Detective flow imaging versus contrast-enhanced EUS in solid pancreatic lesions

Area of Science:

• Gastroenterology
• Medical Imaging
• Oncology

Background:

• Detective flow imaging EUS (DFI-EUS) is an advanced endoscopic ultrasound technology.
• It visualizes fine vessels and low-flow velocity in real-time without contrast agents.
• DFI-EUS offers superior resolution compared to conventional methods like color Doppler and eFLOW.

Purpose of the Study:

• To compare the efficacy of DFI-EUS with contrast-enhanced EUS (CE-EUS).
• To evaluate the assessment of vascularization in solid pancreatic lesions using both techniques.

Main Methods:

• A retrospective single-center study included 107 patients with pancreatic masses.
• Patients underwent both DFI-EUS and CE-EUS assessments.
• Histological diagnosis or a minimum 1-year follow-up confirmed lesion type.

Main Results:

• The study analyzed 107 patients, with 64.5% having pancreatic adenocarcinoma.
• Intralesional microvascularization incidence showed a strong correlation between DFI-EUS (43.9%) and CE-EUS (48.6%) (P = 0.0001).
• DFI-EUS demonstrated high sensitivity (88.5%), specificity (98.2%), PPV (97.9%), and NPV (90%) for detecting intralesional vessels compared to CE-EUS.

Conclusions:

• DFI-EUS shows a remarkable correlation with CE-EUS for evaluating microvascularization in solid pancreatic lesions.
• The technique exhibits high sensitivity and specificity.
• DFI-EUS eliminates the need for contrast agents, thereby avoiding associated risks.