Ultrasound Time-Harmonic Elastography of the Pancreas: Reference Values and Clinical Feasibility
Burkhardt C, Tzschaetzsch H, Schmuck R, Bahra M, Juergensen C, Pelzer U, Hamm B, Braun J, Sack I, Garcia SRM (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 55
Pages Range: 270-276
Journal Issue: 5
DOI: 10.1097/RLI.0000000000000638
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a very aggressive tumor with a very low 5-year survival rate of 8%. The aims of this study are to determine reference values and physiologic confounders in healthy pancreas and to assess the diagnostic accuracy of ultrasound time-harmonic elastography (THE) in the detection of PDAC. Materials and Methods From March 2017 through May 2019, a total of 54 study participants with healthy pancreas (n = 33, CTR) or PDAC (n = 21) were prospectively enrolled. Repeatability of THE was tested in a CTR subgroup (n = 5) undergoing repeat measurement on 4 different days. Interobserver variability was analyzed in 10 healthy volunteers. Age-matched and sex-matched subgroups of CTR (n = 13) and PDAC (n = 13) were compared. In participants with histopathologically proven PDAC, measurements were performed separately in tumorous (PDAC-T) and nontumorous pancreatic tissue (PDAC-NT). Diagnostic performance of pancreatic THE was assessed by receiver operating characteristic curve analysis. Results Time-harmonic elastography was highly repeatable (intraclass correlation coefficient, 0.99), and interobserver agreement was excellent (intraclass correlation coefficient, 0.97). Shear wave speed (SWS) of PDAC-T (mean [95% confidence interval] in meters per second, 1.88 ± 0.07 [1.84-1.92]) was higher than SWS of CTR (1.63 ± 0.04 [1.60-1.66], P < 0.001) and PDAC-NT (1.59 ± 0.03 [1.57-1.61], P < 0.001). The exploratory diagnostic performance of THE in separating PDAC-T was excellent (area under the receiver operating characteristic curve, 1.0). Tumorous pancreatic ductal adenocarcinoma was distinguished from CTR and PDAC-NT with cutoff values of 1.73 m/s and 1.70 m/s, respectively. Conclusions Pancreatic ultrasound THE has high repeatability and provides excellent imaging contrast based on SWS, allowing detection of PDAC without overlap to nontumorous pancreatic tissue.
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Germany (DE)How to cite
APA:
Burkhardt, C., Tzschaetzsch, H., Schmuck, R., Bahra, M., Juergensen, C., Pelzer, U.,... Garcia, S.R.M. (2020). Ultrasound Time-Harmonic Elastography of the Pancreas: Reference Values and Clinical Feasibility. Investigative Radiology, 55(5), 270-276. https://doi.org/10.1097/RLI.0000000000000638
MLA:
Burkhardt, Christian, et al. "Ultrasound Time-Harmonic Elastography of the Pancreas: Reference Values and Clinical Feasibility." Investigative Radiology 55.5 (2020): 270-276.
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