Clinical Value of Contrast-Enhanced Harmonic Endoscopic Ultrasonography in the Differential Diagnosis of Pancreatic and Gallbladder Masses
- Author:
Galam LEEM
1
;
Moon Jae CHUNG
;
Jeong Youp PARK
;
Seungmin BANG
;
Si Young SONG
;
Jae Bock CHUNG
;
Seung Woo PARK
Author Information
- Publication Type:Original Article
- Keywords: Contrast-enhanced harmonic endoscopic ultrasonography; EUS; Pancreatic mass; Gallbladder mass
- MeSH: Adenocarcinoma; Complement System Proteins; Diagnosis; Diagnosis, Differential; Endosonography; Gallbladder; Humans; Microvessels; Neuroendocrine Tumors; Pancreas; Perfusion; ROC Curve; Sensitivity and Specificity; Seoul; Ultrasonography
- From:Clinical Endoscopy 2018;51(1):80-88
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Recent studies have revealed that contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) is beneficial in the differential diagnosis of malignant neoplasms of the pancreas and gallbladder from benign masses, in terms of the evaluation of microvasculature and real-time perfusion. In this study, we aimed to prove the clinical value of CEH-EUS in the differential diagnosis of pancreatic and gallbladder masses by direct comparison with that of conventional EUS. METHODS: We reviewed the sonographic images and medical information of 471 patients who underwent conventional EUS and CEH-EUS for the diagnosis of pancreatic and gallbladder masses at a single medical center (Severance Hospital, Seoul, Korea) between March 2010 and March 2016. RESULTS: The enhancement pattern of CEH-EUS of the pancreatic solid masses showed higher sensitivity and specificity in differentiating pancreatic adenocarcinoma and neuroendocrine tumors (82.0% and 87.9% for pancreatic adenocarcinoma and 81.1% and 90.9% for neuroendocrine tumors, respectively), and the area under the receiver operating characteristic curves was higher than that of conventional EUS. The enhancement texture of CEH-EUS of the gallbladder masses showed a higher sensitivity in differentiating malignant masses than that of conventional EUS; however, the difference between the areas under the receiver operating characteristic curves was not statistically significant. CONCLUSIONS: CEH-EUS can complement conventional EUS in the diagnosis of pancreatic and gallbladder masses, in terms of the limitations of the latter.
