Role of contrast harmonic endoscopic ultrasonography in other pancreatic solid lesions: Neuroendocrine tumors, autoimmune pancreatitis and metastases

Endosc Ultrasound. 2016 Nov-Dec;5(6):373-376. doi: 10.4103/2303-9027.195870.

Abstract

Contrast harmonic endoscopic ultrasonography (CH-EUS) is a new technique which allows the dynamic study of the microvascularization of a target tissue. Its application is validated for the diagnosis of pancreatic adenocarcinoma but remains unclear for other solid pancreatic tumors (neuroendocrine tumors [NETs], autoimmune pancreatitis [AIP], metastases). The purpose of this review is to outline the potential role of the CH-EUS in these indications. NETs are typically iso/hyperenhanced at CH-EUS, and a heterogeneous enhancement seems a good predictor of malignancy in neuroendocrine pancreatic tumor. AIP is often iso/hyperenhanced at CH-EUS. Quantitative analysis of time-intensity parameters is promising for the distinction between pancreatic adenocarcinoma and AIP. The appearance of pancreatic metastases at CH-EUS is various depending on the origin of the primary tumor. Data from the literature remain to this day weak to determine the role of the CH-EUS in the management of rare solid tumor of the pancreas (NETs, AIP, and metastases). Specific studies are expected to further clarify the impact of this procedure in this field.

Publication types

  • Review