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Gastrointest Endosc. 2018 Sep;88(3):495-501. doi: 10.1016/j.gie.2018.05.019. Epub 2018 May 31.

The usefulness of contrast-enhanced harmonic EUS-guided fine-needle aspiration for evaluation of hepatic lesions (with video).

Author information

1
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
2
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
3
Department of Gastroenterology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.

Abstract

BACKGROUND AND AIMS:

Small hepatic masses often do not have distinct margins on B-mode EUS images. Contrast-enhanced harmonic EUS (CEH-EUS) is widely used for evaluating ambiguous pancreatic lesions. However, its role in detecting hepatic lesions and the use of EUS-guided FNA are not well evaluated. We investigated the usefulness of CEH-EUS-guided FNA for evaluating hepatic lesions.

METHODS:

Thirty consecutive patients with hepatic masses underwent CEH-EUS and CEH-EUS-guided FNA between September 2010 and November 2016.

RESULTS:

Twenty-eight patients (93.3%) had malignant tumors and 2 patients (6.7%) had benign hepatic masses. Before contrast enhancement, 73.3% of the hepatic lesions (22/30) in the patient cohort were visible on B mode. After contrast enhancement, 93.3% of these hepatic lesions (28/30) were distinguishable from the surrounding liver parenchyma. The technical success rate was 100%. The median tumor size on EUS and the number of needle passes were 24.5 mm (interquartile range [IQR], 14.5-40.8) and 2 (IQR, 2-3), respectively. The diagnostic accuracy of CEH-EUS-guided FNA was 86.7% (26/30 cases). There were no procedure-related adverse events.

CONCLUSIONS:

CEH-EUS-guided FNA can be a safe and efficient method for the diagnosis of hepatic masses. It can result in high diagnostic accuracy in cases where the hepatic lesions are poorly visible on conventional EUS.

PMID:
29859228
DOI:
10.1016/j.gie.2018.05.019
[Indexed for MEDLINE]

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