Evaluation of the diagnostic performance of the EFSUMB CEUS Pancreatic Applications guidelines (2017 version): a retrospective single-center analysis of 455 solid pancreatic masses

Jia, Wanying; Gui, Yan; Chen, Xue-qi; Zhang, Xiaoqian; Zhang, Jiahui; Dai, Menghua; Guo, Junchao; Chang, Xiaoyan; Tan, Li Kuo; Bai, Chunmei; Cheng, Yuejuan; Li, Jianchu; Lv, Ke; Jiang, Yuxin

doi:10.1007/s00330-022-08879-0

Cited by 4 publications

(4 citation statements)

References 24 publications

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Section: Discussionmentioning

confidence: 99%

“…With the development of US technology, CEUS has played an essential role in diagnosing PDAC ( 10 , 11 , 17 ). Compared to CECT, which uses iodine or gadolinium technology for contrast imaging ( 11 ), CEUS uses microbubbles in pure blood pool imaging, which, with a diameter of less than 10 µm, can freely pass through capillaries, effectively simulating the hemodynamic properties of red blood cells. This technique has the advantage of real-time observation and realistic response to microvascular changes and is more conducive to the presentation of the microcirculation of the lesion.…”

Section: Discussionmentioning

confidence: 99%

“…The US contrast agent has a diameter of <10 μm and can freely pass through capillaries, which can effectively mimic the hemodynamic characteristics of red blood cells and visualize the tumor microcirculation. PDAC shows 2 types of enhancement in CEUS, hypo-enhancement and isoenhancement, with the former being the most common and the difference between them being mainly related to its microenvironmental composition (10)(11)(12)(13). Hypoenhancement PDAC has more fibrous stroma and fewer microvessels, resulting in fewer vessels involved in the microcirculation and lesions showing hypo-enhancement.…”

Section: Introductionmentioning

confidence: 99%

“…Hypoenhancement PDAC has more fibrous stroma and fewer microvessels, resulting in fewer vessels involved in the microcirculation and lesions showing hypo-enhancement. In contrast, iso-enhancement PDAC contains more glandular vesicle cells and less fibrous matrix, resulting in a higher number of vessels involved in the microcirculation (11,14,15). We speculated upon whether it is possible to show the different areas of perfusion in the lesion using CEUS, thus providing more information for the assessment of hepatic metastases in PDAC.…”

Section: Introductionmentioning

confidence: 99%

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Pancreatic ductal adenocarcinoma with synchronous and metachronous hepatic metastasis predicted by contrast-enhanced ultrasound

Jia¹,

Yang²,

Chen³

et al. 2023

Quant Imaging Med Surg

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Background: Contrast-enhanced ultrasound (CEUS) has proven valuable in diagnosing benign and malignant pancreatic diseases, but its value in evaluating hepatic metastasis remains to be further explored.This study investigated the relationship between CEUS features of pancreatic ductal adenocarcinoma (PDAC) and concomitant or recurrent liver metastases after treatment.Methods: This retrospective study included 133 participants with PDAC who were diagnosed with pancreatic lesions with CEUS at Peking Union Medical College Hospital from January 2017 to November 2020. According to the CEUS classification methods in our center, all the pancreatic lesions were classified as either with rich or poor blood supply. Additionally, quantitative ultrasonographic parameters were measured in the center and periphery of all pancreatic lesions. CEUS modes and parameters of the different hepatic metastasis groups were compared. The diagnostic performance of CEUS was calculated for diagnosing synchronous and metachronous hepatic metastasis.Results: The proportions of rich blood supply and poor blood supply were 46% (32/69) and 54% (37/69), respectively, in the no hepatic metastasis group; 42% (14/33) and 58% (19/33), respectively, in the metachronous hepatic metastasis (MHM) group; and 19% (6/31) and 81% (25/31), respectively, in the synchronous hepatic metastasis (SHM) group. The wash-in slope ratio (WIS ratio) between the center of the lesion and around the lesion and peak intensity ratio (PI ratio) between the center of the lesion and around the lesion had higher values in the negative hepatic metastasis group (P<0.05). In predicting synchronous and metachronous hepatic metastasis, the WIS ratio had the best diagnostic performance. The sensitivity (SEN), specificity (SPE), accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) were 81.8%, 95.7%, 91.2%, 90.0%, and 91.7%, respectively, for MHM; and 87.1%, 95.7%, 93.0%, 90.0%, and 94.3%, respectively, for SHM. MethodsThis study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The institutional review board of Peking Union Medical College Hospital approved the study (No. SK1733), and the requirement for individual consent for this retrospective analysis was waived.Conclusions: CEUS would be helpful in image surveillance for synchronous or metachronous hepatic metastasis of PDAC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pancreatic ductal adenocarcinoma with synchronous and metachronous hepatic metastasis predicted by contrast-enhanced ultrasound

