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Contrast-enhanced endoscopic ultrasound for diagnosis of pancreatic malignancy—a visual aid or a distraction?

Nature Clinical Practice Gastroenterology & Hepatology volume 5, pages 662–663 (2008)Cite this article

Abstract

Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is the gold standard for diagnosis of pancreatic malignancy. This commentary discusses the findings and limitations of a study by Dietrich and colleagues that examined the operative characteristics of contrast-enhanced EUS (CE-EUS) in patients with a solitary, solid, pancreatic mass of less than 4 cm in diameter. The authors compared the vascularity of adenocarcinomas with that of neuroendocrine tumors and other lesions of the pancreas. The finding of decreased vascularity on CE-EUS had a sensitivity of 92% and a specificity of 100% for the differentiation of adenocarcinomas from neuroendocrine tumors. It seems unlikely that CE-EUS will replace EUS-FNA for the diagnosis of pancreatic malignancy, but CE-EUS might have a role in differentiating adenocarcinomas from neuroendocrine tumors. It might be possible to use CE-EUS to assist in confirming the diagnosis of neuroendocrine tumors and perhaps in directing EUS-FNA.

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Author notes

  1. Massachusetts General Hospital, GI Unit, Blake 452c, Boston, MA 02114, USA wbrugge@partners.org

Authors and Affiliations

  1. WR Brugge is Professor of Medicine at Harvard Medical School, and Director of GI Endoscopy at the Massachusetts General Hospital, Boston, MA, USA.,

    William R Brugge

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  1. William R Brugge
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Competing interests

WR Brugge is a Consultant for Boston Scientific and has received educational grant/research support from Pentax.

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Brugge, W. Contrast-enhanced endoscopic ultrasound for diagnosis of pancreatic malignancy—a visual aid or a distraction?. Nat Rev Gastroenterol Hepatol 5, 662–663 (2008). https://doi.org/10.1038/ncpgasthep1285

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