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    Contrast-enhanced endoscopic ultrasound for differentially diagnosing autoimmune pancreatitis and pancreatic cancer

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    Author
    Cho, M.K.
    Moon, S.-H.
    Song, T.J.
    Date
    2018
    Journal
    Gut and Liver
    Publisher
    Editorial Office of Gut and Liver
    Type
    Article
    
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    See at
    https://dx.doi.org/10.5009/gnl17391
    Abstract
    Background/Aims: Differentially diagnosing focal-type autoimmune pancreatitis (f-AIP) and pancreatic cancer (PC) is challenging. Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) may provide information for differentiating pancreatic masses. In this study, we evaluated the usefulness of CEH-EUS in differentiating f-AIP from PC. Methods: Data were collected prospectively and analyzed on patients who underwent CEH-EUS between May 2014 and May 2015. Eighty consecutive patients were diagnosed with f-AIP or PC. PC and f-AIP were compared for enhancement intensity, contrast agent distribution, and internal vasculature. Results: The study group comprised 53 PC patients and 27 f-AIP patients (17 with type-1 AIP [15 definite and two probable], two with probable type-2 AIP, and eight with AIP, not otherwise specified). Hyper- to iso-enhancement in the arterial phase (f-AIP, 89% vs PC, 13%; p<0.05), homogeneous contrast agent distribution (f-AIP, 81% vs PC, 17%; p<0.05), and absent irregular internal vessels (f-AIP, 85% vs PC, 30%; p<0.05) were observed more frequently in the f-AIP group. The combination of CEH-EUS and enhancement intensity, absent irregular internal vessels improved the specificity (94%) in differentiating f-AIP from PC. Conclusions: CEH-EUS may be a useful noninvasive modality for differentially diagnosing f-AIP and PC. Combined CEH-EUS findings could improve the specificity of CEH-EUS in differentiating f-AIP from PC. Copyright 2018 Editorial Office of Gut and Liver. All rights reserved.
    Keyword
    Autoimmune pancreatitis
    Biopsy
    Contrast media
    Endo-sonography
    Fine-needle
    Pancreatic neoplasms
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85053355859&doi=10.5009%2fgnl17391&partnerID=40&md5=30ebc3db9e0507637202547d527fa317; http://hdl.handle.net/10713/9465
    ae974a485f413a2113503eed53cd6c53
    10.5009/gnl17391
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