Contrast-Enhanced Ultrasonograpic Findings in Pancreatic Tumors

Recaldini, Chiara; Carrafiello, Gianpaolo; Bertolotti, Elena; Angeretti, Maria Gloria; Fugazzola, Carlo

doi:10.7150/ijms.5.203

Cited by 32 publications

(35 citation statements)

References 15 publications

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“…The variation in this study in comparison with Fusaroli et al [57] may have occurred because more patients with severe chronic pancreatitis were enrolled in the Fusaroli et al [57] study, which may have altered the enhanced pattern of pancreatic adenocarcinomas. Severe forms of chronic pancreatitis mean less intense intralesional "parenchymographic" enhancement and fibrosis resulting in decreasing vascular flow [62][63][64] . [65] compared the aforesaid QE-EUS to CEH-EUS.…”

Section: The Role Of Eus As Palliative Treatment Of Pancreatic Cancermentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

Gonzalo-Marin¹

2014

WJGO

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Endoscopic ultrasonography (EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography, computed tomography (CT) and transabdominal ultrasound for recognising early pancreatic tumors. As a diagnostic modality for pancreatic cancer, EUS has proved rates higher than 90%, especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for CT. Besides, EUS has a very high negative predictive value and thus EUS can reliably exclude pancreatic cancer. The complication rate of EUS is as low as 1.1%-3.0%. New technical developments such as elastography and the use of contrast agents have recently been applied to EUS, improving its diagnostic capability. EUS has been found to be superior to the recent multidetector CT for T staging with less risk of overstaying in comparison to both CT and magnetic resonance imaging, so that patients are not being ruled out of a potentially beneficial resection. The accuracy for N staging with EUS is 64%-82%. In unresectable cancers, EUS also plays a therapeutic role by means of treating oncological pain through celiac plexus block, biliary drainage in obstructive jaundice in patients where endoscopic retrograde cholangiopancreatography is not affordable and aiding radiotherapy and chemotherapy. Key words: Endosonography; Pancreatic neoplasms; Endoscopy; Diagnosis; Neoplasm Staging; Therapeutics Core tip: In this article, the role of endoscopic ultrasonography as a diagnostic, staging and therapeutic procedure in patients with pancreatic cancer is discussed and all the current knowledge on this subject is summarized, providing the reader with a quick update.Gonzalo-Marin J, Vila JJ, Perez-Miranda M. Role of endoscopic ultrasound in the diagnosis of pancreatic cancer. World J Gastrointest Oncol 2014; 6(9): 360-368 Available from: URL:

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Section: The Role Of Eus As Palliative Treatment Of Pancreatic Cancermentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

Gonzalo-Marin¹

2014

WJGO

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“…To assess tumor resectability, contrast enhanced CT/MRI are needed for a more accurate evaluation of the local extension and metastatic spread [6], even if in the same CEUS session we can examine the liver in the late phase to search for metastases. Thus, the most important role of CE-CT/MRI is to search for a possible invasion of the adjacent vessels.…”

Section: Discussionmentioning

confidence: 99%

“…The criteria used for pancreatic tumor differentiation in US [6,18] and CEUS [16], are presented in Table I.…”

Section: Methodsmentioning

confidence: 99%

“…The innovative use of CEUS for the study of the pancreas created the need for a precise definition of the most dynamic features of pancreatic masses (solid and cystic) [5]. Thus, CEUS can aid in the differential diagnosis of pancreatic tumors [4] and can provide dynamic information, with a high temporal and spatial resolution, concerning macro and micro-circulation of focal lesions and normal parenchyma [3,6]. Its high capability in showing tumoral microcirculation also makes CEUS accurate in the study of neoangiogenesis [5,7].…”

Section: Introductionmentioning

confidence: 99%

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The value of Contrast-Enhanced Ultrasound in the characterization of vascular pattern of solid pancreatic lesions

et al. 2015

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The aim of our study was to evaluate the accuracy of CEUS in the characterization of pancreatic solid lesions, considering cross sectional imaging techniques (CE-CT/MRI) as the "gold standard" methods. Material and methods: We performed a retrospective, monocentric study that included 91 solid pancreatic lesions which were evaluated by CEUS and by a secondline contrast imaging technique (CT or MRI), considered as the reference method. Results: The rate of a conclusive diagnosis based on a typical enhancement pattern was 94% (78/83 cases). In 72 cases out of 83 (86.7%) there was a perfect concordance between CEUS and the "gold-standard" imaging method (CE-CT/MRI). In our study, 88% (73/83) of the pancreatic lesions were categorized as malignant due to their typical wash-out aspect in the late phase. The overall accuracy of CEUS for the differential diagnosis of solid pancreatic tumors was approximately 81%. The accuracy of CEUS for the diagnosis of hypoenhancing pancreatic tumors was approximately 89.1%; while for the diagnosis of hyperenhancing pancreatic tumors it was approximately 72.8%. Conclusion: CEUS allows the differentiation between hypo-vs. hyperenhancing pancreatic solid lesions, with a considerable diagnostic accuracy, a fundamental step in the precise diagnosis of pancreatic tumors.

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“…Contrast agents might show the intraductal growth (Badea et al, 2009). However, in most PCN cases, CEUS does not add significant diagnostic information; therefore CT scans and other diagnostic modalities are always necessary for their proper characterization (Recaldini et al, 2008).…”

Section: Contrast Enhanced Ultrasound (Ceus)mentioning

confidence: 99%

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

Bai

Zhang

Masood

et al. 2013

J. Zhejiang Univ. Sci. B

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Pancreatic cystic neoplasms (PCNs) are a diverse group of neoplasms in the pancreas, and are more increasingly encountered with widespread abdominal screening and improved imaging techniques. The most common types of PCNs are serous cystic neoplasms (SCNs), mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Clinicians frequently feel bewildered in the differential diagnosis and subsequent management among the various types of lesions in the pancreas, which may lead to overtreatment or delayed treatment. The current review provides recent developments in the understanding of the three most common types of PCNs, the latest modalities used in preoperative diagnosis and differential diagnosis, as well as the most up to date management. Suggestions for diagnosis and differential diagnosis of SCNs, MCNs, and IPMNs are also provided for young surgeons. Better understanding of these neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.

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Contrast-Enhanced Ultrasonograpic Findings in Pancreatic Tumors

Cited by 32 publications

References 15 publications

Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

The value of Contrast-Enhanced Ultrasound in the characterization of vascular pattern of solid pancreatic lesions

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

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