Endoscopic ultrasound in pancreatic tumor diagnosis

Rösch, Thomas; Lorenz, Reinhard; Braig, Christine; Feuerbach, Stefan; Siewert, J. R.; Schusdziarra, V.; Classen, Meinhard

doi:10.1016/s0016-5107(91)70729-3

Cited by 407 publications

(186 citation statements)

References 13 publications

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“…Several reports have described that this modality can be used to diagnose early pancreatic cancers that cannot be recognized by CT (20)(21)(22)(23)(24)(25)(26). We suggest that EUS should be selected to diagnose pancreatic cancer at an early stage in patients with acute pancreatitis.…”

Section: Discussionmentioning

confidence: 95%

Acute Pancreatitis as a Possible Indicator of Pancreatic Cancer: The Importance of Mass Detection

2015

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Objective The aims of this study were to assess the incidence of pancreatic cancer and the contributing factors for the diagnosis of tumors in patients with acute pancreatitis and to gain insight into how patients with acute pancreatitis should be followed up. Methods Using the electronic medical database of Shizuoka General Hospital, 177 patients admitted for acute pancreatitis in the past 6 years were evaluated retrospectively for pancreatic cancer. Results Twelve patients (6.8%) were newly diagnosed with pancreatic cancer. During the first hospitalization, 5 patients (41.7%) with a detected pancreatic mass underwent surgical treatment: the final tumor stages were IA, IIA, and IIB in 1, 2, and 2 patients, respectively. In 7 patients (58.3%) without a detected pancreatic mass at the first admission, a pancreatic mass was recognized on follow-up computed tomography (CT) in 2 patients with main pancreatic duct (MPD) dilatation, and 1 patient with recurrent acute pancreatitis. The tumor stages were IA, IIA, and IA, respectively. Among the remaining 4 patients without follow-up, the tumor stage was IV. The patient gender, age, MPD dilatation, tumor marker, and serum amylase level were not significantly associated with pancreatic cancer. The detection of a pancreatic mass on CT led to the diagnosis of pancreatic cancer. Conclusion Acute pancreatitis should be considered as a possible diagnostic indicator of pancreatic cancer. Various factors associated with acute pancreatitis and pancreatic cancer were not predictive of a diagnosis of pancreatic cancer. Only the detection of a pancreatic mass led to the early diagnosis of pancreatic cancer. Patients hospitalized for acute pancreatitis should be followed up with a diagnostic imaging modality.

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Section: Discussionmentioning

confidence: 95%

Acute Pancreatitis as a Possible Indicator of Pancreatic Cancer: The Importance of Mass Detection

2015

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“…[1][2][3][4][5] EUS is superior to the CT scan, transabdominal ultrasonography, and endoscopic cholangiopancreatography in the detection of pancreatic tumors and adenopathy. 4,8 -11 However, the reliability of endosonographic features to differentiate between an inflammatory process and malignancy has been questioned.…”

Section: Discussionmentioning

confidence: 99%

“…4,8 -11 However, the reliability of endosonographic features to differentiate between an inflammatory process and malignancy has been questioned. 3,6,9 In a study of 132 patients with suspected pancreatic mass examined using EUS, Rosch et al 3 reported an overall accuracy of 76% for malignancy 0 6 6 6 Benign 33 3 1 37 Nondiagnostic 3 3 0 6 EUS-FNAB: endoscopic ultrasound-guided fine-needle aspiration biopsy a Included four left adrenal glands, one bile duct lesion, and one retroperitoneal mass.…”

Section: Discussionmentioning

confidence: 99%

“…EUS is useful for the diagnosis and staging of GI and pancreatic malignancies. [1][2][3][4][5] However, EUS is limited in its ability to distinguish an inflammatory/reactive process from a malignancy, particularly in evaluating lymph nodes and small lesions within the pancreas. 6,7 Similarly, EUS may be useful to identify submucosal masses but it is only diagnostic in a limited number of conditions such as varices and leiomyoma of the GI tract.…”

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Endoscopic ultrasound-guided fine-needle aspiration biopsy

