A Single-Center Experience of Endoscopic Ultrasonography for Enlarged Pancreas on Computed Tomography

Ho, Sammy; Bonasera, Robert J.; Pollack, Bonnie J.; Grendell, James H.; Feuerman, Martin; Gress, Frank G.

doi:10.1016/s1542-3565(05)00859-1

Cited by 33 publications

(18 citation statements)

References 27 publications

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“…The latter certainly represents a group of cases in whom a negative FNA should be doubted and put into perspective with clinical likelihood. This study confirmed previous experience from other centers, partially also focusing on indeterminate CT findings in which the rate of missed cancers by EUS was excessively low [49][50][51] ; they nevertheless exist [3] . It can, however, be concluded that -with indeterminate CT or transabdominal ultrasound findings -an EUS examination negative for a tumor mass appears to be quite reliable.…”

Section: Pancreatic Cancer: 'Diagnosis' and Differential Diagnosissupporting

confidence: 89%

Endoscopic Ultrasound in Pancreatic Disease — Its Influence on Surgical Decision-Making An Update 2008

et al. 2009

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Section: Pancreatic Cancer: 'Diagnosis' and Differential Diagnosissupporting

confidence: 89%

Endoscopic Ultrasound in Pancreatic Disease — Its Influence on Surgical Decision-Making An Update 2008

et al. 2009

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“…Pancreatic cancer was found in 21% of the patients in our study compared with 8% reported by Ho et al [11]. Our results further demonstrate the superiority of EUS over CT for diagnosis of pancreatic cancer.…”

Section: Discussionsupporting

confidence: 79%

“…Although EUS has the highest detection rate for a pancreatic mass compared with other modalities, such as ultrasound, CT, and endoscopic retrograde cholangiopancreatography (ERCP) [9], and is being increasingly used in the evaluation of patients with inconclusive CT findings [10]; however, the clinical significance of such indeterminate CT findings has not been extensively reported [11]. Such patients in the appropriate clinical context are certainly at high-risk of pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasonography Findings in Patients with Non-Specific Changes of the Pancreas on Computed Tomography: A Single-Center Experience

et al. 2008

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Inconclusive findings on abdominal computerized tomography (CT) scans such as "enlarged or prominent pancreas" are commonly reported; however, their clinical significance is not clearly understood. The objective was to evaluate the efficacy of endoscopic ultrasound (EUS) in a cohort of patients with indeterminate findings on CT. We undertook a retrospective, single-center study at a tertiary care university hospital. About 107 consecutive patients (56 men) underwent EUS evaluation for inconclusive CT findings. The main intervention was EUS with fine needle aspiration (FNA) The main outcome measurement was to describe lesions identified by EUS in this cohort of patients. About 22 patients (21%) had pancreatic adenocarcinoma, 14 (13%) had chronic pancreatitis, 28 (26%) had benign lesions, and 35 patients (33%) had a normal EUS exam. Pancreatic cancer was more likely to be found on EUS in patients with significant weight loss (OR 10.1; 95% CI: 3.3-30.60), hyperbilirubinemia (OR 9; 95% CI: 3-26.0), or common bile duct (CBD) dilatation (OR 3.2; 95% CI: 1.25-8.5). The limitations of the study were that we were unable to control the uniformity of CT interpretation because the scans were reviewed by multiple radiologists. There were also limited follow-up data on patients who had benign lesions or normal EUS. In conclusion, EUS is an effective modality for evaluating pancreatic lesions in patients with inconclusive findings on abdominal CT. This assists in the prompt diagnosis and institution of appropriate treatment strategies for a variety of pancreatic diseases including cancer. In the setting of inconclusive CT findings, patients with hyperbilirubinemia, significant weight loss, or CBD dilatation should undergo EUS evaluation as they are at a higher risk of having underlying pancreatic cancer.

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“…In a study by Catanzaro et al [26], 80 patients with suspected pancreatic cancer on the basis of CT or clinical/laboratory findings underwent a negative EUS, and none were found to ultimately develop pancreatic cancer. Similarly, in a group of patients with ambiguous pancreatic head enlargement on CT reported by Ho et al [27], none of the patients with a negative EUS result had their diagnosis change with follow-up.…”

Section: Pancreatic Adenocarcinomamentioning

confidence: 74%

Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know

2013

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As the technology has improved, endoscopic ultrasound (EUS) has taken on an important role in the diagnosis of a number of different neoplastic and non-neoplastic pancreatic diseases. EUS can provide high-resolution images with subtle anatomic detail, and has also taken on an important role in the targeted biopsy of the pancreas and adjacent structures. This review seeks to familiarize radiologists with the role of EUS in the diagnosis of chronic and autoimmune pancreatitis, solid pancreatic masses, and cystic pancreatic neoplasms.

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A Single-Center Experience of Endoscopic Ultrasonography for Enlarged Pancreas on Computed Tomography

Cited by 33 publications

References 27 publications

Endoscopic Ultrasound in Pancreatic Disease — Its Influence on Surgical Decision-Making An Update 2008

Endoscopic Ultrasound in Pancreatic Disease — Its Influence on Surgical Decision-Making An Update 2008

Endoscopic Ultrasonography Findings in Patients with Non-Specific Changes of the Pancreas on Computed Tomography: A Single-Center Experience

Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know

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