title: Differentiation of Pancreatic Cyst Types by Analysis of Rheological Behavior of Pancreatic Cyst Fluid.
abstract: Differentiation between mucinous and non-mucinous pancreatic cysts is exceedingly important and challenging, particularly as the former bears malignant transformation potential. Pancreatic cyst fluid (PCF)-based diagnostics, including analyses of biochemical markers, as well as cytology, has shown inadequate accuracy. Herein, a preliminary single-center study of 22 PCF samples, collected by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), assessed the rheological behavior of PCF and its correlation with lesion type. The dependence of PCF shear viscosity on shear rate was found to follow a power law and could be fitted using Ostwald-de Waele model. Three types of flow curves were identified, where two types correlated with non-mucinous cysts, differing by their power law exponent, and the third type corresponding to mucinous cysts. Viscosity measured at a high shear rate was shown to serve as an accurate and independent marker distinguishing between mucinous and non-mucinous cysts, with an optimal cutoff value of ηc= 1.3 cP The accuracy of this novel technique proved superior to string-sign, cytology, carcinoembryonic antigen, and amylase assessments. Moreover, the combined predictive value of ηcand patient age provided for sensitivity and specificity of 100% and 95.5%, respectively. This simple and rapid diagnostic tool can be immediately implemented after EUS-FNA sampling.
authors.affiliation: Department of Gastroenterology, Bruce Rappaport Sch Med, Technion IIT, Haifa 32000, Israel.|Gastroenterology department, Rambam Health Care Campus, Haifa 31096, Israel.
authors.forename: Iyad
authors.initials: I
authors.lastname: Khamaysi
authors.affiliation: NanoEngineering Group, Faculty of Mechanical Engineering, Technion - IIT, Haifa 32000, Israel.
authors.forename: Aiman
authors.initials: A
authors.lastname: Abu Ammar
authors.affiliation: NanoEngineering Group, Faculty of Mechanical Engineering, Technion - IIT, Haifa 32000, Israel.
authors.forename: Gleb
authors.initials: G
authors.lastname: Vasilyev
authors.affiliation: NanoEngineering Group, Faculty of Mechanical Engineering, Technion - IIT, Haifa 32000, Israel.
authors.forename: Arkadii
authors.initials: A
authors.lastname: Arinstein
authors.affiliation: Department of Gastroenterology, Bruce Rappaport Sch Med, Technion IIT, Haifa 32000, Israel.|Gastroenterology department, Rambam Health Care Campus, Haifa 31096, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Chowers
authors.affiliation: NanoEngineering Group, Faculty of Mechanical Engineering, Technion - IIT, Haifa 32000, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Zussman
mesh_terms: D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology*; D012212:Rheology; D012680:Sensitivity and Specificity; D014783:Viscosity; D055815:Young Adult