Publication details

Contrast-enhanced endoscopic ultrasound in the differential diagnosis of pancreatic cystic lesions

Authors

ZOUNDJIEKPON Vincent KUNOVSKÝ Lumír CVEKOVA Silvia TICHY Tomas VANEK Petr SLODICKA Peter ZAPLETALOVA Jana GURUNG Namrata SKALICKY Pavel FALT Premysl URBAN Ondrej

Year of publication 2023
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Citation
Description Background: The differential diagnosis of some pancreatic cystic lesions remains difficult. In these cases, contrast-enhanced endoscopic ultrasound (CE-EUS) was proven to be useful. This study aims to evaluate the accuracy of CE-EUS for diagnosing pancreatic cystic lesions with a suspicion of risk factors for malignancy. Methods: A retrospective analysis of patients with suspected pancreatic cystic neoplasms who underwent a CE-EUS at the University Hospital Olomouc from January 2020 - February 2022 was performed. The final diagnosis of cystic lesion was then confirmed using other cross-sectional imaging methods, cytologic, and biochemical findings by EUS fine needle aspiration, postoperative histology, or the long-term follow-up of the patients. Results: During the study period, EUS was performed in a total of 167 patients with a pancreatic cystic lesion. 29 patients (17.4%) were then referred for CE-EUS for suspected risk features. Enhancement was observed in 9/29 patients (31%), from which 4 patients were operated on with a confirmation of a premalignant or malignant diagnosis. Twenty patients (69%) were without enhancement, from which one patient (5%) was operated on with a confirmation of premalignancy. The remaining 19 patients were referred to follow-up. In this group, 2 (10.5%) patients had a premalignant cystic lesion, and 17 (89.5%) patients had a benign diagnosis. No complications were reported during the procedure. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CE-EUS were 70%, 89.5%, 77.8%, 85% and 82.8%, respectively. Conclusion: CE-EUS is a feasible and safe method used for the differential diagnosis of suspected pancreatic cystic neoplasms to guide further treatment. However, the results are limited by a low number of provided CE-EUS, and a prospective randomised study with more patients is necessary to confirm these results.

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