| セッション情報 |
International Session3(消化器内視鏡学会・消化器病学会合同)
IgG4-related disease and endoscopy
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| タイトル |
内IS3-7：Quantitative analysis of contrast-enhanced EUS for differentiating focal AIP from pancreatic cancer
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| 演者 |
M. Fukasawa（First Department of Internal Medicine, University of Yamanashi） |
| 共同演者 |
S. Takano（First Department of Internal Medicine, University of Yamanashi）, N. Enomoto（First Department of Internal Medicine, University of Yamanashi） |
| 抄録 |
Background: Despite recent advances in diagnostic modalities, differentiation of focal autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC) remains a challenge and has major therapeutic consequences. This study was aimed to evaluate the value of software-aided quantitative analysis of contrast-enhanced EUS (CH-EUS) for differentiating focal AIP from PDAC. Methods: Consecutive patients with focal AIP (n=24) and PDAC (n=74) were examined using CH-EUS. Time-intensity curves (TIC) were obtained in 2 regions of interest: within the lesion and within normal pancreatic tissue. The following parameters were obtained by TIC: baseline intensity, peak intensity, intensity at 60 s, and time-to-peak. Absolute values and the ratio of the lesion to normal tissue were evaluated. Results: The mean size of focal AIP and PDAC were 22.5±7.6mm and 26.2±11mm, respectively. The peak ratio (lesion/normal tissue) was significantly lower in PDAC compared to focal AIP (42±6% vs. 96±6%). With peak ratio range from 85-115% defined as 'iso-peak' intensity, most cases of PDAC demonstrated a hypo-peak ratio, while focal AIP presented iso-peak ratio. The sensitivity and specificity of peak ratio for detecting focal AIP were 92% and 95%, respectively (area under the receiver operating curve, 0.921). Time-dependent parameters did not significantly differ across pancreatic diseases. Conclusions: Quantitative analysis of CH-EUS substantiates subjective visual assessments, establishing the peak intensity ratio as a statistically reliable objective criterion to facilitate differential diagnosis between focal AIP and PDAC. |
| 索引用語 |
contrast-enhanced endoscopic ultrasonography, quantitative analysis |
