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ORIGINAL ARTICLE
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Utility of contrast-enhanced harmonic EUS for diagnosis of portal vein invasion by pancreatic cancer


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
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/EUS-D-21-00185

PMID: 35848657

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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