The usefulness of EUS‐FNA with contrast‐enhanced harmonic imaging of solid pancreatic lesions: A prospective study. Issue 12 (29th June 2020)

• Record Type: Journal Article
• Authors: Itonaga, Masahiro; Kitano, Masayuki; Kojima, Fumiyoshi; Hatamaru, Keiichi; Yamashita, Yasunobu; Tamura, Takashi; Nuta, Junya; Kawaji, Yuki; Shimokawa, Toshio; Tanioka, Kensuke; Murata, Shin‐ichi
• Is Part Of: Journal of gastroenterology and hepatology. Volume 35:Issue 12(2020)
• Page Start: 2273
• Page End: 2280
• Publication Date: 2020-06-29
• Subjects: Endoscopic ultrasound -- Imaging and advanced technology/applied therapeutics -- Pancreatic cancer; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.15144
• Languages: English
• ISSNs: 0815-9319

Abstract

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% 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.