Endoscopic ultrasound elastography in the diagnosis of pancreatic masses: A meta-analysis

Zhang, Binglan; Zhu, Fengqin; Li, Pan; Yu, Shijie; Zhao, Yajing; Li, Minmin

doi:10.1016/j.pan.2018.07.008

Cited by 46 publications

(41 citation statements)

References 43 publications

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“…The pooled analysis revealed that the sensitivity for the diagnosis of malignant pancreatic masses were 0.98 for qualitative EUS elastography, and 0.95 for quantitative EUS elastography, respectively. On the other hand, the specificity of both methods was around 60% (17). Thus, as in the previous meta-analyses, the authors concluded that EUS elastography cannot replace EUS-FNA but might be used in addition to it to avoid unnecessary biopsies in benign lesions owing to its considerably high sensitivity to detect malignant pancreatic masses.…”

Section: Discussionmentioning

confidence: 55%

Noninvasive assesment in differentiating benign and malign pancreatic lesions with endosonographic elastography score and strain ratio

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Karatay

et al. 2020

Journal of Health Sciences and Medicine

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Amaç: Endosonografik elastografi skoru (EUS-EG) ve sertlik oranının (strain ratio (SR)) benign ve malign pankreatik lezyonların ayırıcı tanısındaki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2016-Haziran 2019 döneminde tek merkezde EUS-EG uygulanan hastaların verileri retrospektif olarak değerlendirildi. Çalışmada kronik pankreatit tanısı kesin olan hastaların endosonografik bulguları ile solid pankreatik lezyonların endosonografik bulguları karşılaştırıldı. Solid pankreas lezyonlarının (SPL) kesin tanısı histopatolojik inceleme ile konuldu. Kontrol grubunda biası önlemek için Rosement A kriterlerini karşılayan kronik pankreatitli (CP) hastalar değerlendirmeye alındı. Rosement B-C değerlendirmeye alınmadı. Elastografi kalitatif (elastografi skorları) ve kantitatif SR yöntemi ile değerlendirildi. Bulgular: Ortalama yaş 58,8±15,3 (19-80) olan toplam 66 hasta (42 (%63,6) kadın / 24 (%63,6) erkek) çalışmaya dahil edildi. Otuz sekiz hastada SLP; 28 hastada CP vardı. SPL grubunda 32'sinde (%84,2) adenokarsinom, 6'sında (%15,8) nöroendokrin tümör vardı. Benign pankreatik lezyonu olan 28 hastanın 23'ünde (%82,1) CP, 5'inde (%17,9) otoimmün pankreatit vardı. SPL'li hastalarda medyan SR değerleri CP'li hastalardan anlamlı olarak daha yüksekti (44,0 (10,0-110.0) ve 7,0 (2,6-14,6), p<0.001). Sertlik skorları da SLP ve CP'li hastalar arasında anlamlı olarak farklıydı (p<0.001). Elastikiyet skorları adenokarsinom ve CP arasında anlamlı olarak farklıydı (p<0.001). Sertlik skoru için cutoff değeri 14 olarak belirlendi, SPL ve alıcı işletim karakteristik eğrileri için %97 duyarlı ve %100 özgüllüğe sahipti ve 0.99.6 eğrisinin altında bir alan gösterdi. Likelihood Ratio test, benign ve malign lezyonların ayırt edilmesinde en iyi parametrenin SR olduğunu göstermiştir (X 2 =54,031, p<0.001). Sonuç: Çalışmamız, EUS-EG ve SR skorlarının malign ve benign pankreatit lezyonlarını ayırmada oldukça etkin bir yöntem olduğunu göstermiştir.

