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

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Fältnamn	Indikatorer	Metadata
000		04249naa a2200565 4500
001		oai:gup.ub.gu.se/253343
003		SwePub
008		240528s2017 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://gup.ub.gu.se/publication/2533432 URI
024	7	a https://doi.org/10.1177/20506406166406352 DOI
040		a (SwePub)gu
041		a eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Iglesias-Garcia, J.4 aut
245	1 0	a Differential diagnosis of solid pancreatic masses: contrast-enhanced harmonic (CEH-EUS), quantitative-elastography (QE-EUS), or both?
264		c 2017-03
264	1	b Wiley,c 2017
520		a 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.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Gastroenterologi0 (SwePub)302132 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Gastroenterology and Hepatology0 (SwePub)302132 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
653		a Solid pancreatic lesion
653		a stiffness
653		a vascularization
653		a tissue acquisition
653		a endoscopic ultrasound
653		a endoscopic ultrasound elastography
653		a fine-needle-aspiration
653		a focal
653		a pancreatitis
653		a lesions
653		a ultrasonography
653		a metaanalysis
653		a adenocarcinoma
653		a accuracy
653		a cancer
653		a discrimination
653		a Gastroenterology & Hepatology
700	1	a Lindkvist, Björnu Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine4 aut0 (Swepub:gu)xlibjo
700	1	a Larino-Noia, J.4 aut
700	1	a Abdulkader-Nallib, I.4 aut
700	1	a Dominguez-Munoz, J. E.4 aut
710	2	a Göteborgs universitetb Institutionen för medicin4 org
773	0	t United European Gastroenterology Journald : Wileyg 5:2, s. 236-246q 5:2<236-246x 2050-6406x 2050-6414
856	4	u https://journals.sagepub.com/doi/pdf/10.1177/2050640616640635
856	4 8	u https://gup.ub.gu.se/publication/253343
856	4 8	u https://doi.org/10.1177/2050640616640635

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

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