Value of contrast‐enhanced harmonic endoscopic ultrasound for diagnosing hepatic metastases of pancreatic cancer: A prospective study. Issue 12 (31st August 2021)

• Record Type: Journal Article
• Authors: Emori, Tomoya; Nuta, Junya; Kawaji, Yuki; Tamura, Takashi; Hatamaru, Keiichi; Itonaga, Masahiro; Yamashita, Yasunobu; Ashida, Reiko; Shimokawa, Toshio; Koike, Masataka; Ikoma, Akira; Sonomura, Tetsuo; Kawai, Manabu; Kitano, Masayuki
• Is Part Of: Journal of gastroenterology and hepatology. Volume 36:Issue 12(2021)
• Page Start: 3402
• Page End: 3409
• Publication Date: 2021-08-31
• Subjects: contrast harmonic endoscopic ultrasound -- contrast‐enhanced computed tomography -- hepatic metastases -- Kupffer‐phase imaging -- left hepatic lobe metastases -- pancreatic cancer -- prospective study; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.15661
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aims: This study aimed to compare contrast‐enhanced harmonic endoscopic ultrasound (CH‐EUS) with fundamental B‐mode endoscopic ultrasonography (EUS) and contrast‐enhanced computed tomography (CE‐CT) for the diagnosis of left hepatic lobe metastases of pancreatic adenocarcinoma. Methods: In this single‐center prospective study, CE‐CT, EUS, and CH‐EUS were performed to detect left hepatic lobe metastases in patients with pancreatic adenocarcinoma, and the detection rates were compared between EUS plus CH‐EUS and the other two modalities. Subgroup comparisons of between‐modality detection rate were performed in patients with only metastases of <10 mm. The number of pancreatic adenocarcinoma patients whose clinical stage and treatment strategy were changed because of EUS plus CH‐EUS findings was also assessed. Results: Thirty‐one patients were diagnosed with left hepatic lobe metastases. For overall detection of left hepatic lobe metastases, EUS plus CH‐EUS had significantly higher accuracy (94.3%) than CE‐CT (86.7%) and EUS alone (87.6%) ( P = 0.021 and P = 0.020, respectively). For detection of left hepatic lobe metastases < 10 mm, EUS plus CH‐EUS (93.3%) was significantly superior to CE‐CT (84.4%) and EUS alone (85.6%) ( P = 0.021 and P = 0.020, respectively). In five of the 11 patients in whom only CH‐EUS allowed detection of hepatic metastases, the stage and/or treatment strategy of the pancreatic adenocarcinoma was changed after CH‐EUS. Conclusion: This study demonstrated that EUS plus CH‐EUS has advantages over CE‐CT and EUS alone with regard to the accuracy of detecting left hepatic lobe metastases, particularly small hepatic metastases and accurate staging.