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Section: Discussionmentioning

confidence: 55%

Noninvasive assesment in differentiating benign and malign pancreatic lesions with endosonographic elastography score and strain ratio

Utku

Ergül

Karatay

et al. 2020

Journal of Health Sciences and Medicine

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“…Moreover, published meta-analyses did not show clear differences between qualitative and semi-quantitative elastography measurements. [20,[24][25][26] Although all efforts were assumed to standardize elastography and contrast-enhanced examinations, there were inherent bias sources caused by manual selection of the ROI for quantitative evaluations.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of strain histogram EUS elastography and contrast-enhanced EUS for the differential diagnosis of focal pancreatic masses: A prospective multicentric study

et al. 2020

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Background: Recent advances in EUS techniques (real-time EUS elastography and contrast-enhanced EUS) have allowed a better characterization of focal pancreatic masses. Mean strain histograms (SHs) are considered a good parameter for the semi-quantitative evaluation of focal pancreatic masses, alongside complementary contrast-enhanced EUS parameters which can be quantified during both the early arterial and late venous phase. Materials and Methods: The study design was prospective, blinded, and multicentric, assessing real-time EUS elastography and contrast-enhanced EUS results for the characterization of focal pancreatic masses using parametric measurements, in comparison with pathology which is the gold standard. SHs were performed based on the embedded software of the ultrasound system, with the values being reversed as opposed to our initially published data on hue histograms. Consequently, a cutoff of 80 was derived from previous multicentric trials. Contrast-enhanced EUS also allowed the focal masses to be classified as hyper-, iso-, or hypoenhanced in comparison with the normal pancreatic parenchyma. EUS-FNA was then performed for all patients, with a positive cytological diagnosis taken as a final proof of malignancy for the pancreatic masses. The diagnoses obtained by EUS-FNA were verified further either by surgery or during a clinical follow-up of at least 6 months. Results: A total number of 97 consecutive patients with focal pancreatic masses were included in the study. Based on previously defined cutoffs of 80, the values of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the mean SHs for the diagnosis of pancreatic cancer were 100%, 29.63%, 78.65%, 100%, and 80.41%, respectively. Corresponding values for contrast-enhanced EUS (taking into consideration hypoenhencement as a

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“…On EUS-elastography, strain indicating the stiffness of target lesions may help to differentiate harder pancreatic cancers from surrounding tissues. In eight meta-analyses, the pooled sensitivity and specificity of EUS-elastography were 95-99% and 63-76%, respectively [9,[57][58][59][60][61][62][63].…”

Section: Complementary Role Of Eus-elastography Relative To Eus-fnamentioning

confidence: 99%

“…The accuracy of EUS for the evaluation of pancreatic lesions, lymph nodes, and liver lesions can be increased by image enhancement technologies, including contrast-enhanced harmonic (CH)-EUS and EUS-elastography. At present, both of these methods play important roles in the clinical evaluation of pancreatic cancer [8][9][10][11][12]. CE-EUS and EUS-elastography can provide information complementary to that of EUS-FNA for the diagnosis and staging of pancreatobiliary cancer, and can help to identify the EUS-FNA target, reducing the requirement for repeated EUS-FNA.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement

2020

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Although endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is useful in the differential diagnosis of solid pancreatic lesions, lymph nodes, and liver lesions, inadequate sampling may result in an incorrect pathological diagnosis. The accuracy of EUS for the evaluation of pancreatobiliary lesions may be increased by image enhancement technologies, including contrast-enhanced harmonic (CH)-EUS and EUS-elastography. These methods can provide information that complement EUS-FNA for the diagnosis and staging of pancreatobiliary cancer, and can help to identify the EUS-FNA target, reducing the requirement for repeat FNA.

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Endoscopic ultrasound elastography in the diagnosis of pancreatic masses: A meta-analysis

Cited by 46 publications

References 43 publications

Noninvasive assesment in differentiating benign and malign pancreatic lesions with endosonographic elastography score and strain ratio

Noninvasive assesment in differentiating benign and malign pancreatic lesions with endosonographic elastography score and strain ratio

Clinical impact of strain histogram EUS elastography and contrast-enhanced EUS for the differential diagnosis of focal pancreatic masses: A prospective multicentric study

Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement

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