioned in the manuscript that lymph nodes were also evaluated, but the
information was not presented in the current table.
4. Please provide two figure examples of FDG PET/CT  showing patient who relapsed and one
didn't.
assistant