Takishin Yunosuke, Kuwatani Masaki, Nishida Mutsumi, Mitsuhashi Tomoko, Kishi Kazuma, Nagai Kosuke, Furukawa Ryutaro, Hirata Hajime, Hirata Koji, Kato Shin, Kawakubo Kazumichi, Sakamoto Naoya
Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan.
Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
J Gastroenterol Hepatol. 2023 Apr;38(4):656-663. doi: 10.1111/jgh.16143. Epub 2023 Feb 24.
Recently, dispersion imaging by shear wave elastography has been developed to visualize a tissue viscosity-related factor by measuring the dispersion slope. However, clinical significance of dispersion imaging in the field of pancreatic cancer is unknown. This study aimed to investigate the clinical significance of dispersion imaging in the treatment and diagnosis of pancreatic cancer.
We measured shear wave dispersion slope (SWD) (m/s/kHz) and shear wave elasticity (SWE) (kPa) in patients with pancreatic ductal adenocarcinoma (PDA). The primary endpoint was the relationship between the changes in SWD and SWE values before and after chemotherapy and the response to chemotherapy. Secondary endpoints included SWD and SWE values in relation to differences between PDA and non-PDA sites and histopathological scores of stroma, inflammation, fibrosis, and necrosis in endoscopic ultrasound-guided fine-needle aspiration specimens.
Fifty-six patients were included, 30 of whom underwent chemotherapy. There was no relationship between the changes of SWD and SWE values and chemotherapy responses. In 56 patients, the median SWD value was 12.20 m/s/kHz (interquartile range [IQR]: 10.88-13.61) at PDA sites and 13.57 m/s/kHz (IQR: 12.28-16.20) at non-PDA sites (P = 0.005). The median SWE value was 8.18 kPa (IQR: 7.00-9.74) at PDA sites and 6.14 kPa (IQR: 5.40-6.77) at non-PDA sites (P < 0.001). Histopathological evaluation revealed that inflammation scores were correlated with SWD values (r = 0.42, P < 0.001).
Dispersion imaging in pancreatic cancer would be useful for diagnosis and assessing inflammation.
最近，通过测量频散斜率来可视化组织黏度相关因子的剪切波弹性成像频散成像技术已经得到发展。然而，频散成像在胰腺癌领域的临床意义尚不清楚。本研究旨在探讨频散成像在胰腺癌治疗和诊断中的临床意义。
我们测量了胰腺导管腺癌（PDA）患者的剪切波频散斜率（SWD）（m/s/kHz）和剪切波弹性（SWE）（kPa）。主要终点是化疗前后SWD和SWE值的变化与化疗反应之间的关系。次要终点包括与PDA和非PDA部位差异相关的SWD和SWE值，以及内镜超声引导下细针穿刺标本中基质、炎症、纤维化和坏死的组织病理学评分。
纳入56例患者，其中30例接受了化疗。SWD和SWE值的变化与化疗反应之间没有关系。在56例患者中，PDA部位的SWD值中位数为12.20 m/s/kHz（四分位数间距[IQR]：10.88 - 13.61），非PDA部位为13.57 m/s/kHz（IQR：12.28 - 16.20）（P = 0.005）。PDA部位的SWE值中位数为8.18 kPa（IQR：7.00 - 9.74），非PDA部位为6.14 kPa（IQR：5.40 - 6.77）（P < 0.001）。组织病理学评估显示，炎症评分与SWD值相关（r = 0.42，P < 0.001）。
胰腺癌的频散成像在诊断和评估炎症方面可能有用。
