Endoscopic ultrasonography for microvascular imaging without contrast enhancement in the differential diagnosis of pancreatic lesions.

Autor: Yamashita Y; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Yamazaki H; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Nakahata A; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Shimokawa T; Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan., Tamura T; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.; Department of Human Pathology, Wakayama Medical University, Wakayama, Japan., Kawaji Y; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Tamura T; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Hatamaru K; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Itonaga M; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Ashida R; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan., Kitano M; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
Jazyk: angličtina
Zdroj: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society [Dig Endosc] 2024 Aug 11. Date of Electronic Publication: 2024 Aug 11.
DOI: 10.1111/den.14889
Abstrakt: Objectives: Detective flow imaging endoscopic ultrasonography (DFI-EUS) is a recent imaging modality developed for detecting fine vessels without the need for ultrasound contrast agents. The aim of the present study was to evaluate the utility of DFI-EUS for solid pancreatic lesions and to compare the diagnostic ability for pancreatic cancer (PC) between DFI-EUS, directional power Doppler (eFLOW) EUS, and contrast-enhanced harmonic (CH)-EUS.
Methods: Patients with a pancreatic lesion who underwent DFI-EUS, eFLOW-EUS, and CH-EUS between March 2019 and November 2023 were retrospectively enrolled. Final diagnoses were confirmed by pathologic examination of EUS-guided tissue acquisition and/or resected specimens. Lesions were categorized into the three patterns of poor, mild, and rich vascularity on DFI-EUS and eFLOW-EUS, and hypo-, iso-, and hypervascular on CH-EUS. PC was defined as a poor pattern on DFI-EUS and eFLOW-EUS, and a hypovascular pattern on CH-EUS.
Results: The final diagnoses of 90 examined tumors were PC (n = 57), inflammatory mass (n = 6), autoimmune pancreatitis (n = 13), neuroendocrine tumor (n = 9), and others (n = 5). The sensitivity, specificity, and accuracy for diagnosis of PC were 93%, 82%, and 88%, respectively, on DFI-EUS, 97%, 42%, and 77% on eFLOW-EUS, and 95%, 89%, and 92% on CH-EUS. The accuracy of DFI-EUS was significantly superior to eFLOW-EUS (P = 0.005), but no significant difference was found between DFI-EUS and CH-EUS.
Conclusion: DFI-EUS is more sensitive for depicting vasculature than eFLOW-EUS, and has higher diagnostic sensitivity for PC. Evaluation of vascularity on DFI-EUS is useful for the differential diagnosis of pancreatic lesions without the need for intravenous contrast agent.
(© 2024 Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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