Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm
Intraductal papillary mucinous neoplasms (IPMNs) have a wide pathologic spectrum and it can be difficult to diagnose malignancy, including pathological grade. The aim of this study was to evaluate contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for the diagnosis of malignant IPMN and...
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MDPI AG
2022-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/9/2141 |
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| author | Yasunobu Yamashita Yuki Kawaji Toshio Shimokawa Hirofumi Yamazaki Takashi Tamura Keiichi Hatamaru Masahiro Itonaga Reiko Ashida Manabu Kawai Masayuki Kitano |
| author_facet | Yasunobu Yamashita Yuki Kawaji Toshio Shimokawa Hirofumi Yamazaki Takashi Tamura Keiichi Hatamaru Masahiro Itonaga Reiko Ashida Manabu Kawai Masayuki Kitano |
| author_sort | Yasunobu Yamashita |
| collection | DOAJ |
| description | Intraductal papillary mucinous neoplasms (IPMNs) have a wide pathologic spectrum and it can be difficult to diagnose malignancy, including pathological grade. The aim of this study was to evaluate contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for the diagnosis of malignant IPMN and IPMN-associated invasive carcinoma (invasive IPMC). From 5009 patients diagnosed with IPMN at Wakayama medical university between December 2009 and December 2021, 115 patients who underwent contrast-enhanced computed tomography (CE-CT), conventional EUS, CH-EUS, and surgical resection were enrolled. The detection of mural lesions was compared with pathological findings. Malignant IPMN and invasive IPMC were also assessed according to mural lesion size and vascularity on CH-EUS. CH-EUS and conventional EUS showed significantly higher accuracy than CE-CT in the detection of mural nodules (92%, 83%, and 72%, respectively) and diagnosis of malignant IPMN (75%, 73%, and 63%, respectively). An early wash-out pattern on CH-EUS was observed in significantly more patients with invasive IPMC than in those with low-, intermediate-, or high-grade dysplasia. When compared with CE-CT, CH-EUS was significantly more accurate for detecting mural nodules and more useful for diagnosing malignant IPMN. The vascular pattern on CH-EUS was also useful for diagnosing invasive IPMC. |
| first_indexed | 2024-03-10T00:17:28Z |
| format | Article |
| id | doaj.art-f3304be6f8474c66aa49554a63765f6e |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T00:17:28Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-f3304be6f8474c66aa49554a63765f6e2023-11-23T15:49:24ZengMDPI AGDiagnostics2075-44182022-09-01129214110.3390/diagnostics12092141Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous NeoplasmYasunobu Yamashita0Yuki Kawaji1Toshio Shimokawa2Hirofumi Yamazaki3Takashi Tamura4Keiichi Hatamaru5Masahiro Itonaga6Reiko Ashida7Manabu Kawai8Masayuki Kitano9Second Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanClinical Study Support Center, Wakayama Medical University Hospital, Wakayama 641-8510, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanSecond Department of Surgery, Wakayama Medical University, Wakayama 641-8509, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, JapanIntraductal papillary mucinous neoplasms (IPMNs) have a wide pathologic spectrum and it can be difficult to diagnose malignancy, including pathological grade. The aim of this study was to evaluate contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for the diagnosis of malignant IPMN and IPMN-associated invasive carcinoma (invasive IPMC). From 5009 patients diagnosed with IPMN at Wakayama medical university between December 2009 and December 2021, 115 patients who underwent contrast-enhanced computed tomography (CE-CT), conventional EUS, CH-EUS, and surgical resection were enrolled. The detection of mural lesions was compared with pathological findings. Malignant IPMN and invasive IPMC were also assessed according to mural lesion size and vascularity on CH-EUS. CH-EUS and conventional EUS showed significantly higher accuracy than CE-CT in the detection of mural nodules (92%, 83%, and 72%, respectively) and diagnosis of malignant IPMN (75%, 73%, and 63%, respectively). An early wash-out pattern on CH-EUS was observed in significantly more patients with invasive IPMC than in those with low-, intermediate-, or high-grade dysplasia. When compared with CE-CT, CH-EUS was significantly more accurate for detecting mural nodules and more useful for diagnosing malignant IPMN. The vascular pattern on CH-EUS was also useful for diagnosing invasive IPMC.https://www.mdpi.com/2075-4418/12/9/2141intraductal papillary mucinous neoplasmcontrast-enhanced harmonic endoscopic ultrasonographyinvasive intraductal papillary mucinous carcinomahypoenhancement patternmural nodule size |
| spellingShingle | Yasunobu Yamashita Yuki Kawaji Toshio Shimokawa Hirofumi Yamazaki Takashi Tamura Keiichi Hatamaru Masahiro Itonaga Reiko Ashida Manabu Kawai Masayuki Kitano Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm Diagnostics intraductal papillary mucinous neoplasm contrast-enhanced harmonic endoscopic ultrasonography invasive intraductal papillary mucinous carcinoma hypoenhancement pattern mural nodule size |
| title | Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm |
| title_full | Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm |
| title_fullStr | Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm |
| title_full_unstemmed | Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm |
| title_short | Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm |
| title_sort | usefulness of contrast enhanced harmonic endoscopic ultrasonography for diagnosis of malignancy in intraductal papillary mucinous neoplasm |
| topic | intraductal papillary mucinous neoplasm contrast-enhanced harmonic endoscopic ultrasonography invasive intraductal papillary mucinous carcinoma hypoenhancement pattern mural nodule size |
| url | https://www.mdpi.com/2075-4418/12/9/2141 |
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