Abstract
Background: To investigate the efficacy of two-dimensional shear wave elastography (2D-SWE) for the diagnosis of pancreatic mass lesions. Methods: This ethics committee–approved cross-sectional study included 52 patients with histologically-proven pancreatic tumors (pancreatic ductal adenocarcinoma (PDAC), 36; tumor-forming pancreatitis (TFP), 15; neuroendocrine tumor, 1) and 33 control subjects. The 2D-SWE was performed for the tumor/non-tumor tissues, and SWE-mapping patterns and propagation quality were assessed. Results: Three mapping patterns were detected based on the size and distribution of the coloring areas. Pattern A (whole coloring) was detected in all non-tumor tissues and TFP, whereas pattern C (multiple small coloring spots) was detected in PDAC only. Pattern B (partial coloring with smaller spots) was detected in other lesions. The specificity and positive predictive value of pattern A for non-PDAC and those of pattern C for PDAC were 100%. The SWE value was higher in tumor lesions than in the non-tumor tissues (38.1 vs. 9.8 kPa; p < 0.001) in patients with PDAC. The SWE value in the non-tumor lesion was higher in patients with PDAC than in control (9.8 vs. 7.5 kPa; p < 0.001). Conclusions: 2D-SWE may play a role as a novel diagnostic tool for PDAC to detect a specific mapping pattern with quantitative assessment.
Highlights
The global incidence of pancreatic ductal adenocarcinoma (PDAC) is increasing by about 1% annually [1]
This study aimed to investigate the specific findings on percutaneous 2D-Shear wave elastography (SWE) mapping images for the histologically proven PDAC as well as to provide the actual diagnostic performance
In-/out-patients with pancreatic tumor lesions and those scheduled for surgical procedure or fine needle biopsy (FNA) for histological examination or out-patients with focal pancreatic lesions that have already been confirmed histologically as benign by a past Endoscopic ultrasonography (EUS)-guided FNA (EUS-FNA); and ii. patients without any abdominal surgical history
Summary
The global incidence of pancreatic ductal adenocarcinoma (PDAC) is increasing by about 1% annually [1]. Methods: This ethics committee–approved cross-sectional study included 52 patients with histologically-proven pancreatic tumors (pancreatic ductal adenocarcinoma (PDAC), 36; tumor-forming pancreatitis (TFP), 15; neuroendocrine tumor, 1) and 33 control subjects. The 2D-SWE was performed for the tumor/non-tumor tissues, and SWEmapping patterns and propagation quality were assessed. Pattern A (whole coloring) was detected in all non-tumor tissues and TFP, whereas pattern C (multiple small coloring spots) was detected in PDAC only. The SWE value was higher in tumor lesions than in the non-tumor tissues (38.1 vs 9.8 kPa; p < 0.001) in patients with PDAC. The SWE value in the non-tumor lesion was higher in patients with PDAC than in control (9.8 vs 7.5 kPa; p < 0.001). Conclusions: 2D-SWE may play a role as a novel diagnostic tool for PDAC to detect a specific mapping pattern with quantitative assessment
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