Endoscopic Ultrasonography-Guided Diagnosis of Subepithelial Tumors

Alkhatib, Amer A.; Faigel, Douglas O.

doi:10.1016/j.giec.2012.04.006

Cited by 23 publications

(19 citation statements)

References 101 publications

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“…Endoscopic resection using a ligation device or a transparent cap yields definite diagnosis in approximately 90% of SM-layer tumors. [ 11 ] Endoscopic partial resection with the unroofing technique or single-incision needle-knife biopsy yields a 92.8% to 93.7% definite diagnosis rate. [ 12 – 14 ] The associated procedure-related bleeding rate was 56% (9/16), but could be controlled easily through endoscopic bleeding techniques.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound without tissue acquisition has poor accuracy for diagnosing gastric subepithelial tumors

et al. 2016

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Incidental gastric subepithelial tumor (SET) is frequently found during endoscopy. Although endoscopic ultrasonography (EUS) can provide useful information, its diagnostic accuracy varies. Most of the potentially malignant tumors observed on EUS are hypoechoic lesions. Therefore, we aimed to investigate the diagnostic accuracy of EUS for hypoechoic lesions located in the submucosa or proper muscle layer. We also evaluated various characteristics for potential associations with diagnostic accuracy.A retrospective review was conducted of the medical records of 99 patients who were diagnosed with gastric SET and who underwent EUS with pathologic confirmation between March 2008 and April 2015. After reviewing the endoscopic and pathologic findings, we attempted to analyze factors that were associated with the diagnostic accuracy of EUS.The mean ± standard deviation size of the lesions was 20.0 ± 12.7 mm. The most common location was the upper third of the stomach (43.4%). The overall accuracy of EUS was 66.7%. No statistically significant difference in EUS accuracy was observed according to the location, size, or layer of the lesion. The following pathologic diagnostic methods were used: EUS-guided fine needle aspiration (3.0%), forceps biopsy (16.2%), deep tissue biopsy using cap-assisted mucosal resection (8.1%), endoscopic submucosal dissection (25.2%), and operation (47.5%). The accuracy of EUS according to the expected diagnosis of the lesion was 77.1% for gastrointestinal stromal tumor, 50% for neuroendocrine tumor, and 50% for ectopic pancreas.Although EUS is a useful tool for gastric SET in clinical practice, the accuracy of diagnostic EUS is suboptimal. When considering whether to treat gastric SET, the decision should be made based on the pathologic diagnosis.

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound without tissue acquisition has poor accuracy for diagnosing gastric subepithelial tumors

et al. 2016

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“…93,94 The typical EUS appearance is a smooth, welldefined tubular to round, hypoechoic or anechoic lesion arising from the submucosa or extrinsic to the gut wall. 12 Hypoechoic features can be seen secondary to mucinous material within the cyst. A "duplication" of GI tract wall layers may be noted within the cyst.…”

Section: Duplication Cystsmentioning

confidence: 99%

“…10,11 EUS also permits measurement of lesion size and evaluation of any associated lymphadenopathy for further staging. 9,12 Finally, EUS-guided FNA (EUS-FNA) and fine-needle biopsy (FNB) allow tissue diagnosis to guide further management.…”

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confidence: 99%

The role of endoscopy in subepithelial lesions of the GI tract

Faulx¹,

Kothari²,

Acosta³

et al. 2017

Gastrointestinal Endoscopy

189

184

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“…Several management algorithms and guidelines for SELs have been produced [9][10][11][12][13][14][15][16]. Recently, the European Society of Gastrointestinal Endoscopy (ESGE) clinical guidelines regarding the indications, results, and clinical impact of EUS-guided sampling in gastroenterology were published [17].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Upper Endoscopic and Endoscopic Ultrasound Features in the Differential Diagnosis of Gastrointestinal Stromal Tumors and Leiomyomas in the Upper Gastrointestinal Tract

et al. 2019

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Background: Differentiation between benign and malignant subepithelial lesions (SELs) in the upper gastrointestinal tract (UGT) leads to far-reaching clinical consequences. An accurate diagnosis can be challenging because of the insufficient diagnostic yield of upper endoscopy, endoscopic ultrasound (EUS), and different types of biopsy. Aim: Our aim was to reveal the efficacy of upper endoscopic and EUS features for the differential diagnosis of hypoechogenic SELs (gastrointestinal stromal tumors [GISTs] and leiomyomas) in the UGT. Materials and Methods: The research covers a case series study of 27 hypoechogenic SELs in the UGT between 2012 and 2015 at Vilnius University Hospital Santaros Klinikos. Upper endoscopic and EUS features of SELs were recorded. In order to standardize the diagnostic approach to GISTs and leiomyomas, we assigned scores for seven upper endoscopic and EUS features. Results: The mean total scores in the GIST group were significantly higher than those in the leiomyoma group: 3.25 ± 1.71 and 0.53 ± 0.83 (p < 0.0001), respectively. Increment by one score increased the odds ratio for GIST 5.87 times (95% CI 1.63-21.11; p = 0.007). The total score demonstrated very good discriminatory features of GISTs against leiomyomas (area under the receiver operating characteristic curve 0.94 [0.86-1]). The cutoff value of 1.5 total score indicated 83.3% sensitivity and 93.3% specificity in diagnosing GISTs. Conclusions: Upper endoscopy and EUS are useful methods in making a definite diagnosis of SELs. Their diagnostic accuracy for the differential diagnosis of GISTs and leiomyomas is sufficient.

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Endoscopic Ultrasonography-Guided Diagnosis of Subepithelial Tumors

Cited by 23 publications

References 101 publications

Endoscopic ultrasound without tissue acquisition has poor accuracy for diagnosing gastric subepithelial tumors

Endoscopic ultrasound without tissue acquisition has poor accuracy for diagnosing gastric subepithelial tumors

The role of endoscopy in subepithelial lesions of the GI tract

Evaluation of Upper Endoscopic and Endoscopic Ultrasound Features in the Differential Diagnosis of Gastrointestinal Stromal Tumors and Leiomyomas in the Upper Gastrointestinal Tract

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