CC BY-NC-ND 4.0 · Endoscopy 2021; 53(06): 595-602
DOI: 10.1055/a-1217-3112
Original article

Defining the endoscopic ultrasound features of chronic pancreatitis in Asians: a multicenter validation study

Calvin Jianyi Koh
 1  Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
 2  Division of Gastroenterology and Hepatology, National University Hospital, Singapore, Singapore
,
Sundeep Lakhtakia
 3  Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
,
Mitsuhiro Kida
 4  Department of Gastroenterology, Kitasato University Hospital, Sagamihara, Kanagawa, Japan
,
Cosmas Rinaldi A. Lesmana
 5  Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia
,
Tiing Leong Ang
 6  Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
,
Charles Kieng Fong Vu
 7  Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore
,
Than Than Aye
 8  Department of Gastroenterology, Sanpya General Hospital, Thingan Gyun, Myanmar
,
Sun Hwa Park
 9  Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
,
Majid A. Almadi
10  Department of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
,
Charing Ching-Ning Chong
11  Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
,
Raymond Shing Yan Tang
12  Institute of Digestive Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
,
Xi Wu
13  Department of Gastroenterology, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
,
Ida Hilmi
14  Division of Gastroenterology, University of Malaya, Kuala Lumpur, Malaysia
,
Vinay Dhir
15  Institute of Digestive and Liver Care, Global Hospital, Mumbai, India
,
Nonthalee Pausawasdi
16  Mahidol University Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
,
Jahangeer Basha
 3  Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
,
Zhen-Dong Jin
17  Department of Gastroenterology, The Second Military Medical University, Shanghai, China
,
Ai Ming Yang
13  Department of Gastroenterology, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
,
Anthony Yuen Bun Teoh
11  Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
,
Dong-Wan Seo
 9  Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
,
Hsiu-Po Wang
18  Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
,
Khek Yu Ho
 1  Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
 2  Division of Gastroenterology and Hepatology, National University Hospital, Singapore, Singapore
› Author Affiliations


Abstract

Background Although endoscopic ultrasound (EUS) features and criteria have been described in chronic pancreatitis, challenges remain with interoperator variability and ease of adoption. The aim of this study was to define and validate the EUS features of chronic pancreatitis in a multicenter prospective study in Asia.

Method The study was divided into two parts: the first part was conducted to derive the EUS features of chronic pancreatitis with adequate interoperator agreement; the second was to prospectively evaluate these features in a multicenter cross-sectional study and determine the optimal combination of features for the diagnosis of chronic pancreatitis. Prospectively enrolled cases had standard internationally validated radiologic or histologic features of chronic pancreatitis, and controls were patients without chronic pancreatitis who underwent EUS examination.

Results The top six EUS features that had good interobserver agreement (mean kappa 0.73, range 0.60 – 0.90) were selected to be further evaluated in part II of the study. These included: hyperechoic foci with shadowing, lobularity with honeycombing, cysts, dilated main pancreatic duct, dilated side branches, and calculi in the main pancreatic duct. A total of 284 subjects (132 cases, 152 controls) were enrolled from 12 centers in Asia. All six features had high accuracy ranging from 63.3 % to 89.1 %. Two or more of these six EUS features accurately defined chronic pancreatitis (sensitivity 94.7 %, specificity 98.0 %), with an area under the receiver operating curve of 0.986.

Conclusion This multicenter Asian study characterized and defined the EUS features of chronic pancreatitis. This provides a useful tool in clinical practice and further research in pancreatic cancer surveillance.

Supplementary material



Publication History

Received: 19 February 2020

Accepted: 10 July 2020

Publication Date:
10 July 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany