Differential diagnosis of solid pancreatic masses: contrast-enhanced harmonic (CEH-EUS), quantitative-elastography (QE-EUS), or both?

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Iglesias-Garcia, J. (författare)

Differential diagnosis of solid pancreatic masses: contrast-enhanced harmonic (CEH-EUS), quantitative-elastography (QE-EUS), or both?

Artikel/kapitelEngelska2017

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2017-03
Wiley,2017

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LIBRIS-ID:oai:gup.ub.gu.se/253343
https://gup.ub.gu.se/publication/253343URI
https://doi.org/10.1177/2050640616640635DOI

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Språk:engelska

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Background: Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) and quantitative-elastography endoscopic ultrasound (QE-EUS) are considered useful tools for the evaluation of solid pancreatic tumors (SPT). The aim of our study was to evaluate the diagnostic accuracy of CEH-EUS, QE-EUS, and the combination of both for the differential diagnosis of SPT. Methods: Sixty-two consecutive patients (mean age 64.3 years, range 32-89 years, 44 male) who underwent EUS for the evaluation of SPT were prospectively included. EUS was performed with a linear Pentax-EUS and a Hitachi-Preirus processor. The mass (area A) and a reference area B were selected during QE-EUS, and results expressed as B/A (strain ratio). A strain histogram of the mass was also evaluated. Microvascularization of the tumor was evaluated over 2min during CEH-EUS after intravenous injection of 4.8mL SonoVue. Final diagnosis was based on histopathology of surgical specimens or EUS-guided tissue acquisition and clinical follow-up in non-operated cases. Diagnostic accuracy of CEH-EUS, QE-EUS, and their combination was calculated. Results: Median size of the masses was 32 mm (range 12-111). Final diagnosis was pancreatic adenocarcinoma (n=45), neuroendocrine tumor (n=3), inflammatory mass (n=10), pancreatic metastasis (n=2), autoimmune pancreatitis (n=1), and a mucinous cystadenocarcinoma (n=1). Overall accuracies for determination of malignancy using QE-EUS, CEH-EUS, their combination, and EUS-guided tissue acquisition were 98.4% (95% confidence interval (CI): 91.4-99.7), 85.5% (95% CI: 74.7-92.2), 91.9% (95% CI: 82.5-96.5), and 91.5% (95% CI: 83.6-99.5), respectively. Conclusion: The combination of QE-EUS and CEH-EUS is a useful tool for the differential diagnosis of SPT, giving complementary information. However, this combination does not significantly increase the diagnostic accuracy of either of the techniques performed alone.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Gastroenterologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Gastroenterology and Hepatology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
Solid pancreatic lesion
stiffness
vascularization
tissue acquisition
endoscopic ultrasound
endoscopic ultrasound elastography
fine-needle-aspiration
focal
pancreatitis
lesions
ultrasonography
metaanalysis
adenocarcinoma
accuracy
cancer
discrimination
Gastroenterology & Hepatology

Biuppslag (personer, institutioner, konferenser, titlar ...)

Lindkvist, BjörnGothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine(Swepub:gu)xlibjo (författare)
Larino-Noia, J. (författare)
Abdulkader-Nallib, I. (författare)
Dominguez-Munoz, J. E. (författare)
Göteborgs universitetInstitutionen för medicin (creator_code:org_t)

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Ingår i:United European Gastroenterology Journal: Wiley5:2, s. 236-2462050-64062050-6414

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Av författaren/redakt...: Iglesias-Garcia, ...; Lindkvist, Björn; Larino-Noia, J.; Abdulkader-Nalli ...; Dominguez-Munoz, ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

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Av lärosätet: Göteborgs universitet

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