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Role of contrast-enhanced ultrasound with time-intensity curve analysis for differentiating hypovascular solid pancreatic lesions

  • Ultrasound
  • Published:
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Abstract

Objectives

To evaluate the clinical value of contrast-enhanced ultrasound (CEUS) with time-intensity curve (TIC) in distinguishing different types of hypovascular solid pancreatic lesions.

Methods

A total of 89 patients with 90 pancreatic lesions (all confirmed by surgery or biopsy pathology) that manifested hypoenhancement on contrast-enhanced ultrasound (CEUS) were included in this study. Six peak enhancement patterns were proposed for differentiating hypovascular pancreatic lesions. CEUS qualitative and TIC-based quantitative parameters were analyzed, and each lesion was scored based on the statistically significant qualitative parameters to evaluate the diagnostic ability of CEUS for hypovascular solid pancreatic lesions.

Results

Qualitative parameters such as peak enhancement pattern II/III/IV, penetrating vessels, centripetal enhancement, and early washout were reliable indicators of malignant lesions, and lesions scored based on these qualitative parameters, with a score ≥ 2, were highly suspected to be malignant lesions. Pattern I had an accuracy of 83.33% for predicting mass-forming pancreatitis (MFP), pattern V had an accuracy of 96.67% for predicting solid pseudopapillary tumors of the pancreas (SPTP), and pattern VI had an accuracy of 81.11% for predicting neuroendocrine tumors/carcinomas (NETs/NECs). For quantitative analysis, nodule/pancreatic parenchyma echo intensity reduction ratio was significantly greater in malignant lesions.

Conclusions

CEUS qualitative and TIC-based quantitative parameters have clinical value in distinguishing malignant from benign hypovascular pancreatic lesions.

Key Points

• Contrast-enhanced ultrasound helps clinicians assess patients with pancreatic lesions.

• Six peak enhancement patterns are proposed for differentiating pancreatic hypovascular lesions.

• Qualitative parameters such as peak enhancement pattern II/III/IV, penetrating vessels, centripetal enhancement, early washout, and quantitative parameter nodule/pancreatic parenchyma echo intensity reduction ratio were important characteristics to discriminate malignant from hypovascular benign lesions.

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Data Availability

The datasets analyzed in this study are available from the corresponding author on reasonable request.

Abbreviations

ACC:

Acinic cell carcinoma

ASCA:

Adenosquamous carcinoma

Met:

Metastasis

MFP:

Mass-forming pancreatitis

NEC:

Neuroendocrine carcinoma

NET:

Neuroendocrine tumor

PDAC:

Pancreatic ductal adenocarcinoma

SPTP:

Solid pseudopapillary tumors of the pancreas

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Ultrasound Medical Center, Lanzhou University Second Hospital, Chengguan District, Cuiyingmen No.82, Lanzhou, 730030, China

    Lan Wang, Fang Nie, Tiantian Dong, Ming Li, Yuanyuan Li & Ci Yin

  2. Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China

    Lan Wang, Fang Nie, Tiantian Dong, Ming Li, Yuanyuan Li & Ci Yin

Authors
  1. Lan Wang
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  2. Fang Nie
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  3. Tiantian Dong
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  4. Ming Li
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  5. Yuanyuan Li
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  6. Ci Yin
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Correspondence to Fang Nie.

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The scientific guarantor of this publication is Fang Nie.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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Wang, L., Nie, F., Dong, T. et al. Role of contrast-enhanced ultrasound with time-intensity curve analysis for differentiating hypovascular solid pancreatic lesions. Eur Radiol 33, 4885–4894 (2023). https://doi.org/10.1007/s00330-023-09393-7

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  • DOI: https://doi.org/10.1007/s00330-023-09393-7

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