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Zhang Y, Yao J, Liu F, Cheng Z, Qi E, Han Z, Yu J, Dou J, Liang P, Tan S, Dong X, Li X, Sun Y, Wang S, Wang Z, Yu X. Radiomics Based on Contrast-Enhanced Ultrasound Images for Diagnosis of Pancreatic Serous Cystadenoma. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2469-2475. [PMID: 37749013 DOI: 10.1016/j.ultrasmedbio.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/23/2023] [Accepted: 08/08/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE The purpose of the study was to develop and validate a radiomics model by using contrast-enhanced ultrasound (CEUS) data for pre-operative differential diagnosis of pancreatic cystic neoplasms (PCNs), especially pancreatic serous cystadenoma (SCA). METHODS Patients with pathologically confirmed PCNs who underwent CEUS examination at Chinese PLA hospital from May 2015 to August 2022 were retrospectively collected. Radiomic features were extracted from the regions of interest, which were obtained based on CEUS images. A support vector machine algorithm was used to construct a radiomics model. Moreover, based on the CEUS image features, the CEUS and the combined models were constructed using logistic regression. The performance and clinical utility of the optimal model were evaluated by area under the receiver operating characteristic curve (AUC), sensitivity, specificity and decision curve analysis. RESULTS A total of 113 patients were randomly split into the training (n = 79) and test cohorts (n = 34). These patients were pathologically diagnosed with SCA, mucinous cystadenoma, intraductal papillary mucinous neoplasm and solid-pseudopapillary tumor. The radiomics model achieved an AUC of 0.875 and 0.862 in the training and test cohorts, respectively. The sensitivity and specificity of the radiomics model were 81.5% and 86.5% in the training cohort and 81.8% and 91.3% in the test cohort, respectively, which were higher than or comparable with that of the CEUS model and the combined model. CONCLUSION The radiomics model based on CEUS images had a favorable differential diagnostic performance in distinguishing SCA from other PCNs, which may be beneficial for the exploration of personalized management strategies.
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Affiliation(s)
- Yiqiong Zhang
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China; Chinese PLA Medical School, Beijing, China
| | - Jundong Yao
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China; Department of Ultrasound, First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, Fifth Medical Centre, Chinese PLA Hospital, Beijing, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, Fifth Medical Centre, Chinese PLA Hospital, Beijing, China
| | - Erpeng Qi
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, Fifth Medical Centre, Chinese PLA Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Centre, Chinese PLA Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, Fifth Medical Centre, Chinese PLA Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Centre, Chinese PLA Hospital, Beijing, China
| | - Shuilian Tan
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Xuejuan Dong
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Xin Li
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Ya Sun
- Department of Ultrasound, Aerospace Center Hospital, Beijing, China
| | - Shuo Wang
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China; Chinese PLA Medical School, Beijing, China
| | - Zhen Wang
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China; Chinese PLA Medical School, Beijing, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, First Medical Centre, Chinese PLA General Hospital, Beijing, China.
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Jia WY, Gui Y, Chen XQ, Zhang XQ, Zhang JH, Dai MH, Guo JC, Chang XY, Tan L, Bai CM, Cheng YJ, Li JC, Lv K, Jiang YX. Evaluation of the diagnostic performance of the EFSUMB CEUS Pancreatic Applications guidelines (2017 version): a retrospective single-center analysis of 455 solid pancreatic masses. Eur Radiol 2022; 32:8485-8496. [PMID: 35699767 DOI: 10.1007/s00330-022-08879-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/15/2022] [Accepted: 05/12/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To explore the diagnostic performance of EFSUMB CEUS Pancreatic Applications guidelines (version 2017) before and after the addition of iso-enhancement and very fast/fast washout as supplementary diagnostic criteria for PDAC. METHODS In this retrospective study, patients diagnosed with solid pancreatic lesions from January 2017 to December 2020 were evaluated. Pancreatic ductal adenocarcinoma (PDAC) is reported to show hypo-enhancement in all phases according to the EFSUMB guidelines. First, based on this definition, all lesions were categorized as PDAC and non-PDAC. Then, iso-enhancement and very fast/fast washout were added as supplementary diagnostic criteria, and all lesions were recategorized. The diagnostic performance was assessed in terms of the accuracy (ACC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), and negative predictive value (NPV). The reference standard consisted of histologic evaluation or composite imaging and clinical follow-up findings. RESULTS A total of 455 nodules in 450 patients (median age, 58.37 years; 250 men) were included. The diagnostic performance using the EFSUMB CEUS guidelines for PDAC had an ACC of 69.5%, SEN of 65.4%, SPE of 84%, PPV of 93.5%, NPV of 40.6%, and ROC of 0.747. After recategorization according to the supplementary diagnostic criteria, the diagnostic performance for PDAC had an ACC of 95.8%, SEN of 99.2%, SPE of 84%, PPV of 95.7%, NPV of 96.6%, and ROC of 0.916. CONCLUSION The EFSUMB guidelines and recommendations for pancreatic lesions can effectively identify PDAC via hypo-enhancement on CEUS. However, the diagnostic performance may be further improved by the reclassification of PDAC lesions after adding iso-enhancement and very fast/fast washout mode. KEY POINTS • In the EFSUMB guidelines, the only diagnostic criterion for PDAC is hypo-enhancement, to which iso-enhancement and very fast/fast washout mode were added in our research. • Using hypo-enhancement/iso-enhancement with very fast/fast washout patterns as the diagnostic criteria for PDAC for solid pancreatic masses on CEUS has high diagnostic accuracy. • The blood supply pattern of PDAC can provide important information, and CEUS has unique advantages in this respect due to its real-time dynamic attenuation ability.
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Affiliation(s)
- Wan-Ying Jia
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yang Gui
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xue-Qi Chen
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xiao-Qian Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jia-Hui Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Meng-Hua Dai
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jun-Chao Guo
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xiao-Yan Chang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Li Tan
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Chun-Mei Bai
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yue-Juan Cheng
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jian-Chu Li
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Ke Lv
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Yu-Xin Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
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