Comparison of the Diagnostic Efficiency of Radial- and Convex-Arrayed Echoendoscopes for Indirect Findings of Pancreatic Cancer: A Retrospective Comparative Study Using Propensity Score Method

Abstract

Endoscopic ultrasonography (EUS) is useful for detecting early-stage pancreatic cancer. Because the detection of small lesions is difficult, it is important to detect indirect findings, namely caliber change, retention cysts, and dilatation of the branch duct, during the procedure. Although two types of EUS endoscopes are frequently used, there is no comparative study on their efficacy for detecting indirect findings. Therefore, we aimed to compare the diagnostic efficacy of these two types for indirect findings. We retrospectively analyzed 316 consecutive patients who had undergone EUS for pancreaticobiliary disease at a single center between January 2017 and December 2018. The main outcome was the detection rate of indirect findings and its comparison between the two echoendoscope types. This outcome was achieved using the inverse probability of treatment weighting (IPTW) analysis. The detection rate of indirect findings was higher for the radial-arrayed endoscope than for the convex-arrayed echoendoscope (9.2% vs. 2.3% (p = 0.02)). The univariate analysis also revealed that the radial-arrayed echoendoscope was significantly superior to the convex-arrayed echoendoscope in terms of the detection of indirect findings (odds ratio, 5.94; 95% confidence interval, 1.68–21.10; p = 0.01) after IPTW. After adjustment for magnetic resonance imaging (MRI) and computed tomography (CT), radial-arrayed echoendoscope remained an independent factor for indirect finding detection (odds ratio, 6.04; 95% confidence interval, 1.74–21.00; p = 0.01). Finally, five patients who had indirect EUS findings were diagnosed with pancreatic cancer. Our results indicate that the radial-arrayed echoendoscope is useful for the detection of indirect findings.

Sequential PET/CT and pathological biomarker crosstalk predict response to PD-1 blockers alone or combined with sunitinib in propensity score-matched cohorts of cancer of unknown primary treatment

“…As there may have been a potential difference in variables not included in the study, patients in each treatment arm were matched by propensity score to reach a 1:1 paired comparison in order to minimize selection bias and confounding variables. Propensity score-matched analysis was carried out by means of a multivariate conditional logistic regression model with a caliper width of 0.05 ( 14 ). Factors included in the regression model included demographics, chemotherapy involved, and baseline metabolic activity on whole-body FDG PET/CT scans associated with tumor aggressiveness, including high standard uptake value (HSUV), whole-body metabolic tumor volume (WMTV), and whole-body total lesion glycolysis (WTLG).…”

Evaluation of a novel radial echoendosonoscope with a piezoelectric-composite transducer

“…However, the radial echoendoscope renders complete and straightforward views of lesions in the gastrointestinal wall and the common bile duct, which is vital in clinical practice. [ 22 23 24 25 26 27 28 ]…”