Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining Their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)

PSÁR, Robert, Ondřej URBAN, Marie ČERNÁ, Tomáš ROHAN and Martin HILL. Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining Their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA). Diagnostics. Švýcarsko: MDPI, 2021, vol. 11, No 5, p. 1-11. ISSN 2075-4418. Available from: https://dx.doi.org/10.3390/diagnostics11050776.

Basic information

• Original name: Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining Their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)
• Authors: PSÁR, Robert (203 Czech Republic, guarantor), Ondřej URBAN (203 Czech Republic), Marie ČERNÁ (203 Czech Republic), Tomáš ROHAN (203 Czech Republic, belonging to the institution) and Martin HILL (203 Czech Republic).
• Edition: Diagnostics, Švýcarsko, MDPI, 2021, 2075-4418.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30224 Radiology, nuclear medicine and medical imaging
• Country of publisher: Switzerland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 3.992
• RIV identification code: RIV/00216224:14110/21:00121876
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.3390/diagnostics11050776
• UT WoS: 000653806900001
• Keywords in English: computed tomography; early diagnosis; endoscopic ultrasound-guided fine needle aspiration; isoattenuation; pancreatic carcinoma
• Tags: 14110216, rivok
• Tags: International impact, Reviewed

Abstract

(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; p < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was <= 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% (p = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.