Aims Contrast-enhanced EUS (CE-EUS) is a helpful tool for the diagnosis of pancreatic
focal lesions, as pancreatic cancer (PC) and pancreatic neuroendocrine tumor (pNEN).
Contrast enhancement is usually assessed qualitatively by the endosonographer. Dedicated
software has been developed to obtain an unbiased quantitative assessment using perfusion
parameters. We evaluated quantitatively the enhancement of pNENs and PC at CE-EUS.
Methods Seventy-three patients (51 PC and 22 pNEN cytologically diagnosed), who underwent
CE-EUS in our hospital were consecutively included. Quantitative analysis of tumor
vascularization was performed with a commercially available software (Vuebox, Bracco).
Time-intensity-curve (TIC) were created and several parameters were evaluated including
the average contrast signal intensity (MeanLin), peak enhancement (PE), time to peak
(TTP), mean transit time (mTT), Wash-in Area Under the Curve (WiAUC), Wash-in Perfusion
Index (WiPI), Wash-out Area Under the Curve (WoAUC).Univariate and multivariate analyses
with patient- and tumor-level variables were conducted
Results Univariate analysis showed that several TIC parameters could significantly distinguish
pNENs from PCs (sensitivity/specificity WiAUC 81.8/75.5%, PE 72.7/92.2%, WiPI 72.7/92.2%).
At univariate analysis mTT was associated with the diameter of the pNEN (p<0.001).
Even if not statistically significant, a trend for an association between TIC and
pNEN aggressiveness was observed
Conclusions Quantitative enhancement evaluation in CE-EUS for pNEN could accurately predict the
diagnosis of pNEN respect to PC
