Endoscopic ultrasound elastography of small solid pancreatic lesions: a multicenter study
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- Andre Ignee
- Medical Department 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
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- Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
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- Paolo G. Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Vita Salute San Raffaele University, Milan, Italy
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- Michael Hocke
- Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany
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- Kathleen Möller
- Medical Department I/Gastroenterology, SANA Hospital Lichtenberg, Berlin, Germany
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- Adrian Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania
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- Uwe Will
- SRH Wald Klinikum Gera, Germany
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- Pietro Fusaroli
- Gastroenterology Unit, Department of Medical and Surgical Sciences University of Bologna, Hospital of Imola, Italy
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- Julio Iglesias-Garcia
- Gastroenterology and Hepatology Department, University Hospital, Santiago de Compostela, Spain
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- Ryan Ponnudurai
- Division of Gastroenterology, Prince Court Medical Centre, Kuala Lumpur, Malaysia
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- Maria C. Petrone
- Pancreato-Biliary Endoscopy and Endosonography Division, Vita Salute San Raffaele University, Milan, Italy
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- Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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- Eike Burmester
- Medical Department I, Sana Hospital Lübeck, Germany
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- Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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- Nathan S. Atkinson
- Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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- Christoph F. Dietrich
- Medical Department 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
Description
<jats:title>Abstract</jats:title><jats:p> 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.</jats:p><jats:p> Methods Patients with solid pancreatic lesions ≤ 15 mm 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.</jats:p><jats:p> Results 218 patients were analyzed. The average size of the lesions was 11 ± 3 mm; 23 % were ductal adenocarcinoma, 52 % neuroendocrine tumors, 8 % metastases, and 17 % other entities; 66 % of the lesions were benign. On elastography, 50 % of lesions were stiffer than the surrounding pancreatic parenchyma (stiff lesions) and 50 % were less stiff or of similar stiffness (soft lesions). High stiffness of the lesion had a sensitivity of 84 % (95 % confidence interval 73 % – 91 %), specificity of 67 % (58 % – 74 %), positive predictive value (PPV) of 56 % (50 % – 62 %), and negative predictive value (NPV) of 89 % (83 % – 93 %) for the diagnosis of malignancy. For the diagnosis of pancreatic ductal adenocarcinoma, the sensitivity, specificity, PPV, and NPV were 96 % (87 % – 100 %), 64 % (56 % – 71 %), 45 % (40 % – 50 %), and 98 % (93 % – 100 %), respectively.</jats:p><jats:p> 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.</jats:p>
Journal
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- Endoscopy
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Endoscopy 50 (11), 1071-1079, 2018-04-24
Georg Thieme Verlag KG
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Details 詳細情報について
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- CRID
- 1360855571018646912
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- ISSN
- 14388812
- 0013726X
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- Data Source
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- Crossref