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

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

Rok publikování 2023
Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Popis 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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