scholarly journals Differential Diagnostics Focal Pancreatics Masses Based on the Analysis of the Echographic Texture of Endosonograms Using Fuzzy Mathematical Models

2021 ◽  
Vol 4 (3) ◽  
pp. 64-73
Author(s):  
V. A. Belozerov ◽  
O. I. Ohotnikov ◽  
N. A. Korenevskij ◽  
S. N. Grigorev
Keyword(s):  
Differential Diagnosis ◽  
Mathematical Models ◽  
Hybrid Model ◽  
Endoscopic Ultrasonography ◽  
Statistical Tests ◽  
Decision Rules ◽  
Ductal Adenocarcinoma ◽  
Differential Diagnostics ◽  
Pancreatic Masses ◽  
Adenocarcinoma Of The Pancreas

Relevance: Differential diagnosis of focal formations of the pancreas is particularly difficult due to the similarity of their echosemiotics. One of the ways to objectify and improve the accuracy of ultrasound data is to use artificial intelligence methods to interpret images.Purpose: Improving the quality of diagnosis of focal pancreatic pathology according to endoscopic ultrasonography based on the analysis of the echographic texture using fuzzy mathematical models.Material and methods: In the Kursk Regional Clinical Hospital, endoscopic ultrasonography was performed in 272 patients for pancreaticobiliary diseases. The endoscopic video system of the company Olympus EVIS EXERA II with the ultrasonic processor EU-ME1 was used. Solid tumors of the pancreas were detected in 109 (40.1 %) patients, focal pancreatic masses were diagnosed in 40 (14.7 %) patients. Based on the research results, the main types of reference endosonograms corresponding to differentiable pathology were identified. On the basis of endosonograms, using hybrid fuzzy mathematical decision rul, a fuzzy hybrid model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas was obtained.Results: The selected source of information and the method of synthesis of hybrid fuzzy decision rules made it possible to obtain a fuzzy hybrid model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas. Based on the results of mathematical modeling and statistical tests on representative control samples, it was shown that the resulting model of differential diagnosis, using reference endosonograms reflecting the echographic texture of focal pancreatic masses, provides confidence in the desired diagnosis at the level of 0.6. The additional information used in the analysis of endosonograms increases the diagnostic confidence to a value of 0.9.Conclusions: The resulting model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas provides confidence in decision-making no worse than 0.9, which is an acceptable quality indicator in clinical practice in conditions of insufficient statistics with poorly formalized data structure. 

DIFFERENTIAL DIAGNOSIS OF PANCREATIC PATHOLOGY ACCORDING TO ENDOSCOPIC ULTRASONOGRAPHY BASED ON FUZZY MATHEMATICAL MODELS

2021 ◽  
pp. 102-110
Author(s):  
Владимир Анатольевич Белозеров ◽  
Николай Алексеевич Кореневский
Keyword(s):  
Differential Diagnosis ◽  
Mathematical Models ◽  
Endoscopic Ultrasonography ◽  
Statistical Tests ◽  
Ductal Adenocarcinoma ◽  
Pancreatic Tumors ◽  
Ultrasound Diagnostics ◽  
Adenocarcinoma Of The Pancreas ◽  
Pancreatic Pathology

Эндоскопическая ультрасонография, являясь высокоинформативным и уточняющим методом диагностики патологии поджелудочной железы остается в значительной мере субъективным и операторзависимым исследованием. Целью работы явилось повышение качества дифференциальной диагностики очаговой патологии поджелудочной железы на основе анализа эталонных эндосонограмм за счет использования гибридных нечетких математических моделей, при синтезе которых формальные процедуры строятся с использованием клинического опыта высококвалифицированных специалистов ультразвуковой диагностики. В отделении эндоскопии Курской областной клинической больницы эндоскопическая ультрасонография выполнена у 729 пациентов. Опухоли поджелудочной железы выявлены у 139 (19,1%) пациентов, различные формы хронического панкреатита диагностированы у 141 (19,3%) больного. По результатам исследований выделены 6 типов эталонных эндосонограмм, соответствующих дифференцируемой патологии, на основании которых, с использованием гибридных нечетких математических решающих правил, разработанных в Юго-Западном государственном университете, получена нечеткая гибридная модель дифференциальной диагностики хронического очагового панкреатита и протоковой аденокарциномы поджелудочной железы. По результатам математического моделирования и статистических испытаний на репрезентативных контрольных выборках было показано, что полученная модель дифференциальной диагностики, использующая только эталонные эндосонограммы, обеспечивает уверенность в искомом диагнозе на уровне 0,6. Дополнительная информация, получаемая при анализе эндосонограмм, повышает диагностическую уверенность до величины 0,9. Таким образом, полученная модель дифференциальной диагностики хронического очагового панкреатита и протоковой аденокарциномы поджелудочной железы обеспечивает приемлемое для клинической практики качество принимаемых решений Endoscopic ultrasonography is a highly informative and clarifying method for diagnosing pancreatic pathology. At the same time, it remains to a large extent subjective and operator-dependent research. The aim of this work is to improve the quality of differential diagnosis of focal pancreatic pathology based on the analysis of reference endosonograms through the use of hybrid fuzzy mathematical models. When synthesizing these models, formal procedures are built using the clinical experience of highly qualified specialists in ultrasound diagnostics. In the endoscopy department of the Kursk Regional Clinical Hospital, endoscopic ultrasonography was performed in 729 patients. Pancreatic tumors were detected in 139 (19.1%) patients, various forms of chronic pancreatitis were diagnosed in 141 (19.3%) patients. Based on the research results, 6 types of reference endosonograms corresponding to differentiable pathology were identified. On the basis of endosonograms, using hybrid fuzzy mathematical decision rules developed at Southwestern State University, a fuzzy hybrid model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas was obtained. Based on the results of mathematical modeling and statistical tests on representative control samples, it was shown that the resulting model of differential diagnosis, using only reference endosonograms, provides confidence in the desired diagnosis at the level of 0.6. Additional information obtained from the analysis of endosonograms increases the diagnostic confidence to a value of 0.9. Thus, the model obtained for the differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas provides an acceptable quality of decisions for clinical practice