Jia¹,

Yang²,

Chen³

et al. 2023

Quant Imaging Med Surg

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Ultrasound Contrast Agents

Mundada,

Pellerito,

Srivastava

et al. 2024

Radiologic Clinics of North America

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Efficacy of color Doppler ultrasound and contrast-enhanced ultrasound in identifying vascular invasion in pancreatic ductal adenocarcinoma

Jia,

Gui,

Chen

et al. 2024

Insights Imaging

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Objectives To compare color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in evaluating vascular invasion in pancreatic ductal adenocarcinoma (PDAC). Materials and methods This retrospective study included 210 patients with PDAC who were evaluated by color Doppler ultrasound, CEUS, and contrast-enhanced computed tomography (CECT) at our institution between January 2017 and December 2020. Pathologic results were used as the gold standard in patients who underwent surgical and intraoperative exploration. For nonsurgical patients, CECT results were used as the reference standard. The vessels evaluated included those in the peripancreatic arterial system and venous system. The diagnostic performances of color Doppler ultrasound and CEUS for vascular invasion were compared. Results In 51 patients who underwent surgery and intraoperative exploration, color Doppler ultrasound and CEUS differed only in assessing venous system invasion in patients with PDAC of the pancreatic body and tail, with the former being superior to the latter. In 159 nonsurgical patients, there was no difference between CEUS and color Doppler ultrasound in assessing superior mesenteric arteriovenous invasion. CEUS was superior to color Doppler ultrasound in evaluating the celiac artery and its branches, with an accuracy of up to 97.8% for some vessels. Color Doppler ultrasound was ideal for evaluating the splenic and portal veins. Conclusion CEUS is more suitable for the evaluation of peripancreatic arteries than color Doppler. CEUS combined with color Doppler ultrasound can be used as a potential supplement to CECT and is also expected to be used to evaluate vascular invasion of PDAC after chemotherapy. Critical relevance statement Contrast-enhanced US and color Doppler in the assessment of vascular invasion in pancreatic ductal adenocarcinoma have their respective advantages, through standardized ultrasound processes are expected to improve the efficiency of inspection. Key Points Contrast-enhanced US has unique advantages in assessing pancreatic ductal adenocarcinoma invasion of the celiac artery. Doppler imaging is of high value in assessing venous system invasion. Standardization of ultrasound imaging procedures for pancreatic ductal adenocarcinoma is expected to improve efficiency. Graphical Abstract

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Evaluation of the diagnostic performance of the EFSUMB CEUS Pancreatic Applications guidelines (2017 version): a retrospective single-center analysis of 455 solid pancreatic masses

Cited by 4 publications

References 24 publications

Pancreatic ductal adenocarcinoma with synchronous and metachronous hepatic metastasis predicted by contrast-enhanced ultrasound

Pancreatic ductal adenocarcinoma with synchronous and metachronous hepatic metastasis predicted by contrast-enhanced ultrasound

Ultrasound Contrast Agents

Efficacy of color Doppler ultrasound and contrast-enhanced ultrasound in identifying vascular invasion in pancreatic ductal adenocarcinoma

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