AI Article Synopsis
- EUS-nCLE is effective for diagnosing pancreatic cystic lesions (PCLs), showing high interobserver agreement (κ = 0.82) and intra-observer reliability.
- The accuracy for differentiating mucinous from non-mucinous PCLs is 94.8%, with excellent performance in identifying specific subtypes like serous cystadenoma and cystic neuroendocrine tumors.
- Overall, EUS-nCLE demonstrates a reliable and accurate approach for diagnosing PCLs via a "virtual biopsy" method.
Article Abstract
Background: Although emerging data evidences that EUS-guided needle-based confocal laser endomicroscopy (nCLE) accurately diagnoses pancreatic cystic lesions (PCLs), there are a lack of interobserver agreement (IOA) studies utilizing reference histopathological diagnosis and for specific PCL subtypes. Hence, we sought to assess the IOA, intra-observer reliability (IOR), and diagnostic performance of EUS-nCLE using a large cohort of patients with histopathological diagnosis amongst a broad panel of international observers.
Methods: EUS-nCLE videos (n = 76) of subjects with PCLs [intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystadenoma (SCA), pseudocyst, and cystic-neuroendocrine tumors/solid pseudopapillary neoplasm (cystic-NET/SPN)], simulating clinical prevalence rates were obtained from 3 prospective studies. An international panel of 13 endosonographers with nCLE experience, blinded to all PCL data, evaluated the video library twice with a two-week washout for PCL differentiation (mucinous vs. non-mucinous) and subtype diagnosis.
Results: The IOA (κ = 0.82, 95% CI 0.77-0.87) and IOR (κ = 0.82, 95% CI 0.78-0.85) were "almost perfect" to differentiate mucinous vs. non-mucinous PCLs. For PCL subtype, IOA was highest for SCA (almost perfect; κ = 0.85), followed by IPMN (substantial, κ = 0.72), and cystic-NET/SPN (substantial, κ = 0.73). The IOA was moderate for MCN (κ = 0.47), and pseudocyst (κ = 0.57). Compared to histopathology, observers differentiated mucinous vs. non-mucinous PCLs with high accuracy (94.8%, 95% CI 93.3-96.1). For detecting specific PCLs subtypes, EUS-nCLE was highly accurate in diagnosing non-mucinous cysts (SCA: 98%; cystic-NET/SPN: 96%; pseudocyst: 96%) and slightly less accurate for mucinous lesions (IPMN: 86%; MCN: 84%).
Conclusion: Diagnosis of PCLs by EUS-nCLE guided virtual biopsy is very accurate and reliable for the most prevalent pancreatic cysts in clinical practice.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548449 | PMC |
| http://dx.doi.org/10.1016/j.pan.2022.08.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Application and progress of non-invasive imaging in predicting lung invasive non-mucinous adenocarcinoma under the new IASLC grading guidelines.
Insights Imaging
January 2025
Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou Key Laboratory of Molecular Imaging, Changzhou, China.
Lung cancer is the leading cause of cancer-related deaths worldwide, with invasive non-mucinous adenocarcinoma (INMA) being the most common type and carrying a poor prognosis. In 2020, the International Association for the Study of Lung Cancer (IASLC) pathology committee proposed a new histological grading system, which offers more precise prognostic assessments by combining the proportions of major and high-grade histological patterns. Accurate identification of lung INMA grading is crucial for clinical diagnosis, treatment planning, and prognosis evaluation.
View Article and Find Full Text PDFLong-term effects of neoadjuvant chemotherapy in variant histology locally advanced colon cancer: a propensity score-matched analysis.
Cancer Biol Ther
December 2025
Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin, China.
Purpose: Neoadjuvant chemotherapy (NAC) has proven valuable in treating locally advanced colon cancer (LACC) and is included as a treatment option for patients with clinical T4b colon cancer by the National Comprehensive Cancer Network. However, the long-term survival benefit of NAC in LACC remains debated, due to a lack of conclusive clinical trial results identifying the patients who would benefit most from NAC. This study aimed to assess the efficacy of NAC in patients with LACC based on histological subtype.
View Article and Find Full Text PDFCT Radiomic Nomogram Using Optimal Volume of Interest for Preoperatively Predicting Invasive Mucinous Adenocarcinomas in Patients with Incidental Pulmonary Nodules: A Multicenter, Large-Scale Study.
Technol Cancer Res Treat
December 2024
Department of Thoracic Surgery, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, P. R. China.
Introduction: This study evaluated the efficacy of radiomic analysis with optimal volumes of interest (VOIs) on computed tomography images to preoperatively differentiate invasive mucinous adenocarcinoma (IMA) from non-mucinous adenocarcinoma (non-IMA) in patients with incidental pulmonary nodules (IPNs).
Methods: This multicenter, large-scale retrospective study included 1383 patients with IPNs, 110 (8%) of whom were pathologically diagnosed with IMA postoperatively. Radiomic features were extracted from multi-scale VOI subgroups (VOI, VOI, VOI , and VOI ).
Thermal Liquid Biopsy: A Promising Tool for the Differential Diagnosis of Pancreatic Cystic Lesions and Malignancy Detection.
Cancers (Basel)
November 2024
Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain.
Pancreatic cystic lesions (PCLs) are a heterogeneous group of lesions with increasing incidence, usually identified incidentally on imaging studies (multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), or endoscopic ultrasound (EUS)) [...
View Article and Find Full Text PDFPhase II trial of dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors SWOG/NCI experience: invasive mucinous or non-mucinous lepidic adenocarcinoma of the lung (formerly bronchioloalveolar carcinoma).
Ther Adv Med Oncol
November 2024
Medical College of Wisconsin, MCW Cancer Center/Administrative Office, 9200 West Wisconsin Avenue, Suite C5300, Milwaukee, WI 53226, USA.
Background: Anti-programmed death-1 (PD-1)/cytotoxic T lymphocyte antigen-4 antibodies are efficacious in various malignancies.
Objectives: This study presents the first results of ipilimumab-nivolumab in invasive mucinous or non-mucinous lepidic adenocarcinoma (invasive mucinous adenocarcinoma (IMA) or invasive non-mucinous lepidic adenocarcinomas (INLA), respectively) of the lung.
Design: Dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors (DART) is a prospective, open-label, multicenter (1016 US sites), multi-cohort phase II trial of ipilimumab (1 mg/kg intravenously (IV) every 6 weeks) plus nivolumab (240 mg IV every 2 weeks).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!