scholarly journals Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

2020 ◽  
Author(s):  
Tatsuya Ishii ◽  
Akio Katanuma ◽  
Haruka Toyonaga ◽  
Koki Chikugo ◽  
Hiroshi Nasuno ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Endoscopic Ultrasound ◽  
Kappa Statistic ◽  
Needle Aspiration ◽  
Neuroendocrine Neoplasms ◽  
Surgical Specimen ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Contrast Enhanced ◽  
Grade Of Malignancy

Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection have become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also evaluate the grade of malignancy. Pooling the data of the studies which compared the PNENs grading between EUS-FNA samples and surgical specimen, the concordance rate was 77.5% (κ-statistic: 0.65, 95% confidence interval = 0.59 - 0.71, P< 0.01). EUS is a particularly important modality for the treatment of PNENs.

scholarly journals Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 316
Author(s):  
Tatsuya Ishii ◽  
Akio Katanuma ◽  
Haruka Toyonaga ◽  
Koki Chikugo ◽  
Hiroshi Nasuno ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Diagnostic Imaging ◽  
Endoscopic Ultrasound ◽  
Needle Aspiration ◽  
Concordance Rate ◽  
Neuroendocrine Neoplasms ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Contrast Enhanced ◽  
Grade Of Malignancy ◽  
Stratified Analysis

Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can now be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection has become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also be used to evaluate the grade of malignancy. Pooling the data of the studies that compared the PNENs grading between EUS-FNA samples and surgical specimens showed a concordance rate of 77.5% (κ-statistic = 0.65, 95% confidence interval = 0.59–0.71, p < 0.01). Stratified analysis for small tumor size (2 cm) showed that the concordance rate was 84.5% and the kappa correlation index was 0.59 (95% confidence interval = 0.43–0.74, p < 0.01). The evolution of ultrasound imaging technologies such as contrast-enhanced and elastography and the artificial intelligence that analyzes them, the evolution of needles, and genetic analysis, will further develop the diagnosis and treatment of PNENs in the future.

Contrast-enhanced harmonic versus standard endoscopic ultrasound-guided fine-needle aspiration in solid pancreatic lesions: a single-center prospective randomized trial

Endoscopy ◽  
2020 ◽  
Vol 52 (12) ◽  
pp. 1084-1090 ◽  
Author(s):  
Andrada Seicean ◽  
Andrada Samarghitan ◽  
Sorana D. Bolboacă ◽  
Cristina Pojoga ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
False Negative ◽  
False Negative Rate ◽  
Random Order ◽  
Needle Aspiration ◽  
Controlled Study ◽  
Surgical Specimen ◽  
Fine Needle ◽  
Contrast Enhanced

Abstract Background Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) can visualize necrotic areas and vessels inside lesions. CH-EUS findings combined with EUS-guided fine-needle aspiration (EUS-FNA) improves diagnosis in pancreatic solid masses. CH-EUS can also guide EUS-FNA (CH-EUS-FNA), potentially improving the diagnostic rate of EUS-FNA, but such superiority has not been proved in prospective studies. We aimed to assess whether CH-EUS-FNA is superior to standard EUS-FNA for specific diagnosis of solid pancreatic masses and what factors affect the diagnostic rate. Methods This randomized controlled study in one tertiary medical academic center included patients with suspected pancreatic solid masses on transabdominal ultrasound or computed tomography (CT) scan. Two passes with a 22-G standard FNA needle were done using EUS-FNA and CH-EUS-FNA in random order, and the visible core obtained was sent for histological analysis. Final diagnosis was based on EUS-FNA or surgical specimen results and on 12-month follow-up by imaging. Results 148 patients were evaluated. EUS-FNA and CH-EUS-FNA showed diagnostic sensitivities of 85.5 % and 87.6 %, respectively (not significantly different) and the combined sensitivity of the two passes was 93.8 %. The false-negative rate was not significantly different when hypoenhanced or hyperenhanced lesions were compared with the EUS-FNA results. No differences were seen for the results related to location, size, tumor stage, chronic pancreatitis features, or presence of biliary plastic stent. Conclusions The diagnostic rates for samples obtained using 22-G needles with standard EUS-FNA and CH-EUS-FNA were not statistically significantly different.

scholarly journals Evaluation of Peritoneal Deposits in Undiagnosed Ascites by Advanced Endoscopic Ultrasound Imaging Techniques

2021 ◽  
Vol 12 (01) ◽  
pp. 049-050
Author(s):  
Surinder Singh Rana ◽  
Ravi Sharma ◽  
Rajesh Gupta
Keyword(s):  
Ascitic Fluid ◽  
Endoscopic Ultrasound ◽  
Imaging Techniques ◽  
Needle Aspiration ◽  
Enhancement Pattern ◽  
Etiological Diagnosis ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Biochemical Evaluation ◽  
Repeat Sampling

AbstractEtiology of ascites can be usually determined with ascitic fluid cytological and biochemical evaluation. Occasionally, the cause of ascites cannot be determined despite repeated ascitic fluid evaluations. These patients with undiagnosed ascites usually undergo diagnostic laparotomy/laparoscopy for etiological diagnosis. Endoscopic ultrasound (EUS) can help in resolving the diagnostic conundrum of undiagnosed ascites by visualizing as well as sampling peritoneal and omental deposits/thickening. However, rarely fine-needle aspiration from deposits may be falsely negative and patient may need repeat sampling. Newer EUS imaging techniques such as elastography and contrast-enhanced harmonic EUS by providing additive information on stiffness and enhancement pattern of the lesion can help in differential diagnosis.

Sign in / Sign up

Export Citation Format

Share Document