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Background: The role of EUS with contrast agents can be expanded through the use of time-intensity curve (TIC) analysis and computer-aided interpretation.

Objective: To validate the use of parameters derived from TIC analysis in an artificial neural network (ANN) classification model designed to diagnose pancreatic carcinoma (PC) and chronic pancreatitis (CP).

Setting: Prospective, multicenter, observational trial-endoscopy units from Romania, Denmark, Germany, and Spain.

Patients: A total of 167 consecutive patients with PC or CP.

Interventions: Contrast-enhanced harmonic EUS (CEH-EUS) and EUS-guided FNA (EUS-FNA), TIC analysis, and ANN processing.

Main Outcome Measurements: Sensitivity, specificity, positive and negative predictive values (PPV, NPV) for EUS-FNA, CEH-EUS, and the ANN.

Results: After excluding all of the recordings that did not meet the technical and procedural criteria, 112 cases of PC and 55 cases of CP were included. EUS-FNA was performed in 129 patients, and the diagnosis was confirmed by surgery (n = 15) or follow-up (n = 23) in the remaining cases. Its sensitivity and specificity were 84.82% and 100%, respectively, whereas the PPV and NPV were 100% and 76.63%, respectively. The sensitivity of real-time quantitative assessment of CEH-EUS was 87.5%, specificity 92.72%, PPV 96.07%, and NPV 78.46%. Peak enhancement, wash-in area under the curve, wash-in rate, and the wash-in perfusion index were significantly different between the groups. No significant differences were found between rise time, mean transit time, and time to peak. For the ANN, sensitivity was 94.64%, specificity 94.44%, PPV 97.24%, and NPV 89.47%.

Limitations: Only PC and CP lesions were included.

Conclusion: Parameters obtained through TIC analysis can differentiate between PC and CP cases and can be used in an automated computer-aided diagnostic system with good diagnostic results. (

Clinical Trial Registration Number: NCT01315548.).

Titel:	Quantitative contrast-enhanced harmonic EUS in differential diagnosis of focal pancreatic masses (with videos).
Autor/in / Beteiligte Person:	Săftoiu, A ; Vilmann, P ; Dietrich, CF ; Iglesias-Garcia, J ; Hocke, M ; Seicean, A ; Ignee, A ; Hassan, H ; Streba, CT ; Ioncică, AM ; Gheonea, DI ; Ciurea, T
Zeitschrift:	Gastrointestinal endoscopy, Jg. 82 (2015-07-01), Heft 1, S. 59-69
Veröffentlichung:	St Louis, Mo : Mosby Yearbook ; <i>Original Publication</i>: Denver., 2015
Medientyp:	academicJournal
ISSN:	1097-6779 (electronic)
DOI:	10.1016/j.gie.2014.11.040
Schlagwort:	Adenocarcinoma pathology Adult Aged Aged, 80 and over Contrast Media Diagnosis, Differential Endoscopic Ultrasound-Guided Fine Needle Aspiration Female Follow-Up Studies Humans Male Middle Aged Neural Networks, Computer Pancreatic Neoplasms pathology Pancreatitis, Chronic pathology Prospective Studies Sensitivity and Specificity Adenocarcinoma diagnostic imaging Diagnosis, Computer-Assisted methods Endosonography methods Pancreatic Neoplasms diagnostic imaging Pancreatitis, Chronic diagnostic imaging
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't; Video-Audio Media Language: English [Gastrointest Endosc] 2015 Jul; Vol. 82 (1), pp. 59-69. <i>Date of Electronic Publication: </i>2015 Mar 16. MeSH Terms: Adenocarcinoma / diagnostic imaging ; Diagnosis, Computer-Assisted / methods ; Endosonography / methods ; Pancreatic Neoplasms / diagnostic imaging ; Pancreatitis, Chronic / *diagnostic imaging ; Adenocarcinoma / pathology ; Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Diagnosis, Differential ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neural Networks, Computer ; Pancreatic Neoplasms / pathology ; Pancreatitis, Chronic / pathology ; Prospective Studies ; Sensitivity and Specificity Molecular Sequence: ClinicalTrials.gov NCT01315548 Substance Nomenclature: 0 (Contrast Media) Entry Date(s): Date Created: 20150321 Date Completed: 20160304 Latest Revision: 20191210 Update Code: 20231215

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Quantitative contrast-enhanced harmonic EUS in differential diagnosis of focal pancreatic masses (with videos).