Sensitivity of CT, MRI, and EUS-FNA/B in the preoperative workup of histologically proven left-sided pancreatic lesions

Gorris, Myrte; Janssen, Quisette P.; Besselink, Marc G.; Broek, Bram L.J. van den; Eijck, Casper H.J. van; Gils, Marjon J. van; Koerkamp, Bas Groot; Struik, Femke; Driel, Lydi M.J.W. van; Hooft, Jeanin E. van

doi:10.1016/j.pan.2021.11.008

Cited by 5 publications

(1 citation statement)

References 32 publications

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“…The standard endoscopic ultrasound (EUS) diagnostic based on morphologic features has a sensitivity of 62% and a specificity of 66% [ 6 ]. EUS fine-needle aspiration (EUS-FNA) was considered as a promising tool for improving diagnosis, but the sensitivity for diagnosing left-sided pancreatic cysts rose to only 75% [ 7 ]. Currently, the diagnosis of mucinous PCL takes into account intracystic fluid assessment of cytology, carcinoembryonic antigen (CEA), glucose, Kirsten rat sarcoma viral oncogene homolog (KRAS), and guanine nucleotide-binding protein alpha-stimulating activity polypeptide (GNAS) assessment with a sensitivity of 46%, 68%, 92%, 55% and 39%, respectively, and a specificity of 89%, 83%, 65%, 93% and 99%, respectively [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Olar,

Iacobescu,

Bolboacă

et al. 2024

IJMS

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Undetermined pancreatic cystic lesion (PCL) differentiation benefits from endoscopic ultrasound (EUS) based on morphology and cyst fluid analysis, but room for new biomarkers exists. Our aim was to assess the intracystic and serum diagnostic value of neutrophil gelatinase-associated lipocalin (Ngal) and interleukin 1 beta (IL-1β) for differentiation of PCLs. This prospective study included patients from one tertiary hospital, evaluated between April 2018 and May 2020. EUS fine-needle aspiration or pancreatic pseudocysts drainage was the source of PCL intracystic liquid. The final diagnosis was based on surgery or EUS results (morphology, cytology, glucose, and CEA—carcinoembryogenic antigen). The intracystic samples were tested for Ngal, IL-1β, glucose, and CEA, and serum for Ngal and IL-1β. We evaluated 63 cysts, 33 pseudocysts, and 30 non-inflammatory cysts. The diagnostic sensitivity and specificity for mucinous PCL was 70.8% and 92.3% for intracystic Ngal (cut-off: 500–800 ng/dL), without correlation with serum Ngal, no matter the inclusion of infected pseudocysts. After exclusion of infected pseudocysts, the sensitivity and specificity for glucose were 87% and 75%, respectively, and for CEA, they were 87.1%, and 96.8%, respectively. Intracystic Ngal shows promise in differentiating mucinous PCLs, but researchers need to conduct further studies to confirm its effectiveness. Intracystic IL-1β and serum Ngal made no diagnostic contribution.

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Section: Introductionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Olar,

Iacobescu,

Bolboacă

et al. 2024

IJMS

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Assessment of resectability of pancreatic cancer using novel immersive high-performance virtual reality rendering of abdominal computed tomography and magnetic resonance imaging

Kunz,

Maloca,

Allemann

et al. 2024

Int J CARS

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Purpose Virtual reality (VR) allows for an immersive and interactive analysis of imaging data such as computed tomography (CT) and magnetic resonance imaging (MRI). The aim of this study is to assess the comprehensibility of VR anatomy and its value in assessing resectability of pancreatic ductal adenocarcinoma (PDAC). Methods This study assesses exposure to VR anatomy and evaluates the potential role of VR in assessing resectability of PDAC. Firstly, volumetric abdominal CT and MRI data were displayed in an immersive VR environment. Volunteering physicians were asked to identify anatomical landmarks in VR. In the second stage, experienced clinicians were asked to identify vascular involvement in a total of 12 CT and MRI scans displaying PDAC (2 resectable, 2 borderline resectable, and 2 locally advanced tumours per modality). Results were compared to 2D standard PACS viewing. Results In VR visualisation of CT and MRI, the abdominal anatomical landmarks were recognised by all participants except the pancreas (30/34) in VR CT and the splenic (31/34) and common hepatic artery (18/34) in VR MRI, respectively. In VR CT, resectable, borderline resectable, and locally advanced PDAC were correctly identified in 22/24, 20/24 and 19/24 scans, respectively. Whereas, in VR MRI, resectable, borderline resectable, and locally advanced PDAC were correctly identified in 19/24, 19/24 and 21/24 scans, respectively. Interobserver agreement as measured by Fleiss κ was 0.7 for CT and 0.4 for MRI, respectively (p < 0.001). Scans were significantly assessed more accurately in VR CT than standard 2D PACS CT, with a median of 5.5 (IQR 4.75–6) and a median of 3 (IQR 2–3) correctly assessed out of 6 scans (p < 0.001). Conclusion VR enhanced visualisation of abdominal CT and MRI scan data provides intuitive handling and understanding of anatomy and might allow for more accurate staging of PDAC and could thus become a valuable adjunct in PDAC resectability assessment in the future.

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Effect of deep learning reconstruction on the assessment of pancreatic cystic lesions using computed tomography

Kanzawa,

Yasaka,

Ohizumi

et al. 2024

Radiol Phys Technol

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This study aimed to compare the image quality and detection performance of pancreatic cystic lesions between computed tomography (CT) images reconstructed by deep learning reconstruction (DLR) and filtered back projection (FBP). This retrospective study included 54 patients (mean age: 67.7 ± 13.1) who underwent contrast-enhanced CT from May 2023 to August 2023. Among eligible patients, 30 and 24 were positive and negative for pancreatic cystic lesions, respectively. DLR and FBP were used to reconstruct portal venous phase images. Objective image quality analyses calculated quantitative image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) using regions of interest on the abdominal aorta, pancreatic lesion, and pancreatic parenchyma. Three blinded radiologists performed subjective image quality assessment and lesion detection tests. Lesion depiction, normal structure illustration, subjective image noise, and overall image quality were utilized as subjective image quality indicators. DLR significantly reduced quantitative image noise compared with FBP (p < 0.001). SNR and CNR were significantly improved in DLR compared with FBP (p < 0.001). Three radiologists rated significantly higher scores for DLR in all subjective image quality indicators (p ≤ 0.029). Performance of DLR and FBP were comparable in lesion detection, with no statistically significant differences in the area under the receiver operating characteristic curve, sensitivity, specificity and accuracy. DLR reduced image noise and improved image quality with a clearer depiction of pancreatic structures. These improvements may have a positive effect on evaluating pancreatic cystic lesions, which can contribute to appropriate management of these lesions.

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Sensitivity of CT, MRI, and EUS-FNA/B in the preoperative workup of histologically proven left-sided pancreatic lesions

Cited by 5 publications

References 32 publications

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Assessment of resectability of pancreatic cancer using novel immersive high-performance virtual reality rendering of abdominal computed tomography and magnetic resonance imaging

Effect of deep learning reconstruction on the assessment of pancreatic cystic lesions using computed tomography

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