Distinguishing pancreatic cancer and autoimmune pancreatitis with in vivo tomoelastography
- PDF / 765,571 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 103 Downloads / 208 Views
HEPATOBILIARY-PANCREAS
Distinguishing pancreatic cancer and autoimmune pancreatitis with in vivo tomoelastography Liang Zhu 1 & Jing Guo 2 & Zhengyu Jin 1 & Huadan Xue 1 & Menghua Dai 3 & Wen Zhang 4 & Zhaoyong Sun 1 & Jia Xu 1 & Stephan R. Marticorena Garcia 2 & Patrick Asbach 2 & Bernd Hamm 2 & Ingolf Sack 2 Received: 13 May 2020 / Revised: 25 August 2020 / Accepted: 13 October 2020 # European Society of Radiology 2020
Abstract Objectives To prospectively investigate the stiffness and fluidity of pancreatic ductal adenocarcinoma (PDAC) and autoimmune pancreatitis (AIP) with tomoelastography, and to evaluate its diagnostic performance in distinguishing the two entities. Methods Tomoelastography provided high-resolution maps of shear wave speed (c in m/s) and phase angle (φ in rad), allowing mechanical characterization of the stiffness and fluidity properties of the pancreas. Forty patients with untreated PDAC and 33 patients with untreated AIP who underwent diagnostic pancreatic MRI at 3-T together with multifrequency MR elastography and tomoelastography data processing were prospectively enrolled. Ten healthy volunteers served as controls. Two radiologists and a technician measured pancreatic stiffness and fluidity independently. The two radiologists also independently evaluated the patients’ conventional MR sequences using the following diagnostic score: 1, definitely PDAC; 2, probably PDAC; 3, indeterminate; 4, probably AIP; and 5, definitely AIP. Interobserver agreement was assessed. Stiffness and fluidity of PDAC, AIP, and healthy pancreas, as well as diagnostic performance of tomoelastography and conventional MRI, were compared. Results AIP showed significantly lower stiffness and fluidity than PDAC and significantly higher stiffness and fluidity than healthy pancreas. Pancreatic fluidity was not influenced by secondary obstructive changes. The intraclass correlation coefficient for pancreatic stiffness and fluidity by the 3 readers was near-perfect (0.951–0.979, all p < 0.001). Both stiffness and fluidity allowed distinguishing PDAC from AIP. AUCs were 0.906 for stiffness, 0.872 for fluidity, and 0.842 for conventional MRI. Conclusions Pancreatic stiffness and fluidity both allow differentiation of PDAC and AIP with high accuracy. Key Points • AIP showed significantly lower stiffness and fluidity than PDAC and significantly higher stiffness and fluidity than healthy pancreas. • Both stiffness and fluidity allowed distinguishing PDAC from AIP. • Pancreatic fluidity could distinguish malignancy from non-malignant secondary obstructive changes. Keywords Pancreatic ductal adenocarcinoma . Autoimmune pancreatitis . MRI . Elastography
Liang Zhu and Jing Guo contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07420-5) contains supplementary material, which is available to authorized users. * Zhengyu Jin [email protected] 1
2
Department of Radiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universit
Data Loading...
