Evaluation of the pancreatic tumors by transabdominal Shear Wave Elastography: preliminary results of a pilot study

Zaro, Razvan; Dina, Liliana; Pojoga, Cristina; Vesa, Ștefan Cristian; Badea, Radu

doi:10.11152/mu-1492

Cited by 16 publications

(12 citation statements)

References 25 publications

(33 reference statements)

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“…Although the sensitivity was slightly lower, our findings are concordant with results from other authors who reported sensitivity rates of 42% up to 100% for localization and characterization of FPLs using endoscopic US or transabdominal US. 6,11,[12][13][14][15][16][17]27 We found intratumoral indurations of 3 m/s or 28.7 kPa to be reasonable cutoff values during intraoperative application, with a sensitivity rate of 74.4%, though the negative predictive value was only about 41%. These cutoffs can be interpreted as initial reference values for intraoperative pancreas tumor characterization and differential diagnosis using IoSWE, but the identification or confirmation of FPL malignancy was more accurate with IoCEUS.…”

Section: Discussionmentioning

confidence: 64%

“…Thereby, reproducible and quantifiable information about the FPLs' elasticity can be gained, which correlates with the benign or malignant nature of the lesion. 3,[11][12][13][14][15][16] Studies of recent literature proved this advantage of SWE, particularly for small FPLs. 14,17,18 Another important feature that helps distinguish malignant from benign FPLs is their microvascularization.…”

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confidence: 94%

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Intraoperative Characterization of Pancreatic Tumors Using Contrast‐Enhanced Ultrasound and Shear Wave Elastography for Optimization of Surgical Strategies

Silva

Engeßer

Hackl

et al. 2020

J of Ultrasound Medicine

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Objectives-To evaluate intraoperative contrast-enhanced ultrasound (IoCEUS) and intraoperative shear wave elastography (IoSWE) for characterization of focal pancreatic lesions (FPLs) in correlation with postoperative histologic results. Thereby, the impact of intraoperative ultrasound (US) on pancreas surgery was evaluated.Methods-Intraoperative CEUS and SWE data from 54 patients, who underwent pancreas surgery between 2017 and 2019, were analyzed retrospectively. Ultrasound examinations were performed with multifrequency linear/T-shaped transducers (3-9 MHz) on a high-end US device (LOGIQ E9; GE Healthcare, Chicago, IL). To analyze FPL stiffness by SWE, regions of interest were placed to measure the shear wave speed (meters per second) and stiffness (kilopascals). After intravenous bolus injections of 2.4 to 10 mL of sulfur hexafluoride microbubbles, a dynamic analysis of FPL microvascularization from arterial to late phases was performed using IoCEUS considering hypoenhancement/irregular vascularization of macrocystic/small solid FPL malignancy criteria. Ultrasound findings were correlated with postoperative histologic results. The impact of intraoperative US on surgery was documented in each case.Results-Of 54 FPLs, IoCEUS could correctly characterize 39 of 39 malignant and 6 of 15 benign FPLs; IoSWE 29 of 39 as malignant and 7 of 15 as benign. Intraoperative CEUS's sensitivity was 100%; specificity, 40%; accuracy, 83.3%; positive predictive value, 81.3%; and negative predictive value, 100% (P < .05). Applying cutoff values of 3 m/s and 28.7 kPa, SWE's sensitivity was 74.4%; specificity, 46.7%; accuracy, 66.7%; positive predictive value; 78.4%; and negative predictive value, 41.2% for cancer detection (P < .05). The combined use of both techniques showed an accuracy rate of 76%, sensitivity of 74.4%, and specificity of 33.3%. In 29.6%, US results had an immediate impact on surgery.Conclusions-Intraoperative SWE and CEUS are highly valuable techniques for intraoperative characterization of FPLs. Although IoCEUS proved to be superior to IoSWE, the combined use can be helpful in particular cases.

