Endoscopy 2018; 50(04): S116
DOI: 10.1055/s-0038-1637373
ESGE Days 2018 ePoster Podium presentations
20.04.2018 – EUS diagnostic: pancreatobiliary 2
Georg Thieme Verlag KG Stuttgart · New York

CAN ENDOSCOPIC ULTRASOUND (EUS) BE USEFUL IN THE STUDY OF AMPULLARY LESIONES (AL)? CASE-SERIE STUDY OF 33 PATIENTS

M Rodríguez Carrasco
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
C Cuadrado Tiemblo
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
M Pérez Carreras
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
M Algara San Nicolás
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
JC Marín Gabriel
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
A Del Pozo García
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
A Pérez Barrios
2   12 de Octubre University Hospital, Pathological Anatomy, Madrid, Spain
,
JB Díaz Tasende
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
,
A Pérez Campos
2   12 de Octubre University Hospital, Pathological Anatomy, Madrid, Spain
,
G Castellano Tortajada
1   12 de Octubre University Hospital, Gastroenterology and Hepatology, Madrid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Imaging evaluation of ampullary region poses a diagnostic challenge due to its high complex anatomy, specially in the differential diagnosis of benign/malignant AL. Owing to its high-spatial-resolution images, EUS is proposed as the most accurate technique for this purpose. The aim of this study was: 1. To evaluate the indications and overall diagnostic accuracy of EUS ± guided fine needle aspiration (FNA) on the evaluation of AL; 2. To compare EUS-FNA diagnostic accuracy with cytological brushing/histological biopsy.

Methods:

Retrospective inclusion of EUS from patients with clinical or radiological suspect of AL, between 2012 – 2016. Indications and diagnosis obtained were analysed and lesions were divided into non-neoplastic and neoplastic lesions, and these into benign and malignant. EUS ± FNA diagnosis accuracy was compared with cytological brushing/histological biopsy.

Results:

33 patients were included (54.5% women, mean age: 68 ± 13). FNA was carried out in 10/33 patients (30.3% with an average of 2.3 passes; 25G/22G needle).

16/33 patients (51.6%) were correctly diagnosed by EUS ± FNA. Neoplastic AL was the most frequent diagnostic (42.3%).

The sensitivity (S) of malignant lesions obtained by EUS, was higher than benign lesions (61.53% vs. 41.6%), showing an specificity of 83.3%, a positive predictive value (PPV) of 73%, and a negative predictive value (NPV) of 75%.

The S of malignant lesions obtained by EUS+FNA was higher than S of cytological brushing/histological biopsy (75% vs. 25%) although it did not reach statistical significance (p-value> 0.05).

Conclusions:

  1. In our study, suspicion of neoplastic AL was the most frequent indication and diagnostic by UES ± FNA.

  2. UES+FNA was specially accurate in the diagnostic of malignant AL.

  3. The overall accuracy of EUS+FNA to diagnose malignant lesions was higher than cytological brushing/histological biopsy although it did was not statistically significant

  4. Further studies are required in order to establish definite conclusions.