Quantitative Contrast-Enhanced Harmonic Endoscopic Ultrasonography for the Discrimination of Solid Pancreatic Masses

Seicean, Andrada; Badea, Radu; Stan-Iuga, Roxana; Mocan, Tudor; Gulei, Iulia; Pascu, Oliviu

doi:10.1055/s-0029-1245833

Cited by 78 publications

(83 citation statements)

References 25 publications

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“…A similarly low negative predictive value (64%) was found previously in a study using core biopsy and cytoblock preparation [6]. To increase this value, a higher number of passes [11], a proper selection of adequate material [6] or guidance under contrast enhancement can be performed [21]. Other reports showed that repeating the EUS-FNA in the case of an initially negative cytology increased the yield of diagnosis [25][26][27], as in our group of patients, where the diagnostic rate increased to 96%, despite some delay for obtaining the final diagnosis.…”

Section: Discussionmentioning

confidence: 53%

“…The sample quality for histological analysis (diagnostic cell clusters, appropriate architecture) differed between two experienced endosonographers, proving the importance of the technique in core sampling [6]. Previously, a diagnosis sensitivity rate of 60-73% by using another 22G needle [10,21,22] was obtained. Only one study used the same type of 22G FNA needle as we did, in a small number of patients; the procurement of core biopsy was 100%, but the optimal histological core was 66.7% [4].…”

Section: Discussionmentioning

confidence: 99%

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Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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“…Qualitative interpretation can be subjective, however, and quantification of contrast uptake is expected to yield new information with improved accuracy. We used a hue histogram analysis and noted that a hypoenhanced aspect can occur even in severe chronic pancreatitis, but the level of contrast enhancement compared with surrounding tissue is much lower in adenocarcinoma than in chronic pancreatitis [100]. Using specialized software to interpret contrast data, our results were confirmed in another study where time to peak (TTP) was associated with sensitivity of 93% and specificity of 89% [101].…”

Section: Contrast-enhanced Eusmentioning

confidence: 58%

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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“…Quantitative postprocedural assessment of uptake of the contrast agent has been proven useful to improve the accuracy of CE-EUS with low mechanical index for differentiating between the two entities [55,56].…”

Section: Contrast-enhanced Endoscopic Ultrasound (Ce-eus)mentioning

confidence: 99%

Contrast‐Enhanced Ultrasound for the Assessment of Pancreatic Lesions

Şirli¹,

Popescu²

2017

Challenges in Pancreatic Pathology

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Transabdominal ultrasound (US) is the first-line imaging method used to diagnose pancreatic lesions, but contrast techniques are needed to differentiate among inflammatory and malignant lesions, as well as between pseudocysts and cystic tumors. Contrast-enhanced (CE) ultrasonography has been proven to be a useful tool in this regard with performance similar to contrast-enhanced computer tomography/magnetic resonance imaging (CT/MRI), being also safer and nonirradiant. According to the EFSUMB guidelines on the nonhepatic use of contrast-enhanced ultrasound (CEUS), this method is useful to improve characterization of ductal adenocarcinoma; to differentiate between pseudocysts and cystic tumors; to differentiate vascular (solid) from avascular (liquid/necrotic) components of a lesion; to better define the dimensions and margins of a lesion, including its relationship with adjacent vessels; and to help the choice for a next imaging technique.

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Quantitative Contrast-Enhanced Harmonic Endoscopic Ultrasonography for the Discrimination of Solid Pancreatic Masses

Cited by 78 publications

References 25 publications

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Contrast‐Enhanced Ultrasound for the Assessment of Pancreatic Lesions

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