Cargando…

Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst

Endoscopic ultrasound fine needle aspiration (EUS-FNA) cytology from an intracystic fluid is useful in the differentiation of pancreatic cysts, with low sensitivity, which increases when the solid component is targeted. The clinical utility of contrast-enhanced guided EUS-FNA (CH-EUS-FNA) in the sol...

Descripción completa

Detalles Bibliográficos
Autores principales: Olar, Miruna Patricia, Bolboacă, Sorana D., Pojoga, Cristina, Moșteanu, Ofelia, Gheorghiu, Marcel, Seicean, Radu, Rusu, Ioana, Sparchez, Zeno, Al Hajjar, Nadim, Seicean, Andrada
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497576/
https://www.ncbi.nlm.nih.gov/pubmed/36140610
http://dx.doi.org/10.3390/diagnostics12092209
_version_ 1784794539838406656
author Olar, Miruna Patricia
Bolboacă, Sorana D.
Pojoga, Cristina
Moșteanu, Ofelia
Gheorghiu, Marcel
Seicean, Radu
Rusu, Ioana
Sparchez, Zeno
Al Hajjar, Nadim
Seicean, Andrada
author_facet Olar, Miruna Patricia
Bolboacă, Sorana D.
Pojoga, Cristina
Moșteanu, Ofelia
Gheorghiu, Marcel
Seicean, Radu
Rusu, Ioana
Sparchez, Zeno
Al Hajjar, Nadim
Seicean, Andrada
author_sort Olar, Miruna Patricia
collection PubMed
description Endoscopic ultrasound fine needle aspiration (EUS-FNA) cytology from an intracystic fluid is useful in the differentiation of pancreatic cysts, with low sensitivity, which increases when the solid component is targeted. The clinical utility of contrast-enhanced guided EUS-FNA (CH-EUS-FNA) in the solid component is not known. We aimed to assess the diagnostic value of CH-EUS-FNA in enhanced mural nodules and discrimination between different cysts using contrast-enhanced endoscopic ultrasound (CH-EUS). The prospective study recruited patients with pancreatic cysts with an unclear diagnosis. The CH-EUS was followed by CH-EUS-FNA. The final diagnosis was based on surgery or the correlation between clinical history, cross-sectional imaging, echoendoscopic morphology, cystic fluid analysis, and follow-up. Fifty-eight patients with pancreatic cysts were evaluated. The mucinous cysts had wall arterial enhancement more often than non- mucinous cysts (p < 0.0001), with 90.2% sensitivity and 70.6% specificity. The CH-EUS-FNA from cystic fluid and mural nodules identified mucinous cysts and malignancy with 82.4% and 84.2% sensitivity and 92% and 100% specificity. Twenty-one cysts had solid components, but only 13 were enhanced mural nodules on EUS assessment with conclusive cytology in all cases and malignancy in 76.9%. Contrast-enhanced endoscopic ultrasound should be completed in all PCN with solid components in order to avoid unnecessary EUS-FNA and to guide FNA for the identification of malignant cysts.
format Online
Article
Text
id pubmed-9497576
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94975762022-09-23 Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst Olar, Miruna Patricia Bolboacă, Sorana D. Pojoga, Cristina Moșteanu, Ofelia Gheorghiu, Marcel Seicean, Radu Rusu, Ioana Sparchez, Zeno Al Hajjar, Nadim Seicean, Andrada Diagnostics (Basel) Article Endoscopic ultrasound fine needle aspiration (EUS-FNA) cytology from an intracystic fluid is useful in the differentiation of pancreatic cysts, with low sensitivity, which increases when the solid component is targeted. The clinical utility of contrast-enhanced guided EUS-FNA (CH-EUS-FNA) in the solid component is not known. We aimed to assess the diagnostic value of CH-EUS-FNA in enhanced mural nodules and discrimination between different cysts using contrast-enhanced endoscopic ultrasound (CH-EUS). The prospective study recruited patients with pancreatic cysts with an unclear diagnosis. The CH-EUS was followed by CH-EUS-FNA. The final diagnosis was based on surgery or the correlation between clinical history, cross-sectional imaging, echoendoscopic morphology, cystic fluid analysis, and follow-up. Fifty-eight patients with pancreatic cysts were evaluated. The mucinous cysts had wall arterial enhancement more often than non- mucinous cysts (p < 0.0001), with 90.2% sensitivity and 70.6% specificity. The CH-EUS-FNA from cystic fluid and mural nodules identified mucinous cysts and malignancy with 82.4% and 84.2% sensitivity and 92% and 100% specificity. Twenty-one cysts had solid components, but only 13 were enhanced mural nodules on EUS assessment with conclusive cytology in all cases and malignancy in 76.9%. Contrast-enhanced endoscopic ultrasound should be completed in all PCN with solid components in order to avoid unnecessary EUS-FNA and to guide FNA for the identification of malignant cysts. MDPI 2022-09-12 /pmc/articles/PMC9497576/ /pubmed/36140610 http://dx.doi.org/10.3390/diagnostics12092209 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Olar, Miruna Patricia
Bolboacă, Sorana D.
Pojoga, Cristina
Moșteanu, Ofelia
Gheorghiu, Marcel
Seicean, Radu
Rusu, Ioana
Sparchez, Zeno
Al Hajjar, Nadim
Seicean, Andrada
Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst
title Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst
title_full Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst
title_fullStr Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst
title_full_unstemmed Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst
title_short Clinical Utility of the Contrast-Enhanced Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Pancreatic Cyst
title_sort clinical utility of the contrast-enhanced endoscopic ultrasound guided fine needle aspiration in the diagnosis of pancreatic cyst
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497576/
https://www.ncbi.nlm.nih.gov/pubmed/36140610
http://dx.doi.org/10.3390/diagnostics12092209
work_keys_str_mv AT olarmirunapatricia clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT bolboacasoranad clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT pojogacristina clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT mosteanuofelia clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT gheorghiumarcel clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT seiceanradu clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT rusuioana clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT sparchezzeno clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT alhajjarnadim clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst
AT seiceanandrada clinicalutilityofthecontrastenhancedendoscopicultrasoundguidedfineneedleaspirationinthediagnosisofpancreaticcyst