Usefulness of EUS combined with contrast-enhancement in the differential diagnosis of malignant versus benign and preoperative localization of pancreatic endocrine tumors

Takuya Ishikawa, Akihiro Itoh, Hiroki Kawashima, Eizaburo Ohno, Hiroshi Matsubara, Yuya Itoh, Yosuke Nakamura, Masanao Nakamura, Ryoji Miyahara, Kazuhiko Hayashi, Masatoshi Ishigami, Yoshiaki Katano, Naoki Omiya, Hidemi Goto, Yoshiki Hirooka

Research output: Contribution to journalArticle

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Abstract

Background: Pancreatic endocrine tumors (PETs) develop in relatively few patients, but they are often difficult to diagnose because of their small size and various clinical symptoms. Objective: The aim of this study was to investigate the usefulness of EUS combined with contrast enhancement (CE-EUS) in the preoperative localization of PETs and the differentiation between malignant and benign PETs. Design and Setting: Single-center retrospective study. Patients: Sixty-two pathologically certified PETs of 41 patients who underwent EUS, multiphasic multidetector computed tomography (MDCT), and transabdominal US at our institute since 2001. Interventions: Intravenous injection of US contrast media. Main Outcome Measurements: Comparison of EUS, MDCT, and US in the preoperative identification of PETs, and the characteristic findings of EUS with malignancy. Results: EUS showed high sensitivity (95.1%) in identifying PETs compared with MDCT (80.6%) and US (45.2%). Multivariable logistic regression analysis showed that heterogeneous ultrasonographic texture was the most significant factor for malignancy (OR = 53.33; 95% CI, 10.79-263.58). Most heterogeneous hypoechoic areas and anechoic areas corresponded to hemorrhage or necrosis on pathologic examination. They were identified as filling defects in CE-EUS and were more clearly recognized than in conventional EUS. Limitations: Retrospective study. Conclusion: EUS has higher sensitivity in preoperative localization of PETs compared with MDCT and US. The characteristics of EUS and CE-EUS findings in malignant PETs were clarified, and they will improve the diagnostic accuracy of PETs.

Original languageEnglish
Pages (from-to)951-959
Number of pages9
JournalGastrointestinal Endoscopy
Volume71
Issue number6
DOIs
Publication statusPublished - 01-05-2010
Externally publishedYes

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Differential Diagnosis
Multidetector Computed Tomography
Neoplasms
Retrospective Studies
Intravenous Injections
Contrast Media
Necrosis
Logistic Models
Regression Analysis
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Ishikawa, Takuya ; Itoh, Akihiro ; Kawashima, Hiroki ; Ohno, Eizaburo ; Matsubara, Hiroshi ; Itoh, Yuya ; Nakamura, Yosuke ; Nakamura, Masanao ; Miyahara, Ryoji ; Hayashi, Kazuhiko ; Ishigami, Masatoshi ; Katano, Yoshiaki ; Omiya, Naoki ; Goto, Hidemi ; Hirooka, Yoshiki. / Usefulness of EUS combined with contrast-enhancement in the differential diagnosis of malignant versus benign and preoperative localization of pancreatic endocrine tumors. In: Gastrointestinal Endoscopy. 2010 ; Vol. 71, No. 6. pp. 951-959.
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abstract = "Background: Pancreatic endocrine tumors (PETs) develop in relatively few patients, but they are often difficult to diagnose because of their small size and various clinical symptoms. Objective: The aim of this study was to investigate the usefulness of EUS combined with contrast enhancement (CE-EUS) in the preoperative localization of PETs and the differentiation between malignant and benign PETs. Design and Setting: Single-center retrospective study. Patients: Sixty-two pathologically certified PETs of 41 patients who underwent EUS, multiphasic multidetector computed tomography (MDCT), and transabdominal US at our institute since 2001. Interventions: Intravenous injection of US contrast media. Main Outcome Measurements: Comparison of EUS, MDCT, and US in the preoperative identification of PETs, and the characteristic findings of EUS with malignancy. Results: EUS showed high sensitivity (95.1{\%}) in identifying PETs compared with MDCT (80.6{\%}) and US (45.2{\%}). Multivariable logistic regression analysis showed that heterogeneous ultrasonographic texture was the most significant factor for malignancy (OR = 53.33; 95{\%} CI, 10.79-263.58). Most heterogeneous hypoechoic areas and anechoic areas corresponded to hemorrhage or necrosis on pathologic examination. They were identified as filling defects in CE-EUS and were more clearly recognized than in conventional EUS. Limitations: Retrospective study. Conclusion: EUS has higher sensitivity in preoperative localization of PETs compared with MDCT and US. The characteristics of EUS and CE-EUS findings in malignant PETs were clarified, and they will improve the diagnostic accuracy of PETs.",
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Ishikawa, T, Itoh, A, Kawashima, H, Ohno, E, Matsubara, H, Itoh, Y, Nakamura, Y, Nakamura, M, Miyahara, R, Hayashi, K, Ishigami, M, Katano, Y, Omiya, N, Goto, H & Hirooka, Y 2010, 'Usefulness of EUS combined with contrast-enhancement in the differential diagnosis of malignant versus benign and preoperative localization of pancreatic endocrine tumors', Gastrointestinal Endoscopy, vol. 71, no. 6, pp. 951-959. https://doi.org/10.1016/j.gie.2009.12.023

