Efficacy of contrast-enhanced harmonic endoscopic ultrasonography in the diagnosis of pancreatic ductal carcinoma

Abstract

Background/Aims:Distinguishing pancreatic ductal carcinoma (DC) from other pancreatic masses remains challenging. This study aims at evaluating the efficacy of contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) in the diagnosis of DC.Patients and Methods:Forty-nine patients with solid pancreatic mass lesions underwent CEH-EUS. EUS (B-mode) was used to evaluate the inner echoes, distributions, and borders of the masses. The vascular patterns of the masses were evaluated with CEH-EUS at 30–50 s (early phase) and 70–90 s (late phase) after the administration of Sonazoid®.Results:The final diagnoses included DCs (37), mass-forming pancreatitis (6), endocrine neoplasms (3), a solid pseudopapillary neoplasm (1), a metastatic carcinoma (1), and an acinar cell carcinoma (1). The sensitivity, specificity, and accuracy of the diagnoses of DC in hypoechoic masses using EUS (B-mode) were 89.2%, 16.7%, and 71.4%, respectively. The sensitivity, specificity, and accuracy for the diagnosis of DC in hypovascular masses using CEH-EUS were 73.0%, 91.7%, and 77.6% in the early phase and 83.8%, 91.7%, and 85.7% in the late phase, respectively.Conclusions:CEH-EUS for the diagnosis of DC is superior to EUS. CEH-EUS in the late phase was particularly efficacious in the diagnosis of DC.

Value of contrast‐enhanced harmonic endoscopic ultrasonography with enhancement pattern for diagnosis of pancreatic cancer: A meta‐analysis

“…A total of 636 articles were originally identified in PubMed, the Cochrane library, and Medline. After application of the inclusion and exclusion criteria, nine articles with a total of 887 patients were selected for the final analysis (Fig. ).…”

“…Contrast‐enhanced harmonic EUS (CH‐EUS) with second‐generation contrast agents is considered an accurate technique for investigation of pancreatic lesions. In fact, the utility of CH‐EUS for the differential diagnosis of pancreatic lesions has been reported in many studies …”

“…In fact, the utility of CH-EUS for the differential diagnosis of pancreatic lesions has been reported in many studies. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Two meta-analyses were previously published on the use of CE-EUS for the diagnosis of pancreatic lesions; 21,22 however, these reports included CE-Doppler EUS and firstgeneration contrast agents. Therefore, we carried out a metaanalysis on the diagnosis of pancreatic cancer using current state-the-art CH-EUS techniques.…”

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

“…The following are potential reasons for these results: (1) EUS is superior to any other modality with respect to spatial resolution; and (2) EUS allows for dynamic and repeated examinations in an area suspected be pancreatic cancer. However, CH-EUS is superior to conventional EUS, and its utility for the differential diagnosis of pancreatic lesions has been reported in many studies [7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], as most pancreatic solid lesions are depicted as a hypoechoic mass in conventional EUS regardless of histology. Therefore, we used CH-EUS in the differential diagnosis for pancreatic lesions.…”

Contrast enhanced ultrasound for solid pancreatic lesions: Does timing after contrast injection also matter?

“…In the current issue of Saudi Journal of Gastroenterology, Uekitani T et al . [ 7 ] described their experience with CH-EUS in 49 patients with solid pancreatic masses who had histological diagnosis or surgical resection. The final diagnosis were ductal carcinoma ( n = 37), mass forming pancreatitis ( n = 6), endocrine tumors ( n = 3) and others ( n = 3).…”