Utility of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Early Diagnosis of Small Pancreatic Cancer

This study aimed to assess whether contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS), compared to multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI), is useful for early diagnosis of small pancreatic cancer (PC). Between March 2010 and June 2018, all three imaging modalities and surgery were performed for patients with a pancreatic solid lesion measuring ≤20 mm; diagnostic ability was compared among modalities. Fifty-one of 60 patients were diagnosed with PC (PC size in 41 patients: 11–20 mm; 10 patients: ≤10 mm). The sensitivity, specificity, and accuracy of CH-EUS, MDCT, and MRI for PC (11–20 mm) detection were 95%/83%/94%, 78%/83%/79%, and 73%/33%/68%, respectively. The diagnostic ability of CH-EUS was significantly superior compared with MDCT and MRI (p = 0.002 and p = 0.007, respectively). The sensitivity, specificity, and accuracy of CH-EUS, MDCT, and MRI for PC (≤10 mm) detection were 70%/100%/77%, 20%/100%/38%, and 50%/100%/62%, respectively. The diagnostic ability of CH-EUS tended to be superior to that of MDCT (p = 0.025). The sensitivity of MDCT for PC (≤10 mm) detection was significantly lower than that for PC (11–20 mm) detection (20% vs. 78%; p = 0.001). CH-EUS, compared to MDCT and MRI, is useful for diagnosing small PCs.

Download Full-text

EARLY DIAGNOSIS OF SMALL PANCREATIC CANCER: ROLE OF ENDOSCOPIC ULTRASONOGRAPHY

Digestive Endoscopy ◽

10.1111/j.1443-1661.2009.00866.x ◽

2009 ◽

Vol 21 ◽

pp. S92-S96 ◽

Cited By ~ 6

Author(s):

Atsushi Irisawa ◽

Ai Sato ◽

Masaki Sato ◽

Tsunehiko Ikeda ◽

Rei Suzuki ◽

...

Keyword(s):

Pancreatic Cancer ◽

Early Diagnosis ◽

Endoscopic Ultrasonography ◽

Small Pancreatic Cancer

Download Full-text

Mo1332 ROLE OF ENDOSCOPIC ULTRASONOGRAPHY FOR DETECTION AND EARLY DIAGNOSIS OF SMALL PANCREATIC CANCER

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.1982 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB449

Author(s):

Yasunobu Yamashita ◽

Takashi Tamura ◽

Yuki Kawaji ◽

Junya Nuta ◽

Masahiro Itonaga ◽

...

Keyword(s):

Pancreatic Cancer ◽

Early Diagnosis ◽

Endoscopic Ultrasonography ◽

Small Pancreatic Cancer

Download Full-text

Endoscopic Ultrasound for Early Diagnosis of Pancreatic Cancer

Diagnostics ◽

10.3390/diagnostics9030081 ◽

2019 ◽

Vol 9 (3) ◽

pp. 81 ◽

Cited By ~ 8

Author(s):

Takeichi Yoshida ◽

Yasunobu Yamashita ◽

Masayuki Kitano

Keyword(s):

Pancreatic Cancer ◽

Early Diagnosis ◽

Endoscopic Ultrasound ◽

Imaging Modality ◽

Needle Aspiration ◽

Familial Pancreatic Cancer ◽

Pancreatic Lesion ◽

Pancreatic Cancers ◽

Contrast Enhanced ◽

Magnetic Resonance Imaging Mri

Detection of small pancreatic cancers, which have a better prognosis than large cancers, is needed to reduce high mortality rates. Endoscopic ultrasound (EUS) is the most sensitive imaging modality for detecting pancreatic lesions. The high resolution of EUS makes it particularly useful for detecting small pancreatic lesions that may be missed by other imaging modalities. Therefore, EUS should be performed in patients with obstructive jaundice in whom computed tomography (CT) or magnetic resonance imaging (MRI) does not identify a definite pancreatic lesion. Interest in the use of EUS for screening individuals at high risk of pancreatic cancer, including those with intraductal papillary mucinous neoplasms (IPMNs) and familial pancreatic cancer is growing. Contrast-enhanced EUS can facilitate differential diagnosis of small solid pancreatic lesions as well as malignant cystic lesions. In addition, EUS-guided fine needle aspiration can provide samples of small pancreatic lesions. Thus, EUS and EUS-related techniques are essential for early diagnosis of pancreatic cancer.

Download Full-text

Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer

Diagnostics ◽

10.3390/diagnostics11020238 ◽

2021 ◽

Vol 11 (2) ◽

pp. 238

Author(s):

Yasutaka Ishii ◽

Masahiro Serikawa ◽

Tomofumi Tsuboi ◽

Ryota Kawamura ◽

Ken Tsushima ◽

...

