Evidence map›Paper›PMID 30637249›Full record

ArticleWorld journal of clinical cases2019

Instant evaluation of contrast enhanced endoscopic ultrasound helps to differentiate various solid pancreatic lesions in daily routine.

Klaus Kannengiesser, Reiner Mahlke, Frauke Petersen, Anja Peters, Torsten Kucharzik, Christian Maaser

Open access · diamondAbstract read
In one paragraph

Article in World journal of clinical cases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Klaus KannengiesserDepartment of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg 21339, Germany. klaus.kannengiesser@klinikum-lueneburg.de.
Reiner MahlkeDepartment of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg 21339, Germany.
Frauke PetersenDepartment of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg 21339, Germany.
Anja PetersDepartment of Pathology, University Teaching Hospital Lueneburg, Lueneburg 21339, Germany.
Torsten KucharzikDepartment of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg 21339, Germany.
Christian MaaserDepartment of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg 21339, Germany.
Klinikum Lüneburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContrast enhanced harmonic endoscopic ultrasound (CEH-EUS) is a spreading technique; some studies have shown its value in the diagnosis of pancreatic adenocarcinoma using quantitative analysis.

aimTo examine the value of CEH-EUS for differentiating various pancreatic lesions in everyday routine with qualitative and quantitative analysis.

methodsData of 55 patients with pancreatic lesions who underwent CEH-EUS were analysed retrospectively. Perfusion characteristics were classified by the investigator qualitatively immediately upon investigation, quantitative analysis was performed later on. Samples from fine needle aspiration (EUS-FNA) or surgical specimen served as gold standard.

resultsCEH-EUS showed 39 hypoenhanced lesions, 3 non-enhanced and 13 hyperenhanced lesions. Concordance of the investigators qualitative classification of peak contrast enhancement with quantitative analysis later on was 100%, while other parameters such as arrival time, time to peak or area under the curve did not show additional value. 34 of 39 hypoenhanced lesions were pancreatic adenocarcinoma; of the hyperenhanced lesions 4 were inflammatory, 3 neuroendocrine carcinomas, 1 lymphoma, 1 insulinoma and 4 metastases (2 of renal cell carcinoma, 2 of lung cancer). Non-enhanced lesions showed up as necroses. Sensitivity for the detection of pancreatic adenocarcinoma was 100%, specificity 87.2% for hypoenhancement alone; in otherwise healthy pancreatic tissue all hypoenhanced lesions were pancreatic adenocarcinoma (sensitivity and specificity 100%, PPV and NPV for adenocarcinoma 100%).

conclusionThis study again shows the excellent value of CEH-EUS in everyday routine for diagnostics of various focal pancreatic lesions suggesting that qualitatively assessed hypoenhancement is highly predictive for adenocarcinoma. Additional quantitative analysis of perfusion parameters does not add diagnostic yield. In case of the various hyperenhanced pancreatic lesions in our data set, histologic sampling is essential for further treatment.

Indexed as

Contrast enhanced endoscopic ultrasoundEndoscopic ultrasoundLymphomaNeuroendocrine carcinomaPancreatic adenocarcinomaPancreatic metastases

Identifiers

PMID30637249
PMCPMC6327129
OpenAlexW2906912315

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.