Citation: | GUI Yang, LYU Ke, LIANG Hua, CHEN Xueqi, JIA Wanying, CHEN Tianjiao, JIANG Yuxin. Accuracy of Contrast-Enhanced Ultrasound Diagnostic Reports for 859 Cases of Pancreatic Space-occupying Lesions[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 825-830. DOI: 10.12290/xhyxzz.2024-0204 |
To evaluate the accuracy of contrast-enhanced ultrasound diagnostic reports for pancreatic lesions.
In this retrospective study, we included patients who underwent contrast-enhanced ultrasound examination of pancreatic lesions at Peking Union Medical College Hospital from January 2017 to December 2022 and received a confirmed pathological diagnosis. Using pathological diagnosis as the gold standard, the study evaluated the accuracy of contrast-enhanced diagnostic ultrasound. It also analyzed the misdiagnosis of contrast-enhanced ultrasound in diagnosing various pathological types of pancreatic lesions.
Of the 859 patients who met inclusion and exclusion criteria, 489 were male(56.9%) and 370 were female(43.1%).Their age ranged from 16 to 85 years, with a median age of 60(53, 66) years. Except for 47 pancreatic space-occupying lesions that were difficult to categorize as either benign or malignant, a total of 812 cases were included in the diagnostic efficacy analysis of benign and malignant lesions. The results suggested that the diagnostic sensitivity and specificity of contrast-enhanced ultrasound for pancreatic malignant lesions were 98.3%(95% CI: 97.1%-99.1%) and 79.0%(95% CI: 70.1%-86.4%), AUC was 0.887(95% CI: 0.863-0.908), positive and negative predictive value were 96.9%(95% CI: 95.6%-97.9%) and 87.4%(95% CI: 79.6%-92.4%), positive and negative likelihood ratio were 4.69(95% CI: 3.24-6.80) and 0.02(95% CI: 0.01-0.04). The diagnostic accuracy rate of contrast-enhanced ultrasound for diagnosing benign and malignant pancreatic lesions was 95.8%. Of the 859 lesions examined, 48 cases were misdiagnosed by contrast-enhanced ultrasound, with a misdiagnosis rate of 5.6%(48/859), including 7 cases(0.8%) of undetermined diagnosis, while the diagnostic accuracy of pancreatic ductal adenocarcinoma was as high as 98.8%. No complications occurred in any of the patients.
Contrast-enhanced ultrasound is a safe and effective imaging method for evaluating microvascular perfusion in various pancreatic lesions. It has significant clinical value in diagnosing both benign and malignant pancreatic lesions, particularly in diagnosing pancreatic ductal adenocarcinoma.
[1] |
Martínez-Noguera A, D'Onofrio M. Ultrasonography of the pancreas. 1. Conventional imaging[J]. Abdom Imaging, 2007, 32(2): 136-149. DOI: 10.1007/s00261-006-9079-y
|
[2] |
Yamashita Y, Shimokawa T, Ashida R, et al. Value of low- mechanical-index contrast-enhanced transabdominal ultrasound for diagnosis of pancreatic cancer: a meta-analysis[J]. Ultrasound Med Biol, 2021, 47(12): 3315-3322. DOI: 10.1016/j.ultrasmedbio.2021.08.005
|
[3] |
Gupta P, Rana P, Marodia Y, et al. Contrast-enhanced ultrasound of solid pancreatic head lesions: a prospective study[J]. Eur Radiol, 2022, 32(10): 6668-6677. DOI: 10.1007/s00330-022-08854-9
|
[4] |
Sidhu P S, Cantisani V, Dietrich C F, et al. The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound(CEUS) in non-hepatic applications: update 2017(long version)[J]. Ultraschall Med, 2018, 39(2): e2-e44. DOI: 10.1055/a-0586-1107
|
[5] |
Italian Society for Ultrasound in Medicine and Biology(SIUMB) Study Group on Ultrasound Contrast Agents. The safety of Sonovue® in abdominal applications: retrospective analysis of 23188 investigations[J]. Ultrasound Med Biol, 2006, 32(9): 1369-1375. DOI: 10.1016/j.ultrasmedbio.2006.05.031
|
[6] |
Wang Y J, Li G H, Yan K, et al. Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions[J]. Eur Radiol, 2022, 32(3): 2060-2069. DOI: 10.1007/s00330-021-08243-8
|
[7] |
Park W, Chawla A, O'Reilly E M. Pancreatic cancer: a review[J]. JAMA, 2021, 326(9): 851-862. DOI: 10.1001/jama.2021.13027
|
[8] |
Zheng R S, Sun K X, Zhang S W, et al. Report of cancer epidemiology in China, 2015[J]. Chin J Oncol, 2019, 41(1): 19-28.
|
[9] |
Jia W Y, Gui Y, Chen X Q, et al. Evaluation of the diagnostic performance of the EFSUMB CEUS Pancreatic Applications guidelines(2017 version): a retrospective single-center analysis of 455 solid pancreatic masses[J]. Eur Radiol, 2022, 32(12): 8485-8496. DOI: 10.1007/s00330-022-08879-0
|
[10] |
Macinga P, Pulkertova A, Bajer L, et al. Simultaneous occurrence of autoimmune pancreatitis and pancreatic cancer in patients resected for focal pancreatic mass[J]. World J Gastroenterol, 2017, 23(12): 2185-2193. DOI: 10.3748/wjg.v23.i12.2185
|
[11] |
Chen L N, Orr C E, Wang T. Prevalence of histological features resembling autoimmune pancreatitis in neoplastic pancreas resections[J]. Histopathology, 2020, 77(4): 673-677. DOI: 10.1111/his.14197
|
[12] |
Gui Y, Dai M H, Meng Z L, et al. Value of contrast-enhanced ultrasound combined with percutaneous ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic lesions[J]. Chin Med J(Engl), 2021, 135(4): 426-432.
|
[13] |
Huang J Y, Yang J, Ding J M, et al. Development and validation of an ultrasound-based prediction model for differentiating between malignant and benign solid pancreatic lesions[J]. Eur Radiol, 2022, 32(12): 8296-8305. DOI: 10.1007/s00330-022-08930-0
|
[14] |
Falconi M, Bartsch D K, Eriksson B, et al. ENETS consensus guidelines for the management of patients with digestive neuroendocrine neoplasms of the digestive system: well-differentiated pancreatic non-functioning tumors[J]. Neuroendocrinology, 2012, 95(2): 120-134. DOI: 10.1159/000335587
|
[15] |
Zhou T T, Tan L, Gui Y, et al. Correlation between enhancement patterns on transabdominal ultrasound and survival for pancreatic ductal adenocarcinoma[J]. Cancer Manag Res, 2021, 13: 6823-6832. DOI: 10.2147/CMAR.S307079
|
[16] |
Jia W Y, Gui Y, Chen X Q, et al. Pancreatic ductal adenocarcinoma with synchronous and metachronous hepatic metastasis predicted by contrast-enhanced ultrasound[J]. Quant Imaging Med Surg, 2023, 13(6): 3902-3914. DOI: 10.21037/qims-22-1132
|
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