The usefulness of EUS-FNA with contrast-enhanced harmonic imaging of solid pancreatic lesions: A prospective study

Published on Dec 1, 2020in Journal of Gastroenterology and Hepatology4.029
路 DOI :10.1111/JGH.15144
Masahiro Itonaga11
Estimated H-index: 11
(Wakayama Medical University),
Masayuki Kitano43
Estimated H-index: 43
(Wakayama Medical University)
+ 8 AuthorsShin-ichi Murata25
Estimated H-index: 25
(Wakayama Medical University)
Sources
Abstract
BACKGROUND AND AIM Few studies have investigated endoscopic ultrasound-guided fine-needle aspiration with contrast-enhanced harmonic imaging (EUS-FNA-CHI) for diagnosing and adequately sampling pancreatic lesions. This study aimed to investigate the efficacy of EUS-FNA-CHI compared with that of endoscopic ultrasound-guided fine-needle aspiration with fundamental B mode imaging (EUS-FNA-FBI) for diagnosing solid pancreatic lesions. METHODS Consecutive patients with solid pancreatic lesions were enrolled prospectively (UMIN 000024467). Only samples obtained during the first needle pass (EUS-FNA-FBI) and second needle pass (EUS-FNA-CHI) were used to compare the accuracy rate for diagnosing pancreatic lesions and rate of adequate sampling for histological evaluation. In patients with hypo-enhancing lesions on contrast-enhanced harmonic EUS (CH-EUS), subgroup analyses were performed. Patients were classified into those with a heterogeneous area in the whole lesion (whole group), those with a heterogeneous area with a non-enhancing area (non-enhancing group), and those with a heterogeneous area with a homogeneous area (homogeneous group). RESULTS Ninety-three patients were enrolled. Overall, the rates of adequate sampling and sensitivity were significantly higher with EUS-FNA-CHI than with EUS-FNA-FBI (84.9% versus 68.8%, P=0.003 and 76.5% versus 58.8%, P=0.011, respectively). The adequate sampling rate and sensitivity was significantly higher with EUS-FNA-CHI than with EUS-FNA-FBI when the mass was >15 mm. In the non-enhancing and homogeneous groups, the adequate sampling rate and sensitivity were significantly higher with EUS-FNA-CHI than with EUS-FNA-FBI. CONCLUSIONS CH-EUS enables improved observation of pancreatic lesions and helps identify the target of EUS-FNA among different pathological areas of the lesions particularly of >15mm.
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Background and Objectives: A needle with Franseen geometry for fine needle aspiration is now available. However, no reports have described prospective evaluations of the Franseen needle or comparisons with the standard needle. The aim of this comparative prospective study was to evaluate the histological diagnostic yield of the Franseen needle and the standard needle using tissue obtained by a single pass of each for the same lesion. Patients and Methods: In this study, only tissue obtained by t...
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BACKGROUND: Current imaging modalities are limited in their ability to distinguish pancreatic cancer (PC) from non-neoplastic pancreatic lesions. The diagnostic use of contrast-enhanced endoscopic ultrasonography (CE-EUS) has increased, and its utility has been reported. Recently, contrast-enhanced harmonic EUS (CH-EUS) was reported to facilitate imaging of parenchymal perfusion and microvessels in pancreatobiliary diseases, leading to a high diagnostic accuracy for PC. The present meta-analysis...
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Endoscopic ultrasound (EUS)-guided tissue acquisition has emerged over the last decade as an invaluable diagnostic tool in approaching the different pancreatic lesions. Given the safety and minimal invasiveness of this approach combined with the high diagnostic yield, it became the standard of care when dealing with different pancreatic pathologies. However, some variables regarding this procedure remain not fully understood. These can influence the diagnostic yield of the procedure and include ...
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#10Hiroshi Watanabe (Fukushima Medical University)H-Index: 18
Abstract Objectives Contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) has been used to diagnose solid pancreatic lesions (SPLs). The aim of this study was to investigate the efficacy of CEH-EUS-guided fine-needle aspiration (CEH-EUS-FNA) compared with that of conventional EUS-FNA for the diagnosis of SPLs. Methods Forty patients with solid pancreatic lesions who visited Fukushima Medical University between September 2013 and June 2014 were recruited for this prospective study. Twen...
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PURPOSE OF REVIEW Pancreatic ductal adenocarcinoma (PDAC) is third leading cause of cancer death in the United States, a lethal disease with no screening strategy. Although diagnosis at an early stage is associated with improved survival, clinical detection of PDAC is typically at an advanced symptomatic stage when best in class therapies have limited impact on survival. RECENT FINDINGS In recent years this status quo has been challenged by the identification of novel risk factors, molecular mar...
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#1Tiing Leong Ang (NUS: National University of Singapore)
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The introduction of endoscopic ultrasound guided fine needle aspiration into clinical practice was a pivotal moment for diagnostic gastrointestinal endoscopy. It facilitated ease of tissue acquisition from previously inaccessible sites. The performance characteristics of cytological diagnosis was excellent. However, there remained areas of inadequacies. These included procedural inefficiencies such as the need for rapid on-site cytological evaluation or macroscopic on-site evaluation, the crucia...
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