EUS accuracy against MRCP for detection of pancreaticobiliary lesions

Akkuzu, Mustafa Zanyar; Altıntaş, Engin; Yaraş, Serkan; Özdoğan, Osman; Üçbilek, Enver; Ateş, Fehmi; Sezgın, Orhan; Aydin, Ferzan; Balci, Hatice; Dirik, Yaren

doi:10.5505/ejm.2020.92195

Cited by 4 publications

(4 citation statements)

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“…This result is similar to those reported by Karwa and Patil (2017), who showed a 95% accuracy rate for the MRCP in the detection of CBD stones, as well as consents with Lee et al (2018), who documented a 93.3% accuracy rate for MRCP in the diagnosis of CBD. In contrast, this finding is relatively better than those reported by Orman et al (2018), who found an 86.4% MRCP sensitivity for choledocholithiasis detection, as well as Akkuzu et al (2020), who reported an 81.5% MRCP sensitivity for hepatobiliary system stones.…”

Section: Diagnosis Of Cbd Stones Using Mrcp and Us Imagingcontrasting

confidence: 74%

Accuracy of Ultrasound and Magnetic Resonance Cholangiopancreatography Findings in the Diagnosis of Biliary System Stones

Naji¹,

Amer²,

Alzofi³

et al. 2022

JST

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This study aimed to evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) and Ultrasound (US) images for the diagnosis of biliary system stones, as well as to assess the consistency between MRCP and US findings. The study sample included 200 cases (90 males and 110 females) with symptomatic biliary system stones between 14 and 82 years. All cases underwent both the US and MRCP imaging for biliary system diagnosis. The study revealed that the most prominent age group with symptoms of biliary system stones was the 33-60-year-old group. It also found that the accuracy of US and MRCP in detecting gallbladder (GB) stones compared with the final diagnosis was 94% and 91%, respectively, with moderate conformity between their results. The accuracy of US and MRCP images in detecting common bile duct (CBD) stones was 61% and 98%, respectively, with fair conformity between their results. In addition, there is a significant agreement between the MRCP and US results in detecting the GB and CBD stones with an agreed percentage of 74% and 71%, respectively. The study concluded that US is the preferred imaging technique for patients with symptomatic gallbladder stones, whereas MRCP is a trustworthy investigation for common bile duct stones.

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Section: Diagnosis Of Cbd Stones Using Mrcp and Us Imagingcontrasting

confidence: 74%

Accuracy of Ultrasound and Magnetic Resonance Cholangiopancreatography Findings in the Diagnosis of Biliary System Stones

Naji¹,

Amer²,

Alzofi³

et al. 2022

JST

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“…Also, Anderson et al (22) and, Early et al (23) reported that ERCP, which is significantly riskier than diagnostic EUS, has a much smaller role as a diagnostic modality, and has a very low complication rate. Several studies have compared MRCP and EUS for the purpose of identifying choledocholithiasis, the majority of them claim that EUS is superior, particularly for seeing tiny stones in non-dilated ducts (5,24) . Scheiman et al (25) performed a cost analysis along with a prospective comparison of EUS, MRCP, and ERCP in patients with suspected biliary disease.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

lotfy¹,

Refaey²,

Elshamy³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: Many etiologies can be behind common bile duct dilatation that is undiagnosed, such as pancreatic and periampullary tumors, choledocholithiasis, or an inflammatory condition as stenosis. Endoscopic ultrasound (EUS) may have a major diagnostic value in detecting etiologies of dilated CBD undetected by other non-invasive modalities.Objectives: This study aimed to determine whether endoscopic ultrasonography is helpful in detecting a common bile duct dilatation that isn't clear. Methods: This study was conducted on 67 participants who had unexplained CBD dilatation at Tropical Medicine Department, Zagazig University. Every patient underwent TUS, CT, MRCP and EUS. Findings of EUS were seen and verified by ERCP, surgery, or a biopsy that revealed cancer. Those who had normal results underwent three months of clinical monitoring. Results: 77.6% and 59.7% of patients underwent US and CT respectively prior to MRCP and EUS. By MRCP, 82.1% of patients were normal, 11.9% had stone, while 3% had CBD mass and 3% had stricture. While by using EUS, 50.7% were normal, 22.4% had stone, while 8.9% had ampullary lesion. Post EUS outcome 37 (55.2%) of patients had only medical follow up while 22.4% had stone extracted by ERCP, 6 patients (8.9%) had sphincterotomy and biopsy from lesions, 4 cases of them had adenocarcinoma, the other 2 cases had adenoma and 2 cases had CBD stricture treated by sphincterotomy and stent dilatation. 2 cases of pancreatic cancer underwent Whipple operation. EUS denied results of MRCP in 25 cases. Conclusion: EUS has a very useful role in the diagnostic work up for patients with unexplained CBD dilatation with or without symptoms.

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“…17 Also, the inability to take tissue samples, the chances of claustrophobia, technical difficulty in jittery/tremulous patients and the use of contrast make MRCP unsuitable for high risk patients. 18 EUS on the contrary can pick up diminutive stones and can be used for histological diagnosis. 19 A cost-analysis study from Thailand concluded that EUS preceding ERCP procedure was more costeffective as EUS could successfully rule out CBD stones, eliminating the need for invasive ERCP.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

Khan¹,

Alam²,

Khan³

et al. 2023

Pak J Med Sci

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Objective: To evaluate the diagnostic accuracy of different imaging modalities in patients with partial biliary obstruction with no obvious aetiology on initial imaging. Methods: This is a prospective single-centre cohort study carried out at Pak Emirates Military Hospital, Rawalpindi from June 2019 to June 2021 with non-probability consecutive sampling. Patients with ages 16 to 75 years, presenting with partial biliary obstruction and undetermined aetiology on initial imaging (TUS and MRCP) were enrolled. EUS was performed for each of these patients and the case was regarded as “true positive” or “true negative” if the findings of imaging modality correlated to those of ERCP. ROC curve, sensitivity, specificity, PPV, NPV and AUC (with 95% confidence interval) were drawn for all the diagnostic tools using SPSS V. 21. Results: A total of 65 patients were enrolled over a period of two years with male to female ratio of 1.4:1. Forty-four patients had an intermediate risk of choledocholithiasis upon preliminary evaluation whereas, 48(74%) of the participants had CBD calculi or sludge confirmed upon subsequent ERCP. Trans-abdominal ultrasound showed the lowest sensitivity (29.2%), specificity (85%), NPV 12% and PPV 93% for diagnosing CBD calculi. This was followed by MRCP with a sensitivity of 37.5%, specificity of 100%, NPV of 36.2% and PPV of 100%. EUS showed the maximum diagnostic accuracy with AUC of 1.0 and a 100% sensitivity and specificity when compared with ERCP as gold standard. Conclusion: EUS is superior to MRCP in terms of diagnostic accuracy as minimally invasive diagnostic tool and EUS superiority is particularly relevant in patients with intermediate risk of choledocholithiasis. doi: https://doi.org/10.12669/pjms.39.5.7280 How to cite this: Khan RSA, Alam L, Khan ZA, Khan UA. Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7280 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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EUS accuracy against MRCP for detection of pancreaticobiliary lesions

Cited by 4 publications

References 0 publications

Accuracy of Ultrasound and Magnetic Resonance Cholangiopancreatography Findings in the Diagnosis of Biliary System Stones

Accuracy of Ultrasound and Magnetic Resonance Cholangiopancreatography Findings in the Diagnosis of Biliary System Stones

Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

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