Endoscopy 2025; 57(S 02): S223
DOI: 10.1055/s-0045-1805548
Abstracts | ESGE Days 2025
Moderated poster
EUS guided tissue acquisition: Needles and techniques 04/04/2025, 10:00 – 11:00 Poster Dome 1 (P0)

EUS-guided Advance Imaging Techniques vs EUS-guided Tissue Acquisition for determining malignancy in solid Pancreatic Lesions: Analysis of a Prospective EUS Registry

Authors

  • Y Dominguez-Novoa

    1   University Hospital of Santiago. Foundation Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain

  • J Lariño Noia

    2   University Hospital of Santiago de Compostela, Santiago de Compostela, Spain

  • J E Dominguez-Munoz

    1   University Hospital of Santiago. Foundation Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain

  • I Abdulkader-Nallib

    3   University Hospital of Santiago de Compostela, Santiago de Compostela, Spain, Spain

  • H Lazare-Iglesias

    2   University Hospital of Santiago de Compostela, Santiago de Compostela, Spain

  • J Iglesias-Garcia

    4   Santiago Clinic Hospital CHUS, Santiago de Compostela, Spain
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Aims to assess the accuracy of endoscopic ultrasound (EUS)-guided advanced imaging compared to EUS-guided tissue acquisition (TA) in determining malignancy in solid pancreatic tumors (SPT).

Methods A prospective EUS registry was used to identify patients who underwent EUS-guided TA and EUS-guided advanced imaging for the evaluation of SPT between 2018 and 2023. The EUS was performed using linear Pentax/FujiFilm echoendoscopes and Hitachi/FujiFilm systems. EUS-guided TA was performed using cytological and/or histological needles. According to prior research, SPTs were classified as malignant on advanced imaging if they exhibited a blue elastographic pattern and a hypovascular or hypervascular pattern after contrast enhancement. Tumours were considered benign if they displayed a green pattern on elastography, and any pattern after contrast enhancement, or a blue elastographic pattern with an isovascular pattern at contrast enhancement. The study analysed diagnostic accuracy using either histological analysis of the surgical specimen or clinical/radiological evaluation with a minimum of 6 months of follow-up in non-operated patients as reference methods. The results are presented as median, range, and percentage. Fisher's exact test was used to test the association between categorical variables

Results The study included 252 patients, with a mean age of 68±11.2 years (range 30-89), of whom 129 were male. The average size of pancreatic tumours was 30±13.9mm. Of the lesions, 130 (51.6%) were located in the pancreatic head, 79 (31.4%) in the body, 27 (10.7%) in the tail, and 16 (6.3%) in the uncinate process. The final diagnosis was a malignant tumour in 201 patients (79.8%) and a benign lesion in 51 patients (20.2%). Sensitivity was higher for EUS-guided advance imaging as compared to EUS-guided TA (98% vs 94.5%; p<0.001), whereas specificity was higher for EUS-guided TA (82.4% vs 100%; p<0.001). No differences were detected in terms of overall accuracy (94.8% vs 95.6%; p=0.547).

Conclusions The use of advanced imaging with EUS is a valuable tool for detecting malignancy in SPT. It has been shown to have higher sensitivity, lower specificity, and similar overall accuracy compared to EUS-guided TA.



Publication History

Article published online:
27 March 2025

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