Keyword(s):

Pancreatic Cancer ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Ultrasonography ◽

Treatment Decision ◽

Needle Aspiration ◽

Pancreatic Tumors ◽

Decision Strategy ◽

Endoscopic Retrograde ◽

Small Pancreatic Cancer ◽

Eus Elastography

Pancreatic cancer has the poorest prognosis among all cancers, and early diagnosis is essential for improving the prognosis. Along with radiologic modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), endoscopic modalities play an important role in the diagnosis of pancreatic cancer. This review evaluates the roles of two of those modalities, endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP), in the diagnosis of pancreatic cancer. EUS can detect pancreatic cancer with higher sensitivity and has excellent sensitivity for the diagnosis of small pancreatic cancer that cannot be detected by other imaging modalities. EUS may be useful for the surveillance of pancreatic cancer in high-risk individuals. Contrast-enhanced EUS and EUS elastography are also useful for differentiating solid pancreatic tumors. In addition, EUS-guided fine needle aspiration shows excellent sensitivity and specificity, even for small pancreatic cancer, and is an essential examination method for the definitive pathological diagnosis and treatment decision strategy. On the other hand, ERCP is invasive and performed less frequently for the purpose of diagnosing pancreatic cancer. However, ERCP is essential in cases that require evaluation of pancreatic duct stricture that may be early pancreatic cancer or those that require differentiation from focal autoimmune pancreatitis.

Download Full-text

The value of contrast-enhanced FLAIR magnetic resonance imaging in detecting meningeal abnormalities in suspected cases of meningitis compared to conventional contrast-enhanced T1WI sequences

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00348-2 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Wael Hamza Kamr ◽

Mohamed Gaber Eissawy ◽

Amr Saadawy

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Early Diagnosis ◽

Diagnosis And Treatment ◽

Effective Management ◽

Resonance Imaging ◽

Flair Sequence ◽

Csf Analysis ◽

Contrast Enhanced ◽

Magnetic Resonance Imaging Mri

Abstract Background Early diagnosis of meningitis with magnetic resonance imaging (MRI) would be useful for appropriate and effective management, decrease morbidity and mortality, and provide better diagnosis and treatment. The objective of the current study is to compare the accuracy of contrast-enhanced FLAIR (CE-FLAIR) and contrast-enhanced T1WI (CE-T1WI) in the detection of meningeal abnormalities in suspected cases of meningitis. Results Out of 45 patients, 37 patients were confirmed to have meningitis on CSF analysis. Out of the 37 patients, 34 patients were positive on CE-FLAIR sequence and 27 were positive on CE-T1WI. The sensitivity of CE-FLAIR sequence was 91.9% and specificity 100%, while the sensitivity of CE-T1WI sequence was 73% and specificity 100%. Conclusion CE-FLAIR is more sensitive than CE-T1WI in diagnosis of meningitis. It is recommended to be used in any cases with clinically suspected meningitis.

Download Full-text

Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA

Medical Ultrasonography ◽

10.11152/mu.2013.2066.181.ich ◽

2016 ◽

Vol 18 (1) ◽

pp. 18 ◽

Cited By ~ 12

Author(s):

Sevastiţa Iordache ◽

Mădălin Ionuţ Costache ◽

Carmen Florina Popescu ◽

Costin Teodor Streba ◽

Sergiu Cazacu ◽

...

Keyword(s):

Pancreatic Cancer ◽

Diagnostic Algorithm ◽

High Sensitivity ◽

Clinical Decision ◽

Needle Aspiration ◽

Clinical Tool ◽

Decision Algorithm ◽

Contrast Enhanced ◽

Pancreatic Masses ◽

Sensitivity Specificity

Aims: It is well known that endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has a high sensitivity (over 85%) and specificity (100%) for diagnosis of pancreatic cancer. The aim of the study was to establish a EUS based clinical diagnostic algorithm in patients with pancreatic masses and negative cytopathology after EUS-FNA, based on previously published results and cut-offs of real-time elastographic (RTE) EUS and contrast-enhanced harmonic (CEH) EUS. Material and methods: We included in the study a subgroup of 50 consecutive patients with focal pancreatic masses which underwent EUS examinations with negative EUS-FNA. RTE-EUS and CEH-EUS were performed sequentially in all patients. The sensitivity, specificity and accuracy of these methods were calculated separately. A clinical decision algorithm based on elastography followed by CEH was established. Results: For the diagnosis of possible malignancy, the sensitivity, specificity and accuracy of RTE-EUS were: 97.7%, 77.4%, and 84% respectively. CEH-EUS had similar results: 89.5%, 80.7%, and 84%, respectively. In 25 patients with soft/mixed appearance during elastography,sequential assessment using contrast-enhanced EUSwas performed. The specificity of CEH-EUS for detection of chronic pancreatitis in this sub-set of patients was excellent (100%). In other 25 patients with hard appearance in elastography (low strain) CEH-EUS had an excellent specificity (100%) and accuracy (93%) in the detection of pancreatic cancer. Conclusions: The proposed algorithm with sequential use of elastography followed by CEH could be a good clinical tool in the set of patients with negative EUS-FNA results for the differentiation between benign and malignant focal pancreatic masses.

Download Full-text