Reviewer's report
Title:Quantitative low mechanical index contrast-enhanced endoscopic
ultrasound for the differential diagnosis of focal pancreatic masses
Version: 1Date:29 September 2012
Reviewer: Pietro Fusaroli
Reviewer's report:
This paper reports about quantitative analysis of contrast enhanced EUS in the
differential diagnosis between pancreatic cancer and chronic pancreatitis. While
the use of qualitative contrast enhanced EUS is widely accepted, quantitative
methods were introduced very recently in the field of contrast enhanced EUS and
very little has been reported on this topic. The authors are well respected
authorities in the field of image enhancement in EUS. The methods of this work
are solid and the data are sound.
Major compulsory revisions
1) The authors state that contrast enhanced EUS is fundamental to take major
decisions about the individual patients, e.g. to decide whether or not to perform
fine needle aspiration. However, as information from quantitative contrast
enhanced EUS are acquired in a post-production fashion, i.e. after the end of the
examination, they can’t be used to undertake real time decisions such as
deciding about performing fine needle aspiration or not. The authors should
rephrase this concept which is stated at the beginning of the discussion, and
provide alternative suggestions about the potential applications of the technique.
2) The authors state that quantitative analysis was performed on .avi files which
are not amenable to any processing unlike line data (such as dicom files). By
doing so, intensity curves might have been dependent on variables unrelated to
the pancreatic mass under investigation, such as gain settings of the ultrasound
processor. Please mention whether attention was paid to keep all image settings
identical throughout all the cases enrolled for the study. Moreover, please explain
if the technique adopted of measuring time intensity curves from two different
areas of the videos (inside and outside the lesion) was adequate to overcome
this potential limitation, i.e. to make the measurements independent from all the
original image settings.
3) It is important to know how much time is required to analyze a video and draw
the quantitative data with the software described in the study. In view of its
possible introduction into clinical practice, it is fundamental that the technique
does not add very much work after performing EUS.
Minor essential revisions
1) Background, 2nd line: please correct misspelling of “sill” in “still”
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Quantitative low mechanical index contrast-enhanced endoscopic
ultrasound for the differential diagnosis of focal pancreatic masses
Version: 1Date:29 September 2012
Reviewer: Pietro Fusaroli
Reviewer's report:
This paper reports about quantitative analysis of contrast enhanced EUS in the
differential diagnosis between pancreatic cancer and chronic pancreatitis. While
the use of qualitative contrast enhanced EUS is widely accepted, quantitative
methods were introduced very recently in the field of contrast enhanced EUS and
very little has been reported on this topic. The authors are well respected
authorities in the field of image enhancement in EUS. The methods of this work
are solid and the data are sound.
Major compulsory revisions
1) The authors state that contrast enhanced EUS is fundamental to take major
decisions about the individual patients, e.g. to decide whether or not to perform
fine needle aspiration. However, as information from quantitative contrast
enhanced EUS are acquired in a post-production fashion, i.e. after the end of the
examination, they can’t be used to undertake real time decisions such as
deciding about performing fine needle aspiration or not. The authors should
rephrase this concept which is stated at the beginning of the discussion, and
provide alternative suggestions about the potential applications of the technique.
2) The authors state that quantitative analysis was performed on .avi files which
are not amenable to any processing unlike line data (such as dicom files). By
doing so, intensity curves might have been dependent on variables unrelated to
the pancreatic mass under investigation, such as gain settings of the ultrasound
processor. Please mention whether attention was paid to keep all image settings
identical throughout all the cases enrolled for the study. Moreover, please explain
if the technique adopted of measuring time intensity curves from two different
areas of the videos (inside and outside the lesion) was adequate to overcome
this potential limitation, i.e. to make the measurements independent from all the
original image settings.
3) It is important to know how much time is required to analyze a video and draw
the quantitative data with the software described in the study. In view of its
possible introduction into clinical practice, it is fundamental that the technique
does not add very much work after performing EUS.
Minor essential revisions
1) Background, 2nd line: please correct misspelling of “sill” in “still”
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Quantitative low mechanical index contrast-enhanced endoscopic
ultrasound for the differential diagnosis of focal pancreatic masses
Version: 1Date:29 September 2012
Reviewer: Pietro Fusaroli
Reviewer's report:
This paper reports about quantitative analysis of contrast enhanced EUS in the
differential diagnosis between pancreatic cancer and chronic pancreatitis. While
the use of qualitative contrast enhanced EUS is widely accepted, quantitative
methods were introduced very recently in the field of contrast enhanced EUS and
very little has been reported on this topic. The authors are well respected
authorities in the field of image enhancement in EUS. The methods of this work
are solid and the data are sound.
Major compulsory revisions
1) The authors state that contrast enhanced EUS is fundamental to take major
decisions about the individual patients, e.g. to decide whether or not to perform
fine needle aspiration. However, as information from quantitative contrast
enhanced EUS are acquired in a post-production fashion, i.e. after the end of the
examination, they can’t be used to undertake real time decisions such as
deciding about performing fine needle aspiration or not. The authors should
rephrase this concept which is stated at the beginning of the discussion, and
provide alternative suggestions about the potential applications of the technique.
2) The authors state that quantitative analysis was performed on .avi files which
are not amenable to any processing unlike line data (such as dicom files). By
doing so, intensity curves might have been dependent on variables unrelated to
the pancreatic mass under investigation, such as gain settings of the ultrasound
processor. Please mention whether attention was paid to keep all image settings
identical throughout all the cases enrolled for the study. Moreover, please explain
if the technique adopted of measuring time intensity curves from two different
areas of the videos (inside and outside the lesion) was adequate to overcome
this potential limitation, i.e. to make the measurements independent from all the
original image settings.
3) It is important to know how much time is required to analyze a video and draw
the quantitative data with the software described in the study. In view of its
possible introduction into clinical practice, it is fundamental that the technique
does not add very much work after performing EUS.
Minor essential revisions
1) Background, 2nd line: please correct misspelling of “sill” in “still”
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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