Usefulness of EUS combined with contrast-enhancement in the differential diagnosis of malignant versus benign and preoperative localization of pancreatic endocrine tumors. / Ishikawa, Takuya; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Matsubara, Hiroshi; Itoh, Yuya; Nakamura, Yosuke; Nakamura, Masanao; Miyahara, Ryoji; Hayashi, Kazuhiko; Ishigami, Masatoshi; Katano, Yoshiaki; Omiya, Naoki; Goto, Hidemi; Hirooka, Yoshiki.

In: Gastrointestinal Endoscopy, Vol. 71, No. 6, 01.05.2010, p. 951-959.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Usefulness of EUS combined with contrast-enhancement in the differential diagnosis of malignant versus benign and preoperative localization of pancreatic endocrine tumors

AU - Ishikawa, Takuya

AU - Itoh, Akihiro

AU - Kawashima, Hiroki

AU - Ohno, Eizaburo

AU - Matsubara, Hiroshi

AU - Itoh, Yuya

AU - Nakamura, Yosuke

AU - Nakamura, Masanao

AU - Miyahara, Ryoji

AU - Hayashi, Kazuhiko

AU - Ishigami, Masatoshi

AU - Katano, Yoshiaki

AU - Omiya, Naoki

AU - Goto, Hidemi

AU - Hirooka, Yoshiki

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Pancreatic endocrine tumors (PETs) develop in relatively few patients, but they are often difficult to diagnose because of their small size and various clinical symptoms. Objective: The aim of this study was to investigate the usefulness of EUS combined with contrast enhancement (CE-EUS) in the preoperative localization of PETs and the differentiation between malignant and benign PETs. Design and Setting: Single-center retrospective study. Patients: Sixty-two pathologically certified PETs of 41 patients who underwent EUS, multiphasic multidetector computed tomography (MDCT), and transabdominal US at our institute since 2001. Interventions: Intravenous injection of US contrast media. Main Outcome Measurements: Comparison of EUS, MDCT, and US in the preoperative identification of PETs, and the characteristic findings of EUS with malignancy. Results: EUS showed high sensitivity (95.1%) in identifying PETs compared with MDCT (80.6%) and US (45.2%). Multivariable logistic regression analysis showed that heterogeneous ultrasonographic texture was the most significant factor for malignancy (OR = 53.33; 95% CI, 10.79-263.58). Most heterogeneous hypoechoic areas and anechoic areas corresponded to hemorrhage or necrosis on pathologic examination. They were identified as filling defects in CE-EUS and were more clearly recognized than in conventional EUS. Limitations: Retrospective study. Conclusion: EUS has higher sensitivity in preoperative localization of PETs compared with MDCT and US. The characteristics of EUS and CE-EUS findings in malignant PETs were clarified, and they will improve the diagnostic accuracy of PETs.

AB - Background: Pancreatic endocrine tumors (PETs) develop in relatively few patients, but they are often difficult to diagnose because of their small size and various clinical symptoms. Objective: The aim of this study was to investigate the usefulness of EUS combined with contrast enhancement (CE-EUS) in the preoperative localization of PETs and the differentiation between malignant and benign PETs. Design and Setting: Single-center retrospective study. Patients: Sixty-two pathologically certified PETs of 41 patients who underwent EUS, multiphasic multidetector computed tomography (MDCT), and transabdominal US at our institute since 2001. Interventions: Intravenous injection of US contrast media. Main Outcome Measurements: Comparison of EUS, MDCT, and US in the preoperative identification of PETs, and the characteristic findings of EUS with malignancy. Results: EUS showed high sensitivity (95.1%) in identifying PETs compared with MDCT (80.6%) and US (45.2%). Multivariable logistic regression analysis showed that heterogeneous ultrasonographic texture was the most significant factor for malignancy (OR = 53.33; 95% CI, 10.79-263.58). Most heterogeneous hypoechoic areas and anechoic areas corresponded to hemorrhage or necrosis on pathologic examination. They were identified as filling defects in CE-EUS and were more clearly recognized than in conventional EUS. Limitations: Retrospective study. Conclusion: EUS has higher sensitivity in preoperative localization of PETs compared with MDCT and US. The characteristics of EUS and CE-EUS findings in malignant PETs were clarified, and they will improve the diagnostic accuracy of PETs.

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U2 - 10.1016/j.gie.2009.12.023

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M3 - Article

VL - 71

SP - 951

EP - 959

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 6

ER -