Cargando…

Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors

OBJECTIVE: Pancreatic neuroendocrine tumors (PNET) represent rare, heterogeneous tumors with clinical, imaging and treatment particularities. The aim of this study was to assess the role of power Doppler endoscopic ultrasound (EUS) in the diagnosis and characterization of PNET. METHODS: All consecut...

Descripción completa

Detalles Bibliográficos
Autores principales: Iordache, Sevastiţa, Angelescu, Radu, Filip, Maria Monalisa, Costache, Mădălin Ionuţ, Popescu, Carmen Florina, Gheonea, Dan-Ionuă, Sãftoiu, Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062227/
https://www.ncbi.nlm.nih.gov/pubmed/24949353
http://dx.doi.org/10.7178/eus.03.006
_version_ 1782321610075668480
author Iordache, Sevastiţa
Angelescu, Radu
Filip, Maria Monalisa
Costache, Mădălin Ionuţ
Popescu, Carmen Florina
Gheonea, Dan-Ionuă
Sãftoiu, Adrian
author_facet Iordache, Sevastiţa
Angelescu, Radu
Filip, Maria Monalisa
Costache, Mădălin Ionuţ
Popescu, Carmen Florina
Gheonea, Dan-Ionuă
Sãftoiu, Adrian
author_sort Iordache, Sevastiţa
collection PubMed
description OBJECTIVE: Pancreatic neuroendocrine tumors (PNET) represent rare, heterogeneous tumors with clinical, imaging and treatment particularities. The aim of this study was to assess the role of power Doppler endoscopic ultrasound (EUS) in the diagnosis and characterization of PNET. METHODS: All consecutive patients with PNET assessed by power Doppler EUS in the Research Centre of Gastroenterology and Hepatology Craiova, Romania, in the past 51 months were included in the study. All EUS examinations were performed initially in gray-scale mode, followed by power Doppler mode examinations, before and after contrast-enhancement. Each recorded EUS movie was further subjected to post-processing using a computer-enhanced dynamic analysis using a special plug-in which permitted assessment of vascularity index (EUS-VI). RESULTS: Based on the analysis of all consecutive malignant focal pancreatic masses diagnosed in the study period, a total number of 131 consecutive patients were included: 14 patients with pancreatic neuroendocrine tumors and 117 patients with pancreatic adenocarcinoma. The sensitivity of the pre-contrast EUS-VI for the diagnosis of PNET was 71.43%, similar to EUS-FNA. After contrast enhancement, the EUS-VI is also higher in PNET (27.07%) as compared to pancreatic adenocarcinoma where it was significantly lower 9.82% (P < 0.001). However, the sensitivity of EUS-VI after contrast enhancement for the diagnosis of PNET was 100%, higher than pre-contrast EUS-VI, with an acceptable specificity (79.49%) and better accuracy (81.68%). CONCLUSION: Power Doppler EUS represents a useful method in the initial assessment of PNET. Using evaluation of vascularity through EUS-VI, the differentiation between PNET and pancreatic cancer could be possible, especially in the subgroup of patients where EUS-guided fine needle aspiration is falsely negative.
format Online
Article
Text
id pubmed-4062227
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-40622272014-06-19 Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors Iordache, Sevastiţa Angelescu, Radu Filip, Maria Monalisa Costache, Mădălin Ionuţ Popescu, Carmen Florina Gheonea, Dan-Ionuă Sãftoiu, Adrian Endosc Ultrasound Original Article OBJECTIVE: Pancreatic neuroendocrine tumors (PNET) represent rare, heterogeneous tumors with clinical, imaging and treatment particularities. The aim of this study was to assess the role of power Doppler endoscopic ultrasound (EUS) in the diagnosis and characterization of PNET. METHODS: All consecutive patients with PNET assessed by power Doppler EUS in the Research Centre of Gastroenterology and Hepatology Craiova, Romania, in the past 51 months were included in the study. All EUS examinations were performed initially in gray-scale mode, followed by power Doppler mode examinations, before and after contrast-enhancement. Each recorded EUS movie was further subjected to post-processing using a computer-enhanced dynamic analysis using a special plug-in which permitted assessment of vascularity index (EUS-VI). RESULTS: Based on the analysis of all consecutive malignant focal pancreatic masses diagnosed in the study period, a total number of 131 consecutive patients were included: 14 patients with pancreatic neuroendocrine tumors and 117 patients with pancreatic adenocarcinoma. The sensitivity of the pre-contrast EUS-VI for the diagnosis of PNET was 71.43%, similar to EUS-FNA. After contrast enhancement, the EUS-VI is also higher in PNET (27.07%) as compared to pancreatic adenocarcinoma where it was significantly lower 9.82% (P < 0.001). However, the sensitivity of EUS-VI after contrast enhancement for the diagnosis of PNET was 100%, higher than pre-contrast EUS-VI, with an acceptable specificity (79.49%) and better accuracy (81.68%). CONCLUSION: Power Doppler EUS represents a useful method in the initial assessment of PNET. Using evaluation of vascularity through EUS-VI, the differentiation between PNET and pancreatic cancer could be possible, especially in the subgroup of patients where EUS-guided fine needle aspiration is falsely negative. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC4062227/ /pubmed/24949353 http://dx.doi.org/10.7178/eus.03.006 Text en Copyright: © Endoscopic Ultrasound http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Iordache, Sevastiţa
Angelescu, Radu
Filip, Maria Monalisa
Costache, Mădălin Ionuţ
Popescu, Carmen Florina
Gheonea, Dan-Ionuă
Sãftoiu, Adrian
Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors
title Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors
title_full Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors
title_fullStr Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors
title_full_unstemmed Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors
title_short Power Doppler Endoscopic Ultrasound for the Assessment of Pancreatic Neuroendocrine Tumors
title_sort power doppler endoscopic ultrasound for the assessment of pancreatic neuroendocrine tumors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062227/
https://www.ncbi.nlm.nih.gov/pubmed/24949353
http://dx.doi.org/10.7178/eus.03.006
work_keys_str_mv AT iordachesevastita powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors
AT angelescuradu powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors
AT filipmariamonalisa powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors
AT costachemadalinionut powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors
AT popescucarmenflorina powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors
AT gheoneadanionua powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors
AT saftoiuadrian powerdopplerendoscopicultrasoundfortheassessmentofpancreaticneuroendocrinetumors