Differential Diagnosis of Solid Pancreatic Lesions Using Detective Flow Imaging Endoscopic Ultrasonography

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2024 May 11

PMID 38732296

Authors

Haruo Miwa

Kazuya Sugimori

Shoichiro Yonei

Hayato Yoshimura

Kazuki Endo

Ritsuko Oishi

Akihiro Funaoka

Hiromi Tsuchiya

Takashi Kaneko

Kazushi Numata

Shin Maeda

Affiliations

Soon will be listed here.

Abstract

The differential diagnosis of solid pancreatic lesions (SPLs) using B-mode endoscopic ultrasonography (EUS) is challenging. Detective flow imaging (DFI) offers the potential for detecting low-flow vessels in the pancreas, thus enhancing diagnostic accuracy. This retrospective study aimed to investigate DFI-EUS findings of SPLs and analyze their differential diagnostic accuracy for pancreatic cancer. We included 104 patients with pathologically confirmed SPLs who underwent EUS between April 2021 and June 2023. Expert endosonographers, blinded to the patients' clinical data, evaluated images obtained through B-mode, eFLOW, and DFI-EUS. The frame rate and vessel detection sensitivity were compared between eFLOW and DFI, and the diagnostic criteria for pancreatic cancer were established. The visualization rate for vessels in SPLs was significantly higher with DFI-EUS (96%) compared to eFLOW (27%). Additionally, DFI showed a superior frame rate, sensitivity (99%), and accuracy (88%) for detecting pancreatic cancer, although with a modest specificity (43%). On DFI-EUS, characteristics such as hypovascularity, peritumoral vessel distribution, or spotty vessel form were suggestive of pancreatic cancer. DFI-EUS significantly improved the visualization of vascular structures within the SPLs, highlighting its efficacy as a diagnostic modality for pancreatic cancer.

Citing Articles

Diagnostic Accuracy of Detective Flow Imaging Endoscopic Ultrasonography for Evaluating Blood Flow Within Mural Nodules of Intraductal Papillary Mucinous Neoplasms.

Endo K, Miwa H, Sugimori K, Shibasaki K, Yonei S, Ishino Y Diagnostics (Basel). 2025; 15(2).

PMID: 39857080 PMC: 11765108. DOI: 10.3390/diagnostics15020196.

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