Contrast-enhanced harmonic endoscopic ultrasound in solid lesions of the pancreas: results of a pilot study
| Autor: | J. C. Souquet, M. Labadie, Jean-Alain Chayvialle, Bertrand Pujol, T. Ponchon, R. Gincoul, Christine Lefort, Jean-Yves Scoazec, M. V. Alvarez-Sanchez, B. Napoléon, P. E. Queneau, Vincent Lepilliez |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Endoscopic ultrasound medicine.medical_specialty Biopsy Fine-Needle Contrast Media Pilot Projects Adenocarcinoma Neuroendocrine tumors Endosonography medicine Humans Prospective Studies Pancreas Aged Aged 80 and over medicine.diagnostic_test business.industry Microcirculation Ultrasound Gastroenterology Pancreatic Diseases Middle Aged medicine.disease digestive system diseases Endoscopy Pancreatic Neoplasms Neuroendocrine Tumors medicine.anatomical_structure Pancreatitis Female Radiology Contrast-Enhanced Harmonic Endoscopic Ultrasound business Carcinoma Pancreatic Ductal |
| Zdroj: | Endoscopy. 42:564-570 |
| ISSN: | 1438-8812 0013-726X |
| DOI: | 10.1055/s-0030-1255537 |
| Popis: | Background and study aims Distinguishing pancreatic adenocarcinoma from other pancreatic masses remains challenging with current imaging techniques. This prospective study aimed to evaluate the accuracy of a new procedure, imaging the microcirculation pattern of the pancreas by contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) with a new Olympus prototype echo endoscope. Patients and methods 35 patients presenting with solid pancreatic lesions were prospectively enrolled. All patients had conventional B mode and power Doppler EUS. After an intravenous bolus injection of 2.4 ml of a second-generation ultrasound contrast agent (SonoVue) CEH-EUS was then performed with a new Olympus prototype echo endoscope (xGF-UCT 180). The microvascular pattern was compared with the final diagnosis based on the pathological examination of specimens from surgery or EUS-guided fine-needle aspiration (EUS-FNA) or on follow-up for at least 12 months. Results The final diagnoses were: 18 adenocarcinomas, 9 neuroendocrine tumors, 7 chronic pancreatitis, and 1 stromal tumor. Power Doppler failed to display microcirculation, whereas harmonic imaging demonstrated it in all cases. Out of 18 lesions with a hypointense signal on CEH-EUS, 16 were adenocarcinomas. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of hypointensity for diagnosing pancreatic adenocarcinoma were 89 %, 88 %, 88 %, 89 %, and 88.5 %, compared with corresponding values of 72 %, 100 %, 77 %, 100 %, and 86 % for EUS-FNA. Of five adenocarcinomas with false-negative results at EUS-FNA, four had a hypointense echo signal at CEH-EUS. Conclusions CEH-EUS with the new Olympus prototype device successfully visualizes the microvascular pattern in pancreatic solid lesions, and may be useful for distinguishing adenocarcinomas from other pancreatic masses. |
| Databáze: | OpenAIRE |
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