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The usefulness of EUS-FNA with contrast-enhanced harmonic imaging of solid pancreatic lesions: A prospective study.
Itonaga, Masahiro; Kitano, Masayuki; Kojima, Fumiyoshi; Hatamaru, Keiichi; Yamashita, Yasunobu; Tamura, Takashi; Nuta, Junya; Kawaji, Yuki; Shimokawa, Toshio; Tanioka, Kensuke; Murata, Shin-Ichi.
Affiliation
  • Itonaga M; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Kitano M; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Kojima F; Department of Human Pathology, Wakayama Medical University, Wakayama, Japan.
  • Hatamaru K; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Yamashita Y; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Tamura T; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Nuta J; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Kawaji Y; Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
  • Shimokawa T; Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan.
  • Tanioka K; Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan.
  • Murata SI; Department of Human Pathology, Wakayama Medical University, Wakayama, Japan.
J Gastroenterol Hepatol ; 35(12): 2273-2280, 2020 Dec.
Article in En | MEDLINE | ID: mdl-32529685
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% vs 68.8%, P = 0.003 and 76.5% vs 58.8%, P = 0.011, respectively). The adequate sampling rate and sensitivity were 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 > 15 mm.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreas / Pancreatic Neoplasms / Image Enhancement / Endosonography / Endoscopic Ultrasound-Guided Fine Needle Aspiration Type of study: Observational_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: J Gastroenterol Hepatol Journal subject: GASTROENTEROLOGIA Year: 2020 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreas / Pancreatic Neoplasms / Image Enhancement / Endosonography / Endoscopic Ultrasound-Guided Fine Needle Aspiration Type of study: Observational_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: J Gastroenterol Hepatol Journal subject: GASTROENTEROLOGIA Year: 2020 Document type: Article Affiliation country: Country of publication: