Mark Ramaekers, Catarina Dinis Fernandes, Xueting Li, Robert-Jan Schipper, Simona Turco, Ignace H J T de Hingh, Joost Nederend, Massimo Mischi, Misha D P Luyer
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引用次数: 0
Abstract
Objective: Early detection of pancreatic cancer is crucial for survival, but detecting smalllesions remains challenging. Intraductal Ultrasound (IDUS) using intracardiac echocardiography (ICE) catheters for B-mode and Shear-Wave Elastography (SWE) potentially offers improved visualization and characterization of small tumors. This study assesses the feasibility of IDUS using ICE catheters to detect and visualize periampullary tumors in surgically resected specimens.
Methods: In this two-phase ex-vivo feasibility study, 25 pancreatic specimens were included, of which the first 10 were used to establish and standardize the imaging protocol, followed by technical feasibility evaluation in the remaining 15 specimens. Catheters were introduced into the pancreatic duct, common bile duct, or positioned extraductally to enable tumor visualization with B-mode imaging and shear-wave elastography (SWE). Tumor visualization rates, catheter insertion success, SWE measurements in normal and tumor tissue, and image quality were assessed.
Results: ICE catheter insertion was successful in 12 of 15 specimens; unsuccessful access was primarily related to large tumor size (>4 cm) or unidentifiable ductal anatomy following surgical resection. However, extraluminal imaging successfully visualized tumors in one of these cases. Median shear-wave speed and elastic modulus for normal pancreatic parenchyma were 1.58 m/s and 7.6 kPa, respectively. SWE measurements in tumor tissue were suboptimal, likely due to ex-vivo tissue variability and catheter strain during repeated use.
Conclusion: IDUS with ICE is feasible for qualitative B-mode visualization of periampullary tumors and enables SWE assessment of pancreatic parenchyma in an ex-vivo setting. Reliable elastography of tumor tissue remained challenging, indicating the need for further technical refinement and in-vivo validation.
期刊介绍：
Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.
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