Dataset Information

Comparative Diagnostic Evaluation with Contrast-Enhanced Ultrasound, Computed Tomography and Magnetic Resonance Imaging in Patients with Pancreatic Cystic Neoplasms.

ABSTRACT: Purpose:The purpose of our study was to evaluate the role of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) and computed tomography (CT) in the pathological diagnosis of pancreatic cystic neoplasms (PCNs). Methods:A total of 90 patients (66 women, 24 men) aged 18-71 years were studied prospectively. CEUS was performed in all patients, whereas MRI was performed in 85 patients and CT in 69 patients. We analyzed the sensitivity and accuracy of these three imaging modalities to diagnose the PCNs. Neoplasm size, location, shape, intralesional mural nodules, septa and duct dilatation were also assessed by different radiologists. Results:There were no significant differences in sensitivity for discriminating PCNs from pancreatic cystic lesions between CEUS and MRI (p=0.614) or between CEUS and CT (p=0.479). The diagnostic accuracy of CEUS for classifying PCNs was 64.4% (58/90), which was higher than that of CT (53.6%, 37/69, P=0.017), and lower than that of MRI (70.6%, 60/85, p=0.791). Regarding tumor size for lesions larger than 3 cm, CEUS was superior to CT in differentiating the specific type of PCN (p=0.041), and CEUS had the same value as MRI (p=0.774). Furthermore, CEUS is valuable for precisely characterizing internal structures, for instance, septa (p=0.003, compared with CT; p=0.443, compared with MRI) and nodules (p= 0.018, compared with CT; p=0.033, compared with MRI). The number of septa (p=0.033) and cyst morphology (p=0.016) were meaningful indicators in differentiating serous and mucinous adenoma. There was no significant difference in evaluating size and detecting duct dilatation among the three imaging methods. Conclusion:CEUS compares favorably with MRI in displaying the inner structure of PCNs and offers advantages over CT. CEUS can contribute in an important way to the diagnosis of pancreatic cystic neoplasms.

SUBMITTER: Sun Y

PROVIDER: S-EPMC7196192 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Comparative Diagnostic Evaluation with Contrast-Enhanced Ultrasound, Computed Tomography and Magnetic Resonance Imaging in Patients with Pancreatic Cystic Neoplasms.

Sun Ya Y Yang Shuo S Qi Erpeng E Liu Fangyi F Zhou Fubo F Lu Yuhan Y Liang Ping P Ye Huiyi H Yu Xiaoling X

Cancer management and research 20200428

<h4>Purpose</h4>The purpose of our study was to evaluate the role of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) and computed tomography (CT) in the pathological diagnosis of pancreatic cystic neoplasms (PCNs).<h4>Methods</h4>A total of 90 patients (66 women, 24 men) aged 18-71 years were studied prospectively. CEUS was performed in all patients, whereas MRI was performed in 85 patients and CT in 69 patients. We analyzed the sensitivity and accuracy of these three i ...[more]

PMID: 32425602

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Project description:BackgroundPancreatic cystic lesions (PCLs) are recommended to be examined by magnetic resonance imaging (MRI), yet MRI still has limitations, such as high costs, the risk of triggering claustrophobia, and relatively low availability compared with ultrasound. Oral contrast agents-assisted ultrasound has been used to examine the gallbladder and stomach, but whether oral contrast agents could improve the accuracy of transabdominal ultrasound (TAUS) for PCLs and could be a potential alternative to non-contrast MRI for PCL follow-up has not been studied. This study aimed to explore the value of cereal-based oral contrast agents in improving the accuracy of PCLs during TAUS.MethodsThis is a prospective cohort study. Patients with PCL who were admitted to our center between January 2023 and January 2024 were enrolled, and TAUS was performed before and after taking cereal-based oral contrast agents. The imaging quality of the PCL was measured by structural visualization scores. The structural visualization scores of oral contrast agent-assisted ultrasound and non-contrast MRI were also compared.ResultsA total of 27 patients with PCLs were enrolled, and 30 PCLs were detected. The sonolucency of the PCL improved after oral contrast agent administration. Before taking the agent, only 30% of patients had satisfactory sonolucency; after taking the oral contrast agent, the corresponding proportion reached 80% (P=0.002). The structural visualization score of the PCL determined by oral contrast agent-assisted TAUS was higher than that determined without the aid of an agent [1 (0-6) vs. 1 (0-3), P=0.001], which was mainly reflected in the increase in the number of visible septa after taking the agent. No significant difference was detected between the structural visualization score of the PCL examined by oral contrast agent-assisted TAUS and that examined by non-contrast MRI and the correlation between the 2 types of scores were satisfactory [1 (0-6) vs. 2 (0-7), P=0.070, Spearman correlation factor r=0.880].ConclusionsThis study used a structured scoring system to confirm that cereal-based oral contrast agents could improve the ultrasound quality of PCLs, and the correlation between the quality of oral contrast agent-assisted ultrasound and non-contrast MRI findings on PCLs was satisfactory. Further research to improve visualization of PCLs on TAUS using oral contrast agents could result in TAUS being a potential alternative to MRI in the follow-up of PCLs in resource-limited situations.

Project description:BackgroundPatients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC.MethodsA literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.ResultsTwenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%-88%; I2 = 0.00%) and 95% (95% CI, 90%-97%; I2 = 63.44%), respectively; the overall +LR, -LR, and DOR values were 15.12 (95% CI, 7.61-30.01), 0.19 (95% CI, 0.13-0.29), and 78.91 (95% CI, 30.94-201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87-92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75-85%; I2 = 66.37%) and 94% (95% CI, 90-96%; I2 = 74.87%); the overall +LR, -LR, and DOR values were 12.91 (95% CI, 7.86-21.20), 0.21 (95% CI, 0.16-0.27), and 62.53 (95% CI, 34.45-113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90-0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42-3.83], P > 0.05).ConclusionsCEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.

Dataset Information

Comparative Diagnostic Evaluation with Contrast-Enhanced Ultrasound, Computed Tomography and Magnetic Resonance Imaging in Patients with Pancreatic Cystic Neoplasms.

Publications

Comparative Diagnostic Evaluation with Contrast-Enhanced Ultrasound, Computed Tomography and Magnetic Resonance Imaging in Patients with Pancreatic Cystic Neoplasms.

Similar Datasets

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