scholarly journals Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Sibin Mei ◽  
Mengyu Wang ◽  
Leimin Sun
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasonography ◽  
Odds Ratio ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Contrast Enhanced ◽  
Pancreatic Masses ◽  
Sensitivity Specificity

Background. Though methods for the diagnosis of pancreatic masses are various, such as ultrasonography (US), computed tomography (CT), endoscopic ultrasonography (EUS), and contrast-enhanced computed tomography (CE-CT), their sensitivity, specificity, and accuracy are not quite satisfying. Contrast-enhanced endoscopic ultrasonography (CE-EUS), as a new technique, has its own unique advantages in diagnosing pancreatic disease. However, its sensitivity, specificity, and accuracy are still controversial. Objective. To evaluate the accuracy of CE-EUS for differential diagnosis between benign and malignant pancreatic mass lesions. Design. Eighteen relevant articles systemically searched from PubMed, Web of Science, Ovid, Scopus, and MEDLINE were selected. The pooled results were calculated in a fixed effects model. Main Outcome Measurement. The pooled sensitivity, specificity, positive likelihood ratio (LR), negative likelihood ratio, diagnostic odds ratio (OR), and summary receiver operating characteristic (SROC) curve. Results. The pooled sensitivity, specificity, and diagnostic odds ratio of CE-EUS for the differential diagnosis of pancreatic adenocarcinomas were 0.91 (95% confidence interval (CI), 0.89-0.93), 0.86 (95% CI, 0.83-0.89), and 69.50 (95% CI, 48.89-98.80), respectively. The SROC area under the curve was 0.9545. The subgroup analysis based on excluding the outliers showed that the heterogeneity was eliminated and the pooled sensitivity and specificity were 0.92 (95% CI, 0.90-0.93) and 0.87 (95% CI, 0.84-0.89), respectively. The SROC area under the curve was 0.9569. Conclusion. CE-EUS is a useful method to distinguish pancreatic adenocarcinoma from other pancreatic diseases. Compared with EUS elastography, it has higher specificity. However, it is still not superior to pathological diagnosis for the identification of pancreatic carcinomas.

Ultrasonic differential diagnostics of cyst and cystic tumors of the spleen

2020 ◽  
Vol 24 (3) ◽  
pp. 63-75
Author(s):  
Yu. A. Stepanova ◽  
M. Z. Alimurzaeva ◽  
D. A. Ionkin
Keyword(s):  
Differential Diagnosis ◽  
Cancer Metastasis ◽  
Malignant Tumors ◽  
Dynamic Control ◽  
Differential Diagnostics ◽  
Epithelial Lining ◽  
Focal Lesions ◽  
Morphological Form ◽  
Cystic Tumors ◽  
Number Of Patients