Chhieng

Jhala

et al. 2002

Cancer

129

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“…Despite various radiographic imaging techniques, such as transabdominal ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography and octreotide scintigraphy, up to 30% of PNETs can be missed during preoperative evaluation (6). Published data suggest the superiority of endoscopic ultrasound (EUS) in detecting and localizing PNETs, particularly those smaller than 2 cm in size, compared with ultrasound, CT, MRI and endoscopic retrograde cholangiopancreatography (7)(8)(9). In asymptomatic patients with MEN1, EUS was able to identify 82% of PNETs before the development of significant biochemical test abnormalities (4).…”

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confidence: 99%

The Impact of Preoperative Endoscopic Ultrasound on the Surgical Management of Pancreatic Neuroendocrine Tumours

Alsohaibani¹,

Bigam²,

Kneteman³

et al. 2008

Canadian Journal of Gastroenterology

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GS Sandha. The impact of preoperative endoscopic ultrasound on the surgical management of pancreatic neuroendocrine tumours. Can J Gastroenterol 2008;22(10):817-820.BACKGROUND: Endoscopic ultrasound (EUS) is accurate in diagnosing pancreatic neuroendocrine tumours (PNETs), but its impact on surgical management is unclear. OBJECTIVE: To determine whether preoperative EUS findings altered the decision for, and extent of, surgery in patients with PNETs. METHODS: A retrospective review of patients referred for EUS because of suspected PNETs was conducted. The diagnosis of PNETs was confirmed by EUS-guided fine needle aspiration cytology, where indicated, or by surgical histology. EUS findings were compared with computed tomography (CT) findings to determine whether there was an impact on the decision for surgical management. RESULTS: Fourteen patients (10 women), with a mean age of 44 years, underwent EUS for suspected PNETs. PNETs were seen with CT in 10 of 13 patients (77%) and with EUS in 14 of 14 patients (100%). One obese patient could not fit into the CT scanner. This patient had five PNETs on EUS. Three patients with a normal CT scan were determined to have one or two PNETs on EUS. Three patients with one or two PNETs on CT were found to have five to eight PNETs on EUS. EUS altered the decision for possible surgical management in five of 14 patients (36%), either by identifying a PNET or by finding multiple and multifocal PNETs that were not visualized on CT scans. CONCLUSION: EUS is useful in the preoperative assessment of PNETs by providing information that significantly influences the decision for surgical intervention or changes the extent of the planned surgery.Key Words: Biopsy; Endosonography; Neuroendocrine tumour; Outcome; Pancreas Les répercussions de l'endoscopie préopértoire sur la prise en charge chirurgicale des tumeurs neuroendocriniennes du pancréas HISTORIQUE : L'endoscopie est une méthode précise pour diagnostiquer les tumeurs neuroendocriniennes du pancréas (TNEP), mais on n'en connaît pas exactement les répercussions sur la prise en charge chirurgicale. OBJECTIF : Déterminer si les résultats des endoscopies préopératoires modifient la décision d'opérer les patients atteints de TNEP et l'importance de la chirurgie. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse rétrospective des patients aiguillés en vue de subir une endoscopie à cause de TNEP pré-sumées. Le diagnostic de TNEP était confirmé au moyen d'une cytologie par aspiration à l'aiguille guidée par endoscopie, au besoin, ou d'une histologie chirurgicale. Les auteurs ont comparé les résultats de l'endoscopie à ceux de la tomodensitométrie pour déterminer si la première avait des répercussions sur la décision de prise en charge chirurgicale. RÉSULTATS : Quatorze patients (dix femmes) d'un âge moyen de 44 ans ont subi une endoscopie à cause de TNEP présumées. La tomodensitométrie a révélé des TNEP chez dix des 13 patients (77 %) et l'endoscopie, chez 14 des 14 patients (100 %). Un patient obèse ne pouvait pénétrer dans le tomodensi...

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Endoscopic ultrasound in pancreatic tumor diagnosis

Cited by 407 publications

References 13 publications

Acute Pancreatitis as a Possible Indicator of Pancreatic Cancer: The Importance of Mass Detection

Acute Pancreatitis as a Possible Indicator of Pancreatic Cancer: The Importance of Mass Detection

Endoscopic ultrasound-guided fine-needle aspiration biopsy

The Impact of Preoperative Endoscopic Ultrasound on the Surgical Management of Pancreatic Neuroendocrine Tumours

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