Contrast-enhanced EUS for differential diagnosis of pancreatic mass lesions: a meta-analysis

Gong, Ting-Ting; Hu, Duanmin; Zhu, Qi

doi:10.1016/j.gie.2012.02.051

Cited by 152 publications

(112 citation statements)

References 44 publications

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“…Both techniques have an excellent accuracy, with a high sensitivity and low specificity reported in published meta-analyses [11][12][13][14][15]. RTE-EUS has a high sensitivity (95-100%) but a lower specificity varying widely (22-74%) [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Real-time elastographic EUS (RTE-EUS) and contrast-enhanced harmonic EUS (CEH-EUS) are two useful methods for the assessment of patients with focal pancreatic masses both reported to have a high sensitivity and specificity [11][12][13][14][15][16]. The high negative predictive value of the combination between elastography and contrast enhancement during EUS as reported [16] has raised hopes that these imaging methods might help the clinical decision making the process of differentiation between benign and malignant focal pancreatic masses, especially in patients with negative EUS-FNA samples.…”

Section: Introductionmentioning

confidence: 99%

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Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA

Iordache

Costache

Popescu³

et al. 2016

Med Ultrason

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Aim: It is well known that endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has a high sensitivity (over 85%) and specificity (100%) for diagnosis of pancreatic cancer. The aim of the study was to establish a EUS based clinical diagnostic algorithm in patients with pancreatic masses and negative cytopathology after EUS-FNA, based on previously published results and cut-offs of real-time elastographic (RTE) EUS and contrast-enhanced harmonic (CEH) EUS. Material and methods: We included in the study a subgroup of 50 consecutive patients with focal pancreatic masses which underwent EUS examinations with negative EUS-FNA. RTE-EUS and CEH-EUS were performed sequentially in all patients. The sensitivity, specificity and accuracy of these methods were calculated separately. A clinical decision algorithm based on elastography followed by CEH was established. Results: For the diagnosis of possible malignancy, the sensitivity, specificity and accuracy of RTE-EUS were: 97.7%, 77.4%, and 84% respectively. CEH-EUS had similar results: 89.5%, 80.7%, and 84%, respectively. In 25 patients with soft/mixed appearance during elastography,sequential assessment using contrast-enhanced EUSwas performed. The specificity of CEH-EUS for detection of chronic pancreatitis in this sub-set of patients was excellent (100%). In other 25 patients with hard appearance in elastography (low strain) CEH-EUS had an excellent specificity (100%) and accuracy (93%) in the detection of pancreatic cancer. Conclusions: The proposed algorithm with sequential use of elastography followed by CEH could be a good clinical tool in the set of patients with negative EUS-FNA results for the differentiation between benign and malignant focal pancreatic masses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA

Iordache

Costache

Popescu³

et al. 2016

Med Ultrason

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“…12,13 Several other studies have recapitulated these findings. Gong et al 14 performed a large metaanalysis which also showed lesion hypoenhancement using CEH-EUS as a reliable means of differentiating pancreatic adenocarcinoma with a pooled sensitivity of 93% and specificity of 93%. [14][15][16] Most notably, Fusaroli et al 17 showed that hyperenhancement essentially excludes pancreatic adenocarcinoma with a specificity of 98%.…”

Section: Contrast-enhanced Harmonic Eusmentioning

confidence: 99%

“…Gong et al 14 performed a large metaanalysis which also showed lesion hypoenhancement using CEH-EUS as a reliable means of differentiating pancreatic adenocarcinoma with a pooled sensitivity of 93% and specificity of 93%. [14][15][16] Most notably, Fusaroli et al 17 showed that hyperenhancement essentially excludes pancreatic adenocarcinoma with a specificity of 98%. CEH-EUS has also proven to be complementary to EUS-FNA, particularly if FNA is inconclusive; CEH-EUS has correctly diagnosed pancreatic adenocarcinoma in these instances to guide appropriate management.…”

Section: Contrast-enhanced Harmonic Eusmentioning

confidence: 99%

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Luthra

Mishra

2017

Int J Gastrointest Interv

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“…Also, CEUS seemed superior to CT scan in detecting lesions under 2 cm in diameter [98]. In total, a meta-analysis of both power Doppler and harmonic CEUS showed that hypoenhancement was associated with pooled sensitivity of 94% and specificity of 89% [99]. Qualitative interpretation can be subjective, however, and quantification of contrast uptake is expected to yield new information with improved accuracy.…”

Section: Contrast-enhanced Eusmentioning

confidence: 99%

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Seicean¹

2014

Pancreatic Cancer - Insights Into Molecular Mechanisms and Novel Approaches to Early Detection and Treatment

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Contrast-enhanced EUS for differential diagnosis of pancreatic mass lesions: a meta-analysis

Cited by 152 publications

References 44 publications

Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA

Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

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