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Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions

  • Ultrasound
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) enhancement patterns for differentiating solid pancreatic lesions and compare them with conventional ultrasound (US) and enhanced computed tomography (CT).

Methods

A total of 210 patients with solid pancreatic lesions who had definite pathological or clinical diagnoses were enrolled. Six CEUS enhancement patterns were proposed for solid pancreatic lesions. Two US doctors blindly observed the CEUS patterns of solid pancreatic lesions and the interrater agreement was analyzed. The diagnostic value of CEUS enhancement patterns for differentiating solid pancreatic lesions was evaluated, and the diagnostic accuracy was compared with that of US and enhanced CT.

Results

There was good concordance for six CEUS enhancement patterns of solid pancreatic lesions between the two doctors, with a kappa value of 0.767. Hypo-enhancement (Hypo-E) or centripetal enhancement (Centri-E) as the diagnostic criteria for pancreatic carcinoma had an accuracy of 87.62%; hyper-enhancement (Hyper-E) for neuroendocrine tumors had an accuracy of 92.89%; capsular enhancement with low or uneven enhancement inside the tumor (Capsular-E) for solid pseudopapillary tumors had an accuracy of 97.63%; and iso-enhancement (Iso-E) or iso-enhancement with focal hypo-enhancement (Iso-fhypo-E) for focal pancreatitis had an accuracy of 89.10%. The diagnostic accuracy of CEUS was significantly different from that of US for 210 cases of solid pancreatic lesions (p < 0.05) and was not significantly different from that of enhanced CT for 146 cases of solid pancreatic lesions (p > 0.05).

Conclusions

The different enhancement patterns of solid pancreatic lesions on CEUS were clinically valuable for differentiation.

Key Points

• Six CEUS enhancement (E) patterns, including Hyper-E, Iso-E, Iso-fhypo-E, Hypo-E, Centri-E, and Capsular-E, are proposed for the characterization of solid pancreatic lesions.

• Using Hypo-E or Centri-E as the diagnostic criteria for pancreatic carcinoma, Hyper-E for neuroendocrine tumors, Capsular-E for solid pseudopapillary tumors, and Iso-E or Iso-fhypo-E for focal pancreatitis on CEUS had relatively high diagnostic accuracy.

• The diagnostic accuracy of CEUS was greatly increased over that of US and was not different from that of enhanced CT.

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Abbreviations

Capsular-E:

Capsular enhancement with heterogeneous or low enhancement inside

Centri-E:

Centripetal enhancement

Hyper-E:

Hyper-enhancement

Hypo-E:

Hypo-enhancement

Iso-E:

Iso-enhancement

Iso-fhypo-E:

Iso-enhancement with focal hypo-enhancement

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Funding

This study was sponsored by National Key Research and Development Plan (No. 2017YFC0107300 and No. 2017YFC0107303).

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Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, China

    Yanjie Wang, Guanghan Li, Kun Yan, Zhihui Fan, Ying Dai & Wei Wu

  2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China

    Rong Long & Jun Shan

Authors
  1. Yanjie Wang
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  2. Guanghan Li
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  3. Kun Yan
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  4. Zhihui Fan
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  5. Rong Long
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  6. Jun Shan
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  7. Ying Dai
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  8. Wei Wu
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Corresponding author

Correspondence to Kun Yan.

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Guarantor

The scientific guarantor of this publication is Kun Yan.

Conflict of interest

The authors declare no competing interests.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

This study analyzed the data in an anonymous manner.

Ethical approval

Ethical approval and informed consent were obtained from institutional review board.

Study subjects or cohorts overlap

This study enrolled 10 years of cases. Among all the enrolled cases, one hundred eleven cases were enrolled in previous paper in our canter. The title of the previous study was “Clinical Value of Contrast-Enhanced Ultrasound Enhancement Patterns for Differentiating Focal Pancreatitis from Pancreatic Carcinoma.” The previous study was about the differentiation between pancreatic carcinoma and focal pancreatitis. This study based on previous studies and experiences and summarized six types of enhancement patterns for four types of solid pancreatic lesions, which was completely different from the previous study.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Yanjie Wang and Guanghan Li contributed equally to this article.

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Cite this article

Wang, Y., Li, G., Yan, K. et al. Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions. Eur Radiol 32, 2060–2069 (2022). https://doi.org/10.1007/s00330-021-08243-8

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  • DOI: https://doi.org/10.1007/s00330-021-08243-8

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