Abstract
Background: The differentiation of focal pancreatitis and pancreatic adenocarcinoma is problematic
and often resolved only by pancreaticoduodenectomy. EUS is the most sensitive imaging
modality for both conditions, yet ultrasonic criteria for distinguishing the two have
not been described and differentiation remains difficult. The aims of this study were
to develop a self-learning computer program that can analyze EUS images and differentiate
malignancy from pancreatitis, and to compare results obtained with this system with
EUS interpretation by experienced endosonographers. Methods: Twenty-one patients with pancreatic cancer and 14 with focal pancreatitis were included.
The diagnosis was confirmed histologically in all cases and each patient had undergone
EUS. A single EUS image from each procedure was used for computer analysis. The results
were compared with the EUS diagnosis reported at the actual procedure as well that
of an endosonographer who reviewed videotapes of the procedures. Results: The software program differentiated focal pancreatitis from malignancy with a maximal
89% accuracy. With sensitivity set at 100% for malignancy, the program was 50% specific
and accuracy was 80%. Sensitivity and accuracy of the endosonographer's impression
at the time of EUS were, respectively, 89% and 85%. A sensitivity of 73% and accuracy
of 83% were achieved with blinded interpretation of EUS videotapes. Conclusions: Analysis of EUS images with computer software programs is feasible and compares favorably
with human interpretation. The application of this technology to EUS and other imaging
scenarios could be a useful adjunct to diagnostic endoscopy and warrants further investigation.
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Article info
Publication history
Accepted:
July 13,
2001
Received in revised form:
April 2,
2001
Received:
February 1,
2001
Footnotes
☆Dr. Norton is supported by an ASGE/ADHF Fellowship in Advanced Endoscopy.
☆☆Reprint requests: Ian D. Norton, Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, 200 1st St., Rochester, MN 55905.
Identification
Copyright
© 2001 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
