Conventional versus contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration for diagnosis of solid pancreatic lesions: A prospective randomized trial

Sugimoto, Mitsuru; Takagi, Tadayuki; Hikichi, Takuto; Suzuki, Rei; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Konno, Naoki; Waragai, Yuichi; Watanabe, Hiroshi; Obara, Katsutoshi; Ohira, Hiromasa

doi:10.1016/j.pan.2015.06.005

Cited by 76 publications

(68 citation statements)

References 29 publications

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“…A recent published study revealed that CEH-EUS guided FNA has a better accuracy [25]. Moreover, fewer needle passes are required to obtain samples [26].…”

Section: Discussionmentioning

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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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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“…A recent published study revealed that CEH-EUS guided FNA has a better accuracy [25]. Moreover, fewer needle passes are required to obtain samples [26].…”

Section: Discussionmentioning

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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“…Early comparative results are summarized in Table 2. While early series have not shown any improvement in diagnostic accuracy or sensitivity with the use of CEUS in endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) for pancreatic lesions, Sugimoto et al 2015 described increased interventional efficiency with the use of CEUS-EUS-FNA compared with EUS-FNA (by percent of samples demonstrating sufficiency with a single needle pass, 60% vs. 25%, N = 20 vs. 20, P < 0.05) [26]. …”

Section: Image Guidance For Interventional Proceduresmentioning

confidence: 99%

Contrast-enhanced ultrasonography in interventional oncology

2018

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Contrast-enhanced ultrasound (CEUS) has evolved from the use of agitated saline to second generation bioengineered microbubbles designed to withstand insonation with limited destruction. While only one of these newer agents is approved by the Food and Drug Administration for use outside echocardiography, interventional radiologists are increasingly finding off-label uses for ultrasound contrast agents. Notably, these agents have an extremely benign safety profile with no hepatic or renal toxicities and no radiation exposure. Alongside diagnostic applications, CEUS has begun to develop its own niche within the realm of interventional oncology. Certainly, the characterization of focal solid organ lesions (such as hepatic and renal lesions) by CEUS has been an important development. However, interventional oncologists are finding that the dynamic and real-time information afforded by CEUS can improve biopsy guidance, ablation therapy, and provide early evidence of tumor viability after locoregional therapy. Even more novel uses of CEUS include lymph node mapping and sentinel lymph node localization. Critical areas of research still exist. The purpose of this article is to provide a narrative review of the emerging roles of CEUS in interventional oncology.

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“…[18][19][20] As CEH-EUS exhibits superior visualization of detecting small lesions compared to traditional EUS, it may assist in pinpointing an appropriate target to increase tissue yield for EUS-FNA. 20,21 Sugimoto et al 22 reported that CEH-EUS-guided FNA was significantly superior to conventional EUS-FNA in obtaining an adequate sample on a single needle pass (60% compared to 25%; P = 0.027). This was attributable to improved visualization of SPL such that samples obtained via CEH-EUS-guided FNA were obtained from areas without fibrosis and necrosis.…”

Section: Contrast-enhanced Harmonic Eusmentioning

confidence: 99%

“…This was attributable to improved visualization of SPL such that samples obtained via CEH-EUS-guided FNA were obtained from areas without fibrosis and necrosis. 22 Although exceedingly rare, reports of tumor seeding following EUS-FNA with multiple needles passes have been reported; thus, CEH-EUS-guided FNA may further diminish this risk by minimizing the number of passes.…”

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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Conventional versus contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration for diagnosis of solid pancreatic lesions: A prospective randomized trial

Cited by 76 publications

References 29 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

Contrast-enhanced ultrasonography in interventional oncology

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

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