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Section: Discussionmentioning

confidence: 64%

mentioning

confidence: 94%

Intraoperative Characterization of Pancreatic Tumors Using Contrast‐Enhanced Ultrasound and Shear Wave Elastography for Optimization of Surgical Strategies

Silva

Engeßer

Hackl

et al. 2020

J of Ultrasound Medicine

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“…Kawada et al [8] reported the use of strain ratio to distinguish between malignancy and benignancy of pancreatic solid tumours. The evaluation of the pancreatic tumours by transabdominal shear wave elastography was reported by Zaro et al [25] in a pilot studied. The mean SWV Pancreatic Elastography DOI: http://dx.doi.org/10.5772/intechopen.89965 of the pathological parenchyma indicated an increase of the SWV at the tumoral (cephalic) level corresponding to 1.54 ± 0.32 m/s compared to 1.21 ± 0.27 m/s for normal pancreas in the control group.…”

Section: Benign Vs Malignant Mass Pancreatic Lesionsmentioning

confidence: 94%

Pancreatic Elastography

Ciobanu¹

2020

Ultrasound Elastography

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Pancreatic elastography represents a challenging new procedure for inflammatory pathology or tumour masses. There are technical difficulties for accurate assessment of pancreatic stiffness due to deep localization. But the new software for both conventional and endoscopic ultrasound are promising techniques for differential diagnosis between malignant tumours and different forms of chronic pancreatitis (groove pancreatitis or autoimmune pancreatitis). Early diagnosis of chronic pancreatitis, noninvasively by transabdominal shear wave elastography, is actively studied nowadays. Elastography might offer a predictive tool for the occurrence of pancreatic fistula after pancreatoduodenectomy. This chapter introduces the recent innovation of pancreatic elastography and makes recommendations for its use.

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“…Park et al showed that shear wave elastography can determine the relative stiffness between a lesion and the background pancreatic parenchyma, which is helpful in differentiating benign and malignant solid pancreatic lesions [17]. Zaro et al, also showed that shear wave elastography can indicate an increase of elasticity in the pancreatic tumor, compared to normal pancreas [18]. Although there are multiple challenges to be solved, such as operator dependency or inadequate reproducibility, elastography may contribute to early detection of pancreatic cancer in the future.…”

Section: Pancreatic Anatomy and Tips To Improve Visualization By Usmentioning

confidence: 99%

The Role of Transabdominal Ultrasound in the Diagnosis of Early Stage Pancreatic Cancer: Review and Single-Center Experience

et al. 2018

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Pancreatic cancer (PC) is the fourth leading cause of cancer-related death with a 5-year survival rate less than 10%. In the absence of effective screening methods, such as blood markers, most clinical diagnoses of PC are made at an advanced stage. However, early stage PC is associated with a more favorable five-year survival rate of 85.8% for stage 0, and 68.7% for stage IA. Transabdominal ultrasound (US) is frequently used as a first-line diagnostic tool in the clinical setting and a preferred modality for routine medical evaluations for asymptomatic individuals. Recently published Japanese data show that most PCs diagnosed in early stage had US findings, such as dilated main pancreatic ducts or pancreas cysts. For surveillance of high-risk individuals, such as those with an intraductal papillary mucinous neoplasm (IPMN), US is an ideal modality in terms of its non-invasive and cost-effective nature. However, the diagnostic performance of ultrasound varies greatly by the operator’s experience and the patient’s condition. This article reviews the present situation of early diagnosis of pancreatic cancer by US, along with tips for improving visualization of the pancreas.

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Evaluation of the pancreatic tumors by transabdominal Shear Wave Elastography: preliminary results of a pilot study

Abstract: Transabdominal SWE represents a surrogate but feasible method for differentiation cancer from the normal pancreatic tissue. In a clinical setting, data regarding the stiffness complementary to an ultrasound evaluation could guide high-risk patients for a close-up pancreatic monitoring.

Cited by 16 publications

References 25 publications

Intraoperative Characterization of Pancreatic Tumors Using Contrast‐Enhanced Ultrasound and Shear Wave Elastography for Optimization of Surgical Strategies

Intraoperative Characterization of Pancreatic Tumors Using Contrast‐Enhanced Ultrasound and Shear Wave Elastography for Optimization of Surgical Strategies

Pancreatic Elastography

The Role of Transabdominal Ultrasound in the Diagnosis of Early Stage Pancreatic Cancer: Review and Single-Center Experience

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