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Utility of contrast-enhanced harmonic EUS for diagnosis of portal vein invasion by pancreatic cancer
Atsushi Nakai1, Ken Kamata1, Tomoko Hyodo2, Takaaki Chikugo3, Akane Hara1, Yasuo Otsuka1, Hidekazu Tanaka1, Tomoe Yoshikawa1, Rei Ishikawa1, Ayana Okamoto1, Tomohiro Yamazaki1, Shunsuke Omoto1, Kosuke Minaga1, Kentaro Yamao1, Mamoru Takenaka1, Yasutaka Chiba4, Tomohiro Watanabe1, Ippei Matsumoto5, Yoshifumi Takeyama5, Masatoshi Kudo1
1 Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
2 Department of Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
3 Department of Diagnostic Pathology, Kindai University Hospital, Osaka-Sayama, Japan
4 Clinical Research Center, Kindai University Hospital, Osaka-Sayama, Japan
5 Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
Correspondence Address:
Ken Kamata,
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama 589-8511
Japan
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/EUS-D-21-00185 PMID: 35848657
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Background: The value of contrast-enhanced harmonic EUS (CH-EUS) for diagnosis of portal vein invasion in patients with pancreatic cancer was evaluated. Patients and Methods: This single-center, retrospective study included consecutive patients with pancreatic cancer who underwent both surgical resection after preoperative EUS, CH-EUS, and contrast-enhanced computed tomography (CE-CT) examinations between April 2015 and August 2017. CH-EUS evaluation was performed during the late phase. Portal vein invasion on EUS and CH-EUS was defined as no continuity in the line of the vessel wall. Definition of portal vein invasion on CE-CT was based on the Loyer's criteria. The accuracy of three modalities for diagnosis of invasion into the portal vein was compared using the McNemar's test. Results: Eighty-eight patients (mean age: 71.0 years, ratio of male to female: 48:40) were eligible. Postoperative pathological results were as follows: seven cases of portal vein invasion; 81 cases without. Diagnostic accuracy of EUS, CH-EUS, and CE-CT for diagnosing invasion into the portal vein was 72.7%, 93.2%, and 81.8%, respectively. The differences between CH-EUS and CE-CT (P = 0.0094) and CH-EUS and EUS (P = 0.0022) were significant. EUS and CE-CT were comparable. Conclusion: CH-EUS is useful for diagnosis of portal vein invasion by pancreatic cancer.
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