Endoscopic ultrasound elastography of small solid pancreatic lesions: a multicenter study.
Endoscopy
; 50(11): 1071-1079, 2018 11.
Article
em En
| MEDLINE
| ID: mdl-29689572
ABSTRACT
BACKGROUND:
The prevalence of malignancy in patients with small solid pancreatic lesions is low; however, early diagnosis is crucial for successful treatment of these cases. Therefore, a method to reliably distinguish between benign and malignant small solid pancreatic lesions would be highly desirable. We investigated the role of endoscopic ultrasound (EUS) elastography in this setting.METHODS:
Patients with solid pancreatic lesionsâ≤â15âmm in size and a definite diagnosis were included. Lesion stiffness relative to the surrounding pancreatic parenchyma, as qualitatively assessed and documented at the time of EUS elastography, was retrospectively compared with the final diagnosis obtained by fine-needle aspiration/biopsy or surgical resection.RESULTS:
218 patients were analyzed. The average size of the lesions was 11 ± 3 mm; 23â% were ductal adenocarcinoma, 52â% neuroendocrine tumors, 8â% metastases, and 17â% other entities; 66â% of the lesions were benign. On elastography, 50â% of lesions were stiffer than the surrounding pancreatic parenchyma (stiff lesions) and 50â% were less stiff or of similar stiffness (soft lesions). High stiffness of the lesion had a sensitivity of 84â% (95â% confidence interval 73â%â-â91â%), specificity of 67â% (58â%â-â74â%), positive predictive value (PPV) of 56â% (50â%â-â62â%), and negative predictive value (NPV) of 89â% (83â%â-â93â%) for the diagnosis of malignancy. For the diagnosis of pancreatic ductal adenocarcinoma, the sensitivity, specificity, PPV, and NPV were 96â% (87â%â-â100â%), 64â% (56â%â-â71â%), 45â% (40â%â-â50â%), and 98â% (93â%â-â100â%), respectively.CONCLUSIONS:
In patients with small solid pancreatic lesions, EUS elastography can rule out malignancy with a high level of certainty if the lesion appears soft. A stiff lesion can be either benign or malignant.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pâncreas
/
Neoplasias Pancreáticas
/
Tumores Neuroendócrinos
/
Carcinoma Ductal Pancreático
/
Técnicas de Imagem por Elasticidade
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha