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Purpose <p>To explore the value of ultrasound (US) and contrast-enhanced ultrasound (CEUS) in differentiating mass-forming Pancreatitis (MFP) and pancreatic ductal adenocarcinoma (PDAC).</p> Methods <p>This retrospective study analyzed clinical and imaging data from 281 patients who underwent pancreatic CEUS between January 2018 and December 2023. Patients were randomly divided into training (<i>n</i> = 196) and validation (<i>n</i> = 85) sets. Logistic regression analyses were conducted to identify independent predictive imaging features for differentiating PDAC from MFP in the training set. Based on the identified predictors, two nomogram models were constructed: the US model and the US + CEUS model. The diagnostic performance of both models was assessed via the area under the receiver operating characteristic curve (AUC), calibration plots, <i>Hosmer-Lemeshow</i> test, and decision-curve analysis (DCA).</p> Results <p>Multivariate logistic regression analysis based on these factors identified taller-than-wide shape (<i>P</i> = 0.002, <i>OR</i> = 0.12), calcification (<i>P</i> = 0.003, <i>OR</i> = 13.76), and washout pattern (<i>P</i> = 0.002, <i>OR</i> = 0.13) as independent predictive factors for distinguishing PDAC from MFP. Compared to the US model, the US + CEUS model demonstrated better performance with AUC values 0.930 (95% <i>CI</i>: 0.895–0.965) in the training set and 0.914 (95% <i>CI</i>: 0.853–0.976) in the validation set. Calibration curve plots and the <i>Hosmer-Lemeshow</i> test (<i>P</i> &gt; 0.05) confirmed that the model has good calibration, and DAC showed significant clinical benefit.</p> Conclusion <p>The nomogram model constructed using taller-than-wide shape, calcification, and washout pattern demonstrated excellent discriminative ability, accuracy, and clinical utility in differentiating PDAC from MFP.</p>

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Development and validation of a nomogram model based on ultrasound and contrast-enhanced ultrasound features for differentiating mass-forming pancreatitis and pancreatic ductal adenocarcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月31日

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  • Hua Liang,
  • Yang Gui,
  • Xueqi Chen,
  • Tianjiao Chen,
  • Jing Zhang,
  • Li Tan,
  • Wanying Jia,
  • Menghua Dai,
  • Weibin Wang,
  • Junchao Guo,
  • Qiang Xu,
  • Ke Lv,
  • Yuxing Jiang

摘要

Purpose

To explore the value of ultrasound (US) and contrast-enhanced ultrasound (CEUS) in differentiating mass-forming Pancreatitis (MFP) and pancreatic ductal adenocarcinoma (PDAC).

Methods

This retrospective study analyzed clinical and imaging data from 281 patients who underwent pancreatic CEUS between January 2018 and December 2023. Patients were randomly divided into training (n = 196) and validation (n = 85) sets. Logistic regression analyses were conducted to identify independent predictive imaging features for differentiating PDAC from MFP in the training set. Based on the identified predictors, two nomogram models were constructed: the US model and the US + CEUS model. The diagnostic performance of both models was assessed via the area under the receiver operating characteristic curve (AUC), calibration plots, Hosmer-Lemeshow test, and decision-curve analysis (DCA).

Results

Multivariate logistic regression analysis based on these factors identified taller-than-wide shape (P = 0.002, OR = 0.12), calcification (P = 0.003, OR = 13.76), and washout pattern (P = 0.002, OR = 0.13) as independent predictive factors for distinguishing PDAC from MFP. Compared to the US model, the US + CEUS model demonstrated better performance with AUC values 0.930 (95% CI: 0.895–0.965) in the training set and 0.914 (95% CI: 0.853–0.976) in the validation set. Calibration curve plots and the Hosmer-Lemeshow test (P > 0.05) confirmed that the model has good calibration, and DAC showed significant clinical benefit.

Conclusion

The nomogram model constructed using taller-than-wide shape, calcification, and washout pattern demonstrated excellent discriminative ability, accuracy, and clinical utility in differentiating PDAC from MFP.