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- Title
Endoscopic Contrast-Enhanced Ultrasound and Fine-Needle Aspiration or Biopsy for the Diagnosis of Pancreatic Solid Lesions: A Systematic Review and Meta-Analysis.
- Authors
Esposto, Giorgio; Massimiani, Giuseppe; Galasso, Linda; Santini, Paolo; Borriello, Raffaele; Mignini, Irene; Ainora, Maria Elena; Nicoletti, Alberto; Zileri Dal Verme, Lorenzo; Gasbarrini, Antonio; Alfieri, Sergio; Quero, Giuseppe; Zocco, Maria Assunta
- Abstract
Simple Summary: We conducted a systematic search of the literature to explore if endoscopic contrast-enhanced ultrasound (ECEUS) could improve the diagnostic success of pancreatic solid lesion biopsy or fine needle aspiration. The analysis that we conducted on 1.178 patients showed a slight trend of more diagnoses and the greater efficacy of a single pass in patients who underwent contrast-guided pancreatic sampling, although this finding did not reach statistical significance. We believe that our analysis provides a useful insight for clinical practice and could aid future investigations on this topic. Introduction: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) are currently recommended for the pathologic diagnosis of pancreatic solid lesions (PSLs). The application of contrast-enhanced endoscopic ultrasound (ECEUS) could aid the endoscopist during an FNA and/or FNB procedure. CEUS is indeed able to better differentiate the pathologic tissue from the surrounding healthy pancreatic parenchyma and to detect necrotic areas and vessels. Objectives: Our objective was to evaluate if ECEUS could reduce the number of needle passes and side effects and increase the diagnostic efficacy of FNA and/or FNB. Methods: A comprehensive literature search of clinical studies was performed to explore if ECEUS-FNA or FNB could increase diagnostic accuracy and reduce the number of needle passes and adverse effects compared to standard EUS-FNA or FNB. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. Results: The proportion of established diagnoses of ECEUS was 90.9% compared to 88.3% of EUS, with no statistically significant difference (p = 0.14). The diagnosis was made through a single step in 70.9% of ECEUS patients and in 65.3% of EUS patients, without statistical significance (p = 0.24). The incidence of adverse reactions was substantially comparable across both groups (p = 0.89). Conclusion: ECEUS-FNA and FNB do not appear superior to standard EUS-FNA and FNB for the diagnosis of pancreatic lesions.
- Subjects
MEDICAL information storage &; retrieval systems; DIAGNOSTIC imaging; DIGESTIVE system endoscopic surgery; ENDOSCOPIC ultrasonography; META-analysis; DESCRIPTIVE statistics; PANCREATIC tumors; SYSTEMATIC reviews; MEDLINE; NEEDLE biopsy; ONLINE information services; CONTRAST media; SENSITIVITY &; specificity (Statistics)
- Publication
Cancers, 2024, Vol 16, Issue 9, p1658
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16091658