Evaluation of vascular signal in pancreatic ductal carcinoma using contrast enhanced ultrasonography: effect of systemic chemotherapy

The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications

“…Lesion size and margins as well as the relationship with peripancreatic vessels are better visualised with CEUS than with conventional US [25,26]. CEUS can demonstrate changes in pancreatic tumour vascularisation during chemotherapy [31,32] raising a hope for future use in clinical practice.…”

Improved characterisation of solitary solid pancreatic tumours using contrast enhanced transabdominal ultrasound

“…Therefore, a method with high sensitivity and speciWcity for tumour diVerentiation is necessary since its diVerentiation is essential for adequate therapy and optimum prognosis. The vascular pattern of pancreatic tumours has been recently examined in patients with cystic and solid tumours using the earlier second harmonic imaging and other contrast enhancing techniques with promising but also contradictory results (Koito et al 1997(Koito et al , 2001Oshikawa et al 2002;Rickes et al 2003Rickes et al , 2004Rickes et al , 2006D'Onofrio et al 2004D'Onofrio et al , 2005aD'Onofrio et al , 2006Numata et al 2005;Ohshima et al 2004;Kobayashi et al 2005;Masaki et al 2005;Itoh et al 2005;Nagase et al 2003;Hirooka et al 1998;Kitano et al 2004;Sofuni et al 2005). The use of more sophisticated CEUS techniques for the diVerential diagnosis of pancreatic tumours was used in few patients as part of a study but examination in a larger group of patients determining the clinical impact has not been reported to date (D'Onofrio et al 2005b).…”

Combined contrast-enhanced power Doppler and real-time sonoelastography performed during EUS, used in the differential diagnosis of focal pancreatic masses (with videos)

“…However, contrast-enhanced US has been suggested for the follow-up of the vascular signals during chemotherapy or antiangiogenic therapy. [35][36][37] Use of contrast-enhanced techniques might thus prove more useful for the follow-up of the patients during treatment compared with simple diagnostic purposes, especially when specific microbubble contrast agents in harmonic imaging modes are used during EUS. 38 Contrast-enhanced harmonic EUS might overcome some of the artifacts asso- ciated with CEPD such as blooming artifacts and variability with Doppler gain.…”