» Articles » PMID: 36140542

Usefulness of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Diagnosis of Malignancy in Intraductal Papillary Mucinous Neoplasm

Overview
Specialty Radiology
Date 2022 Sep 23
PMID 36140542
Authors
Affiliations
Soon will be listed here.
Abstract

Intraductal papillary mucinous neoplasms (IPMNs) have a wide pathologic spectrum and it can be difficult to diagnose malignancy, including pathological grade. The aim of this study was to evaluate contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for the diagnosis of malignant IPMN and IPMN-associated invasive carcinoma (invasive IPMC). From 5009 patients diagnosed with IPMN at Wakayama medical university between December 2009 and December 2021, 115 patients who underwent contrast-enhanced computed tomography (CE-CT), conventional EUS, CH-EUS, and surgical resection were enrolled. The detection of mural lesions was compared with pathological findings. Malignant IPMN and invasive IPMC were also assessed according to mural lesion size and vascularity on CH-EUS. CH-EUS and conventional EUS showed significantly higher accuracy than CE-CT in the detection of mural nodules (92%, 83%, and 72%, respectively) and diagnosis of malignant IPMN (75%, 73%, and 63%, respectively). An early wash-out pattern on CH-EUS was observed in significantly more patients with invasive IPMC than in those with low-, intermediate-, or high-grade dysplasia. When compared with CE-CT, CH-EUS was significantly more accurate for detecting mural nodules and more useful for diagnosing malignant IPMN. The vascular pattern on CH-EUS was also useful for diagnosing invasive IPMC.

Citing Articles

Diagnostic Accuracy of Detective Flow Imaging Endoscopic Ultrasonography for Evaluating Blood Flow Within Mural Nodules of Intraductal Papillary Mucinous Neoplasms.

Endo K, Miwa H, Sugimori K, Shibasaki K, Yonei S, Ishino Y Diagnostics (Basel). 2025; 15(2).

PMID: 39857080 PMC: 11765108. DOI: 10.3390/diagnostics15020196.


Endoscopic Ultrasound-Guided Pancreatic Tissue Sampling: Lesion Assessment, Needles, and Techniques.

Dhar J, Samanta J, Nabi Z, Aggarwal M, Conti Bellocchi M, Facciorusso A Medicina (Kaunas). 2025; 60(12.

PMID: 39768901 PMC: 11727853. DOI: 10.3390/medicina60122021.


Current status of endoscopic ultrasound in the diagnosis of intraductal papillary mucinous neoplasms.

Ohno E, Kuzuya T, Kawabe N, Nakaoka K, Tanaka H, Nakano T DEN Open. 2024; 5(1):e413.

PMID: 39040523 PMC: 11260769. DOI: 10.1002/deo2.413.


Use of contrast-enhanced harmonic endoscopic ultrasonography for the diagnosis of pancreatic cystic lesions.

Ohno E, Kuzuya T, Kawabe N, Nakaoka K, Tanaka H, Nakano T J Med Ultrason (2001). 2023; .

PMID: 37924442 DOI: 10.1007/s10396-023-01376-x.


Novel Technique of Endoscopic Ultrasonography for the Differential Diagnosis of Gallbladder Lesions and Intraductal Papillary Mucinous Neoplasms: A Single-Center Prospective Study.

Yamashita Y, Ashida R, Tamura T, Shimokawa T, Yamazaki H, Kawaji Y Diagnostics (Basel). 2023; 13(13).

PMID: 37443527 PMC: 10341113. DOI: 10.3390/diagnostics13132132.


References
1.
Tanaka M, Fernandez-Del Castillo C, Kamisawa T, Jang J, Levy P, Ohtsuka T . Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017; 17(5):738-753. DOI: 10.1016/j.pan.2017.07.007. View

2.
Frossard J, Amouyal P, Amouyal G, Palazzo L, Amaris J, Soldan M . Performance of endosonography-guided fine needle aspiration and biopsy in the diagnosis of pancreatic cystic lesions. Am J Gastroenterol. 2003; 98(7):1516-24. DOI: 10.1111/j.1572-0241.2003.07530.x. View

3.
Akita H, Takeda Y, Hoshino H, Wada H, Kobayashi S, Marubashi S . Mural nodule in branch duct-type intraductal papillary mucinous neoplasms of the pancreas is a marker of malignant transformation and indication for surgery. Am J Surg. 2011; 202(2):214-9. DOI: 10.1016/j.amjsurg.2010.06.020. View

4.
Maire F, Voitot H, Aubert A, Palazzo L, OToole D, Couvelard A . Intraductal papillary mucinous neoplasms of the pancreas: performance of pancreatic fluid analysis for positive diagnosis and the prediction of malignancy. Am J Gastroenterol. 2008; 103(11):2871-7. DOI: 10.1111/j.1572-0241.2008.02114.x. View

5.
Sakamoto H, Kitano M, Suetomi Y, Maekawa K, Takeyama Y, Kudo M . Utility of contrast-enhanced endoscopic ultrasonography for diagnosis of small pancreatic carcinomas. Ultrasound Med Biol. 2007; 34(4):525-32. DOI: 10.1016/j.ultrasmedbio.2007.09.018. View