Contrast‐enhanced ultrasound of pancreatic tumours

Robertis, Riccardo De; D’Onofrio, Mirko; Crosara, Stefano; Corso, F; Barbi, Emilio; Canestrini, Stefano; Mucelli, Roberto Pozzi

doi:10.1002/j.2205-0140.2014.tb00032.x

Cited by 13 publications

(10 citation statements)

References 60 publications

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“…As a consequence, CEUS shows vascularization exactly in real time, allowing a dynamic study of the enhancement pattern, including wash-in and washout. [18][19][20][21][22][23][24] Pancreatic enhancement begins almost at the same time as aortic enhancement due to an almost exclusively glandular arterial supply, giving an early postcontrast phase, called arterial/pancreatic (from 10 to 30 seconds). Then there is the venous phase (from 30 to ≈120 seconds) and the late phase (≈120 seconds).…”

Section: B-mode and Tissue Harmonic Imagingmentioning

confidence: 99%

“…Margins and lesion size are usually more clearly visible after contrast medium injection. [18][19][20]22,23,35 Contrast Figure 1. Adenocarcinoma of the pancreas, which is stiff on ARFI quantification.…”

Section: Ductal Adenocarcinomamentioning

confidence: 99%

“…Ultrasound contrast media have completely different characteristics in comparison to other ones used in CT or magnetic resonance imaging studies; as a matter of fact, they have a purely intravascular distribution without any interstitial phase. As a consequence, CEUS shows vascularization exactly in real time, allowing a dynamic study of the enhancement pattern, including wash‐in and wash‐out . Pancreatic enhancement begins almost at the same time as aortic enhancement due to an almost exclusively glandular arterial supply, giving an early postcontrast phase, called arterial/pancreatic (from 10 to 30 seconds).…”

Section: Ultrasound Imaging Techniquesmentioning

confidence: 99%

“…After contrast medium injection, ductal adenocarcinoma is a poorly defined mass with poor enhancement due to a typical high desmoplastic reaction and poor vascularity (Figures and ). Margins and lesion size are usually more clearly visible after contrast medium injection . Contrast medium injection during a US examination done for a suspicious pancreatic disease is the first recommendation present in the 2017 European CEUS application guidelines for nonhepatic diseases: all of the pancreatic focal lesions identified by conventional US could be studied with CEUS to increase characterization in ductal adenocarcinoma diagnosis .…”

Section: Clinical Applicationsmentioning

confidence: 99%

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Pancreatic Ultrasound: State of the Art

Ciaravino

D’Onofrio

2019

J of Ultrasound Medicine

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An ultrasound (US) study is often the first imaging approach in patients with abdominal symptoms or signs related to abdominal diseases, and it is often part of the routine workup. The pancreatic gland, despite its retroperitoneal site, can be efficiently examined with US thanks to advances in US technologies. Nowadays, a pancreatic US study could be considered complete if multiparametric, including the use of Doppler imaging, US elastography, and contrast‐enhanced imaging for the study of a pancreatic mass. A complete US examination could contribute to a faster diagnosis, especially if the pancreatic lesion is incidentally detected, addressing second‐step imaging modalities correctly.

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Section: B-mode and Tissue Harmonic Imagingmentioning

confidence: 99%

Section: Ductal Adenocarcinomamentioning

confidence: 99%

Section: Ultrasound Imaging Techniquesmentioning

confidence: 99%

Section: Clinical Applicationsmentioning

confidence: 99%

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Pancreatic Ultrasound: State of the Art

Ciaravino

D’Onofrio

2019

J of Ultrasound Medicine

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“…Contrast-enhanced Doppler techniques have been used in the human field to differentiate between pancreatitis and neoplasia, to detect parenchymal necrosis in individuals with acute severe pancreatitis and to assess pancreatic tumours. [88][89][90] Accordingly, the feasibility of using contrast-enhanced Doppler ultrasound to evaluate the feline pancreas has also been investigated. 91,92 The perfusion pattern of the normal pancreatic parenchyma has been described in detail in 10 clinically healthy cats using a second-generation contrast medium containing sulfur hexafluoride (SonoVue; Bracco UK).…”

Section: Contrast-enhanced Doppler Ultrasoundmentioning

confidence: 99%

Feline abdominal ultrasonography: What’s normal? What’s abnormal? The pancreas

Griffin

2020

Journal of Feline Medicine and Surgery

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Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the pancreas is a vital part of the investigation into feline pancreatic disease. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings such as nodular hyperplasia and pathological changes such as neoplasia can be challenging. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination and appearance of the normal and diseased pancreas. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. Equipment: Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

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Intraoperative Characterization of Pancreatic Tumors Using Contrast‐Enhanced Ultrasound and Shear Wave Elastography for Optimization of Surgical Strategies

Silva

Engeßer

Hackl

et al. 2020

J of Ultrasound Medicine

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Objectives-To evaluate intraoperative contrast-enhanced ultrasound (IoCEUS) and intraoperative shear wave elastography (IoSWE) for characterization of focal pancreatic lesions (FPLs) in correlation with postoperative histologic results. Thereby, the impact of intraoperative ultrasound (US) on pancreas surgery was evaluated.Methods-Intraoperative CEUS and SWE data from 54 patients, who underwent pancreas surgery between 2017 and 2019, were analyzed retrospectively. Ultrasound examinations were performed with multifrequency linear/T-shaped transducers (3-9 MHz) on a high-end US device (LOGIQ E9; GE Healthcare, Chicago, IL). To analyze FPL stiffness by SWE, regions of interest were placed to measure the shear wave speed (meters per second) and stiffness (kilopascals). After intravenous bolus injections of 2.4 to 10 mL of sulfur hexafluoride microbubbles, a dynamic analysis of FPL microvascularization from arterial to late phases was performed using IoCEUS considering hypoenhancement/irregular vascularization of macrocystic/small solid FPL malignancy criteria. Ultrasound findings were correlated with postoperative histologic results. The impact of intraoperative US on surgery was documented in each case.Results-Of 54 FPLs, IoCEUS could correctly characterize 39 of 39 malignant and 6 of 15 benign FPLs; IoSWE 29 of 39 as malignant and 7 of 15 as benign. Intraoperative CEUS's sensitivity was 100%; specificity, 40%; accuracy, 83.3%; positive predictive value, 81.3%; and negative predictive value, 100% (P < .05). Applying cutoff values of 3 m/s and 28.7 kPa, SWE's sensitivity was 74.4%; specificity, 46.7%; accuracy, 66.7%; positive predictive value; 78.4%; and negative predictive value, 41.2% for cancer detection (P < .05). The combined use of both techniques showed an accuracy rate of 76%, sensitivity of 74.4%, and specificity of 33.3%. In 29.6%, US results had an immediate impact on surgery.Conclusions-Intraoperative SWE and CEUS are highly valuable techniques for intraoperative characterization of FPLs. Although IoCEUS proved to be superior to IoSWE, the combined use can be helpful in particular cases.

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Contrast‐enhanced ultrasound of pancreatic tumours

Cited by 13 publications

References 60 publications

Pancreatic Ultrasound: State of the Art

Pancreatic Ultrasound: State of the Art

Feline abdominal ultrasonography: What’s normal? What’s abnormal? The pancreas

Intraoperative Characterization of Pancreatic Tumors Using Contrast‐Enhanced Ultrasound and Shear Wave Elastography for Optimization of Surgical Strategies

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