Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Gastrointest Endosc. 2018 Jun;87(6):1481-1488. doi: 10.1016/j.gie.2017.12.033. Epub 2018 Jan 8.

Contrast harmonic EUS for the prediction of pancreatic neuroendocrine tumor aggressiveness (with videos).

Author information

1
Beaujon Hospital, Department of Digestive Endoscopy, Assistance Publique Hôpitaux de Paris, Clichy, France.
2
Department of Gastroenterology, Jean Mermoz Private Hospital, Lyon, France.
3
Department of Gastroenterology, Edouard Herriot Hospital, Lyon, France.
4
Department of Gastroenterology, Amiens-Picardie University Hospital, Amiens, France.
5
Department of Pathology, Gustave Roussy Institute, Villejuif, France.
6
Department of Pathology, Beaujon Hospital, Clichy, France.
7
Department of Pathology, Bichat Hospital, Paris, France.
8
Department of Hepatobiliary and Pancreatic Surgery, Beaujon Hospital, Clichy, France.
9
Department of Gastroenterology and Pancreatology, Beaujon Hospital, Clichy, France.
10
Department of Endoscopy, Trocadéro Clinic, Paris, France.

Abstract

BACKGROUND AND AIMS:

Contrast harmonic EUS (CH-EUS) has the ability to depict tumor microvasculature. Decreased microvascular density has been identified as a factor associated with tumor aggressiveness. We aimed to study the accuracy of CH-EUS for the prediction of pancreatic neuroendocrine tumor (PNET) aggressiveness.

METHODS:

Between June 2009 and March 2015, all consecutive patients with histology-proven PNETs and CH-EUS examination were included. Nine endosonographers blindly analyzed all videos. CH-EUS tumor aggressiveness was defined as a heterogeneous enhancement at the early arterial phase. The final diagnosis of tumor aggressiveness was defined as follows: G3 tumors, morphologic and/or histologic findings of metastatic disease in G1/G2 tumors. Diagnostic values were calculated. Intratumoral microvascular density and fibrosis were assessed on pathologic specimens.

RESULTS:

Eighty-one tumors were included, of which 26 were aggressive (32.1%). In CH-EUS 35 tumors (43.2%) had a heterogeneous enhancement. The overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CH-EUS for the diagnosis of tumor aggressiveness were 86%, 96%, 82%, 71%, and 98%, respectively. The interobserver agreement among the 9 endosonographers was good (k = .66). The intraobserver agreement was excellent for the junior (κ = .83) and senior (κ = .82) endosonographers. Heterogeneous tumors at CH-EUS corresponded to fewer vascular and more fibrotic tumors (P < .01).

CONCLUSIONS:

CH-EUS is accurate in the prediction of PNET aggressiveness and could be a decision-making element in their management.

PMID:
29325706
DOI:
10.1016/j.gie.2017.12.033
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center