Distinguishing pancreatic cancer and autoimmune pancreatitis with in vivo tomoelastography.
Autoimmune pancreatitis
Elastography
MRI
Pancreatic ductal adenocarcinoma
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
13
05
2020
accepted:
13
10
2020
revised:
25
08
2020
pubmed:
31
10
2020
medline:
16
4
2021
entrez:
30
10
2020
Statut:
ppublish
Résumé
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. 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. 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. Pancreatic stiffness and fluidity both allow differentiation of PDAC and AIP with high accuracy. • 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.
Identifiants
pubmed: 33125553
doi: 10.1007/s00330-020-07420-5
pii: 10.1007/s00330-020-07420-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3366-3374Subventions
Organisme : National Natural Science Foundation of China
ID : 81901716
Organisme : National Natural Science Foundation of China
ID : 81871512
Organisme : National Public Welfare, Basic Scientific Research Program of Chinese Academy of Medical Sciences
ID : 2019PT32008
Organisme : German Research Foundation
ID : SFB1340
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