Efficacy of endoscopic ultrasound in characterizing mass lesions in chronic pancreatitis

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Abstract

BACKGROUND AND GOALS: The aim of this study is to determine the influence of endoscopic ultrasound (EUS) in the detection of chronic pancreatitis and identification of pancreatic masses suspected by other radiographic imaging modalities in such a clinical background. METHODS: Retrospective analysis was performed on 105 consecutive pancreatic EUS examinations in an 18-month period at a single tertiary care referral center. Analysis included 75 patients with a suspected pancreatic mass by computerized axial tomography, magnetic resonance imaging, ultrasound, or endoscopic retrograde cholangiopancreotography. All patients underwent EUS examination and if a mass was visualized, fine-needle aspiration biopsy was performed. Patients underwent either surgical exploration or clinical and radiographic follow-up for 6 months to confirm EUS findings. RESULTS: Chronic pancreatitis was suspected in 53 individuals by clinical or radiographic methods. Using standard EUS parenchymal and ductal criteria, chronic pancreatitis was confirmed in 41 (77%) of patients. In 33 patients with chronic pancreatitis detected by EUS, initial referral was for pancreatic mass. Twenty-eight (85%) patients had an actual mass and the remainder were false-positive clinical findings. Thirty-two percent of pancreatic masses in chronic pancreatitis were found to be malignant adenocarcinoma and the rest were inflammatory in nature. Subset analysis showed EUS-fine-needle aspiration of solid lesions to have a sensitivity and specificity of 87.9% and 100%, respectively. Detection of cystic lesions had a sensitivity and specificity of 88.5% and 100%, respectively. CONCLUSIONS: EUS is superior to other radiographic modalities in the determination of chronic pancreatitis and detection of mass lesions.

Original languageEnglish (US)
Pages (from-to)81-85
Number of pages5
JournalJournal of Clinical Gastroenterology
Volume42
Issue number1
DOIs
StatePublished - Jan 2008

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Chronic Pancreatitis
Fine Needle Biopsy
Tertiary Care Centers
Sensitivity and Specificity
Adenocarcinoma
Referral and Consultation
Tomography
Magnetic Resonance Imaging

Keywords

  • Chronic pancreatitis
  • Endoscopic ultrasound
  • Pancreatic mass

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Efficacy of endoscopic ultrasound in characterizing mass lesions in chronic pancreatitis",
abstract = "BACKGROUND AND GOALS: The aim of this study is to determine the influence of endoscopic ultrasound (EUS) in the detection of chronic pancreatitis and identification of pancreatic masses suspected by other radiographic imaging modalities in such a clinical background. METHODS: Retrospective analysis was performed on 105 consecutive pancreatic EUS examinations in an 18-month period at a single tertiary care referral center. Analysis included 75 patients with a suspected pancreatic mass by computerized axial tomography, magnetic resonance imaging, ultrasound, or endoscopic retrograde cholangiopancreotography. All patients underwent EUS examination and if a mass was visualized, fine-needle aspiration biopsy was performed. Patients underwent either surgical exploration or clinical and radiographic follow-up for 6 months to confirm EUS findings. RESULTS: Chronic pancreatitis was suspected in 53 individuals by clinical or radiographic methods. Using standard EUS parenchymal and ductal criteria, chronic pancreatitis was confirmed in 41 (77{\%}) of patients. In 33 patients with chronic pancreatitis detected by EUS, initial referral was for pancreatic mass. Twenty-eight (85{\%}) patients had an actual mass and the remainder were false-positive clinical findings. Thirty-two percent of pancreatic masses in chronic pancreatitis were found to be malignant adenocarcinoma and the rest were inflammatory in nature. Subset analysis showed EUS-fine-needle aspiration of solid lesions to have a sensitivity and specificity of 87.9{\%} and 100{\%}, respectively. Detection of cystic lesions had a sensitivity and specificity of 88.5{\%} and 100{\%}, respectively. CONCLUSIONS: EUS is superior to other radiographic modalities in the determination of chronic pancreatitis and detection of mass lesions.",
keywords = "Chronic pancreatitis, Endoscopic ultrasound, Pancreatic mass",
author = "Jayaprakash Sreenarasimhaiah",
year = "2008",
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N2 - BACKGROUND AND GOALS: The aim of this study is to determine the influence of endoscopic ultrasound (EUS) in the detection of chronic pancreatitis and identification of pancreatic masses suspected by other radiographic imaging modalities in such a clinical background. METHODS: Retrospective analysis was performed on 105 consecutive pancreatic EUS examinations in an 18-month period at a single tertiary care referral center. Analysis included 75 patients with a suspected pancreatic mass by computerized axial tomography, magnetic resonance imaging, ultrasound, or endoscopic retrograde cholangiopancreotography. All patients underwent EUS examination and if a mass was visualized, fine-needle aspiration biopsy was performed. Patients underwent either surgical exploration or clinical and radiographic follow-up for 6 months to confirm EUS findings. RESULTS: Chronic pancreatitis was suspected in 53 individuals by clinical or radiographic methods. Using standard EUS parenchymal and ductal criteria, chronic pancreatitis was confirmed in 41 (77%) of patients. In 33 patients with chronic pancreatitis detected by EUS, initial referral was for pancreatic mass. Twenty-eight (85%) patients had an actual mass and the remainder were false-positive clinical findings. Thirty-two percent of pancreatic masses in chronic pancreatitis were found to be malignant adenocarcinoma and the rest were inflammatory in nature. Subset analysis showed EUS-fine-needle aspiration of solid lesions to have a sensitivity and specificity of 87.9% and 100%, respectively. Detection of cystic lesions had a sensitivity and specificity of 88.5% and 100%, respectively. CONCLUSIONS: EUS is superior to other radiographic modalities in the determination of chronic pancreatitis and detection of mass lesions.

AB - BACKGROUND AND GOALS: The aim of this study is to determine the influence of endoscopic ultrasound (EUS) in the detection of chronic pancreatitis and identification of pancreatic masses suspected by other radiographic imaging modalities in such a clinical background. METHODS: Retrospective analysis was performed on 105 consecutive pancreatic EUS examinations in an 18-month period at a single tertiary care referral center. Analysis included 75 patients with a suspected pancreatic mass by computerized axial tomography, magnetic resonance imaging, ultrasound, or endoscopic retrograde cholangiopancreotography. All patients underwent EUS examination and if a mass was visualized, fine-needle aspiration biopsy was performed. Patients underwent either surgical exploration or clinical and radiographic follow-up for 6 months to confirm EUS findings. RESULTS: Chronic pancreatitis was suspected in 53 individuals by clinical or radiographic methods. Using standard EUS parenchymal and ductal criteria, chronic pancreatitis was confirmed in 41 (77%) of patients. In 33 patients with chronic pancreatitis detected by EUS, initial referral was for pancreatic mass. Twenty-eight (85%) patients had an actual mass and the remainder were false-positive clinical findings. Thirty-two percent of pancreatic masses in chronic pancreatitis were found to be malignant adenocarcinoma and the rest were inflammatory in nature. Subset analysis showed EUS-fine-needle aspiration of solid lesions to have a sensitivity and specificity of 87.9% and 100%, respectively. Detection of cystic lesions had a sensitivity and specificity of 88.5% and 100%, respectively. CONCLUSIONS: EUS is superior to other radiographic modalities in the determination of chronic pancreatitis and detection of mass lesions.

KW - Chronic pancreatitis

KW - Endoscopic ultrasound

KW - Pancreatic mass

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