Abstract
Background and Aims: EUS elastography is useful in characterizing solid pancreatic lesions (SPLs), and fractal analysis–based technology has been used to evaluate geometric complexity in oncology. The aim of this study was to evaluate EUS elastography (strain ratio) and fractal analysis for the characterization of SPLs. Methods: Consecutive patients with SPLs were prospectively enrolled between December 2015 and February 2017. Elastographic evaluation included parenchymal strain ratio (pSR) and wall strain ratio (wSR) and was performed with a new compact US processor. Elastographic images were analyzed using a computer program to determine the 3-dimensional histogram fractal dimension. A composite cytology/histology/clinical reference standard was used to assess sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve. Results: Overall, 102 SPLs from 100 patients were studied. At final diagnosis, 69 (68%) were malignant and 33 benign. At elastography, both pSR and wSR appeared to be significantly higher in malignant as compared with benign SPLs (pSR, 24.5 vs 6.4 [P <.001]; wSR, 56.6 vs 15.3 [P <.001]). When the best cut-off levels of pSR and wSR at 9.10 and 16.2, respectively, were used, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve were 88.4%, 78.8%, 89.7%, 76.9%, and 86.7% and 91.3%, 69.7%, 86.5%, 80%, and 85.7%, respectively. Fractal analysis showed a significant statistical difference (P =.0087) between the mean surface fractal dimension of malignant lesions (D = 2.66 ±.01) versus neuroendocrine tumor (D = 2.73 ±.03) and a statistical difference for all 3 channels red, green, and blue (P <.0001). Conclusions: EUS elastography with pSR and fractal-based analysis are useful in characterizing SPLs. (Clinical trial registration number: NCT02855151.)
| Original language | English |
|---|---|
| Pages (from-to) | 1464-1473 |
| Number of pages | 10 |
| Journal | Gastrointestinal Endoscopy |
| Volume | 87 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 1 2018 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Gastroenterology
Cite this
EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions. / Carrara, Silvia; Di Leo, Milena; Grizzi, Fabio; Correale, Loredana; Rahal, Daoud; Anderloni, Andrea; Auriemma, Francesco; Fugazza, Alessandro; Preatoni, Paoletta; Maselli, Roberta; Hassan, Cesare; Finati, Elena; Mangiavillano, Benedetto; Repici, Alessandro.
In: Gastrointestinal Endoscopy, Vol. 87, No. 6, 01.06.2018, p. 1464-1473.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions
AU - Carrara, Silvia
AU - Di Leo, Milena
AU - Grizzi, Fabio
AU - Correale, Loredana
AU - Rahal, Daoud
AU - Anderloni, Andrea
AU - Auriemma, Francesco
AU - Fugazza, Alessandro
AU - Preatoni, Paoletta
AU - Maselli, Roberta
AU - Hassan, Cesare
AU - Finati, Elena
AU - Mangiavillano, Benedetto
AU - Repici, Alessandro
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background and Aims: EUS elastography is useful in characterizing solid pancreatic lesions (SPLs), and fractal analysis–based technology has been used to evaluate geometric complexity in oncology. The aim of this study was to evaluate EUS elastography (strain ratio) and fractal analysis for the characterization of SPLs. Methods: Consecutive patients with SPLs were prospectively enrolled between December 2015 and February 2017. Elastographic evaluation included parenchymal strain ratio (pSR) and wall strain ratio (wSR) and was performed with a new compact US processor. Elastographic images were analyzed using a computer program to determine the 3-dimensional histogram fractal dimension. A composite cytology/histology/clinical reference standard was used to assess sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve. Results: Overall, 102 SPLs from 100 patients were studied. At final diagnosis, 69 (68%) were malignant and 33 benign. At elastography, both pSR and wSR appeared to be significantly higher in malignant as compared with benign SPLs (pSR, 24.5 vs 6.4 [P <.001]; wSR, 56.6 vs 15.3 [P <.001]). When the best cut-off levels of pSR and wSR at 9.10 and 16.2, respectively, were used, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve were 88.4%, 78.8%, 89.7%, 76.9%, and 86.7% and 91.3%, 69.7%, 86.5%, 80%, and 85.7%, respectively. Fractal analysis showed a significant statistical difference (P =.0087) between the mean surface fractal dimension of malignant lesions (D = 2.66 ±.01) versus neuroendocrine tumor (D = 2.73 ±.03) and a statistical difference for all 3 channels red, green, and blue (P <.0001). Conclusions: EUS elastography with pSR and fractal-based analysis are useful in characterizing SPLs. (Clinical trial registration number: NCT02855151.)
AB - Background and Aims: EUS elastography is useful in characterizing solid pancreatic lesions (SPLs), and fractal analysis–based technology has been used to evaluate geometric complexity in oncology. The aim of this study was to evaluate EUS elastography (strain ratio) and fractal analysis for the characterization of SPLs. Methods: Consecutive patients with SPLs were prospectively enrolled between December 2015 and February 2017. Elastographic evaluation included parenchymal strain ratio (pSR) and wall strain ratio (wSR) and was performed with a new compact US processor. Elastographic images were analyzed using a computer program to determine the 3-dimensional histogram fractal dimension. A composite cytology/histology/clinical reference standard was used to assess sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve. Results: Overall, 102 SPLs from 100 patients were studied. At final diagnosis, 69 (68%) were malignant and 33 benign. At elastography, both pSR and wSR appeared to be significantly higher in malignant as compared with benign SPLs (pSR, 24.5 vs 6.4 [P <.001]; wSR, 56.6 vs 15.3 [P <.001]). When the best cut-off levels of pSR and wSR at 9.10 and 16.2, respectively, were used, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve were 88.4%, 78.8%, 89.7%, 76.9%, and 86.7% and 91.3%, 69.7%, 86.5%, 80%, and 85.7%, respectively. Fractal analysis showed a significant statistical difference (P =.0087) between the mean surface fractal dimension of malignant lesions (D = 2.66 ±.01) versus neuroendocrine tumor (D = 2.73 ±.03) and a statistical difference for all 3 channels red, green, and blue (P <.0001). Conclusions: EUS elastography with pSR and fractal-based analysis are useful in characterizing SPLs. (Clinical trial registration number: NCT02855151.)
UR - http://www.scopus.com/inward/record.url?scp=85042315907&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042315907&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2017.12.031
DO - 10.1016/j.gie.2017.12.031
M3 - Article
C2 - 29329992
AN - SCOPUS:85042315907
VL - 87
SP - 1464
EP - 1473
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 6
ER -