The value of Contrast-Enhanced Ultrasound in the characterization of vascular pattern of solid pancreatic lesions

Abstract

The aim of our study was to evaluate the accuracy of CEUS in the characterization of pancreatic solid lesions, considering cross sectional imaging techniques (CE-CT/MRI) as the "gold standard" methods. Material and methods: We performed a retrospective, monocentric study that included 91 solid pancreatic lesions which were evaluated by CEUS and by a secondline contrast imaging technique (CT or MRI), considered as the reference method. Results: The rate of a conclusive diagnosis based on a typical enhancement pattern was 94% (78/83 cases). In 72 cases out of 83 (86.7%) there was a perfect concordance between CEUS and the "gold-standard" imaging method (CE-CT/MRI). In our study, 88% (73/83) of the pancreatic lesions were categorized as malignant due to their typical wash-out aspect in the late phase. The overall accuracy of CEUS for the differential diagnosis of solid pancreatic tumors was approximately 81%. The accuracy of CEUS for the diagnosis of hypoenhancing pancreatic tumors was approximately 89.1%; while for the diagnosis of hyperenhancing pancreatic tumors it was approximately 72.8%. Conclusion: CEUS allows the differentiation between hypo-vs. hyperenhancing pancreatic solid lesions, with a considerable diagnostic accuracy, a fundamental step in the precise diagnosis of pancreatic tumors.

Contrast-Enhanced Ultrasonographic Detection and Dual-Phase Computed Tomographic Angiography in a 5-Year-Old Boxer with Pancreatic Insulinoma<br/>—Case Report

“…However, in a recent case series of three dogs with pancreatic nodules with histologically confirmed insulinoma the nodules were visible using both conventional and CEUS [6]. In a study performed on humans, an overall accuracy of CEUS for the differential diagnosis in solid pancreatic masses was 81%, and CEUS had good diagnostic accuracy in differentiating contrastenhancing and non-contrast-enhancing pancreatic solid lesions [7].…”

Contrast-Enhanced Ultrasound for differential diagnosis of pancreatic mass lesions: a meta-analysis.

“…Thirteen studies were on the subject of diagnosis [12][13][14][15][16][17][20][21][23][24][25][27][28][29][30][32][33] and 5 studies were concerned with suspicion in the clinical setting [18][19]22,26,31]. In these studies 2704 patients were enrolled while 2664 were included in the analysis.…”

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

“…For both types of lesions, CEUS is useful for detecting liver metastases in the late phase ("wash-out" of liver lesions). Several studies proved the utility of CEUS for the characterization of pancreatic tumors [94][95][96][97][98]. The accuracy for the diagnosis of solid pancreatic lesions varies from 91.7% to 93.8% [94,95,97].…”