Characterization of the pancreas in vivo using EUS spectrum analysis with electronic array echoendoscopes

Abstract

Background Spectral analysis of the radio-frequency (RF) signals that underlie grayscale EUS images has been used to provide quantitative, objective information about tissue histology. Objective Our purpose was to validate RF spectral analysis as a method to distinguish between chronic pancreatitis (CP) and pancreatic cancer (PC). Design & Setting A prospective study of eligible patients was conducted to analyze the RF data obtained using electronic-array echoendoscopes. Patients Pancreatic images were obtained using electronic array echoendoscopes from 41 patients in a prospective study, including 15 patients with pancreatic cancer, 15 with chronic pancreatitis, and 11 with normal pancreas. Main outcome measurements Midband fit, slope, intercept, correlation coefficient, and root-mean-square (RMS) deviation from a linear regression of the calibrated power spectra were determined and compared among the groups. Results Statistical analysis showed that significant differences were observable between groups for mean midband fit, intercept, and RMS deviation (T-test p < 0.05). Discriminant analysis of these parameters was then performed to classify the data. For CP (n = 15) vs. PC (n = 15), the same parameters provided 83% accuracy and AUC of 0.83. Limitations Moderate sample size and spatial averaging inherent to the technique. Conclusions This study shows that mean spectral parameters of the backscattered signals obtained using electronic array echoendoscopes can provide a non-invasive method to quantitatively discriminate between chronic pancreatitis and pancreatic cancer.

Noninvasive Quantification of In Vitro Osteoblastic Differentiation in 3D Engineered Tissue Constructs Using Spectral Ultrasound Imaging

“…Spectral analysis has been used in various applications, including characterization of plaque composition by intravascular ultrasound (IVUS) [16] , [17] , lesions induced by high intensity focused ultrasound (HIFU) [18] , [19] and RF ablation [20] . Spectral parameters have also shown the ability to identify changes in tissue state for prostate, breast, pancreas, lymph node, and other cancer types [21] , [22] , [23] , [24] , [25] , [26] , [27] . Oelze et al .…”

New endoscopic ultrasonography criteria for malignant lymphadenopathy based on inter-rater agreement

“…To achieve this, an objective evaluation of each variable using a digital image analysis would be necessary. Recently, many studies have been conducted along these lines[19,20]. Zhu et al[21] reported that digital image processing and computer-aided EUS image differentiation technologies are highly accurate and noninvasive in differential diagnosis between pancreatic cancer and chronic pancreatitis.…”

Current controversies and advances in the management of pancreatic adenocarcinoma

“…In one study, the sensitivity and specificity for detecting pancreatic malignancies were 100% and 92.9% respectively[ 91 ]. Three-dimensional reconstruction and spectrum analysis using EUS has shown -good results, and has the potential to be used more often in the future[ 92 ].…”

“…As pancreatic cancer has the potential to cause micro metastasis even in early stage of disease, research has been carried out to determine the molecular profiling of these tumors. Imaging agents such as peptides that bind to specific factors on the surface of pancreatic tumors have been developed and include: cathepsin E, integrin α v β 6 , plectin 1, claudin-4 and oncolytic adenovarirus mutant[ 92 - 97 ] . Similarly, engineered biological agents such as oncolytic adenovirus have shown efficacy and tumor selectivity in preclinical pancreatic cancer models[ 98 , 99 ].…”