The incidence of focal lesions in the spleen is 3.2–4.2% per 100,000 population. Spleen cysts are rare (incidence 0.75 per 100,000). These are single or multiple, thin- and smooth-walled cavities filled with a transparent liquid. Distinguish between primary (or true) cysts, lined with epithelium, and secondary (or false), devoid of epithelial lining. Among the primary cysts, there are congenital cysts formed in the embryonic period due to the migration of peritoneal cells into the spleen tissue, dermoid and epidermoid cysts. A special group of primary cysts are parasitic cysts. Cystic tumors of the spleen include lymphangioma and lymphoma.The main difficulties in the diagnosis and differential diagnosis of cysts and cystic tumors of the spleen are associated with the rarity of this pathology and, as a consequence, a small number of works, including a significant number of the cases. However, in those works where a large number of the cases are described, most often this is one morphological form and an analysis of its various characteristics.Purpose. Based on the analysis of our own examination data of a significant number of patients with cysts and cystic tumors of the spleen, to assess the possibility of differential diagnosis of individual morphological forms according to ultrasound data.Materials and methods. 323 patients with cysts and cystic tumors of the spleen from 15 to 77 years old (men – 105 (32.5%); women – 218 (67.5%) were treated at A.V. Vishnevsky National Medical Research Center of Surgery for the period from 1980 to 2020. All patients underwent ultrasound during examination. Surgical treatment was carried out in various ways – (85.1%), when making a preoperative diagnosis of an uncomplicated spleen cyst of small size, dynamic observation was carried out (verification by puncture biopsy data).Results. Morphological verification of cysts and cystic tumors of the spleen was presented as follows (taking into account possible difficulties in identifying the epithelial lining): true cyst – 182 (56.4%); dermoid cyst – 3 (0.9%) (malignant – in 1 case); pseudocyst – 16 (5.0%); pancreatogenic – 34 (10.5%); echinococcus – 52 (16.1%); lymphangioma – 24 (7.4%); lymphoma – 10 (3.1%); ovarian cancer metastasis – 2 (0.6%). The article describes the ultrasound signs of the above forms of the lesions with an emphasis on the complexity of diagnosis.Conclusions. Primary and parasitic spleen cysts are well differentiated according to ultrasound; false cysts of the spleen, depending on the cause of their occurrence, can create difficulties in their identification and differentiation (they require careful dynamic control); cystic tumors of the spleen should be differentiated from malignant tumors and metastases of a cystic structure, as a result of which such vigilance should always be present when they are detected.

scholarly journals CT Simplified Radiomic Approach to Assess the Metastatic Ductal Adenocarcinoma of the Pancreas

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1843
Author(s):  
Mirko D’Onofrio ◽  
Riccardo De Robertis ◽  
Gregorio Aluffi ◽  
Camilla Cadore ◽  
Alessandro Beleù ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Ductal Adenocarcinoma ◽  
Newly Diagnosed ◽  
Inclusion Criteria ◽  
Permeability Index ◽  
Metastatic Tumors ◽  
Qualitative And Quantitative ◽  
Portal Phase ◽  
Phase Images ◽  
Adenocarcinoma Of The Pancreas

The aim of this study was to perform a simplified radiomic analysis of pancreatic ductal adenocarcinoma based on qualitative and quantitative tumor features and to compare the results between metastatic and non-metastatic patients. A search of our radiological, surgical, and pathological databases identified 1218 patients with a newly diagnosed pancreatic ductal adenocarcinoma who were referred to our Institution between January 2014 and December 2018. Computed Tomography (CT) examinations were reviewed analyzing qualitative and quantitative features. Two hundred eighty-eight patients fulfilled the inclusion criteria and were included in this study. Overall, metastases were present at diagnosis in 86/288 patients, while no metastases were identified in 202/288 patients. Ill-defined margins and a hypodense appearance on portal-phase images were significantly more common among patients with metastases compared to non-metastatic patients (p < 0.05). Metastatic tumors showed a significantly larger size and significantly lower arterial index, perfusion index, and permeability index compared to non-metastatic tumors (p < 0.05). In the management of pancreatic ductal adenocarcinoma, early detection and correct staging are key elements. The study of computerized tomography characteristics of pancreatic ductal adenocarcinoma showed substantial differences, both qualitative and quantitative, between metastatic and non-metastatic disease.

Clinical Usefulness of Endoscopic Ultrasonography in the Differential Diagnosis of Gallbladder Wall Thickening

2011 ◽  
Vol 57 (2) ◽  
pp. 508-515 ◽  
Author(s):  
Hong Joo Kim ◽  
Jung Ho Park ◽  
Dong Il Park ◽  
Yong Kyun Cho ◽  
Chong Il Sohn ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Endoscopic Ultrasonography ◽  
Gallbladder Wall ◽  
Clinical Usefulness ◽  
Wall Thickening ◽  
Gallbladder Wall Thickening

T1916 Differentiation, Origin and Mesothelial Adhesive Potential Affect Growth and Metastasis of Ductal Adenocarcinoma of the Pancreas

2008 ◽  
Vol 134 (4) ◽  
pp. A-895
Author(s):  
Soeren Torge Mees ◽  
Christina Schleicher ◽  
Mario Colombo-Benkmann ◽  
Norbert Senninger ◽  
Joerg Haier
Keyword(s):  
Ductal Adenocarcinoma ◽  
Adenocarcinoma Of The Pancreas
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