BACKGROUND AND AIMS: Differentiation of gallbladder (GB) carcinoma from benign GB wall thickening is challenging. The recent introduction of second-generation ultrasonic contrast agents has made contrast harmonic imaging with EUS possible. The aim of our study was to evaluate the utility of contrast-enhanced harmonic EUS (CH-EUS) for the differential diagnosis of GB wall thickening. METHODS: Thirty-six consecutive patients with GB wall thickening imaged by CH-EUS and then underwent surgery were enrolled in this study. After the lesions were observed with conventional harmonic EUS (H-EUS), CH-EUS was performed with intravenous injection of 0.015 ml/kg of Sonazoid. Three reviewers with various levels of experience of EUS (Reviewer A: experienced endosonographer, B: EUS trainee, C: experienced gastroenterologist with expertise in transabdominal ultrasound but no EUS experience) were blinded to findings of recorded video of H-EUS and CH-EUS. The diagnostic accuracy of H-EUS and CH-EUS for malignant GB wall thickening was compared. RESULTS: Final diagnoses based on surgical histology were GB carcinoma in 16, cholecystitis in 11, adenomyomatosis in 6 and cholesterolosis in 3. Overall sensitivity, specificity and accuracy for diagnosing malignant GB wall thickening of H-EUS and CH-EUS were 83.3 versus 89.6, 65 versus 98% (p < 0.001) and 73.1 versus 94.4% (p < 0.001). The inter-observer agreement for H-EUS was moderate (κ = 0.51), whereas that for CH-EUS was substantial (κ = 0.77). The inhomogeneous enhanced pattern on CH-EUS was a strong predictive factor of malignant GB wall thickening. CONCLUSION: CH-EUS has the potential to improve the preoperative diagnostic accuracy and inter-observer agreement in the differential diagnosis of GB wall thickening.
BACKGROUND AND AIMS: Differentiation of gallbladder (GB) carcinoma from benign GB wall thickening is challenging. The recent introduction of second-generation ultrasonic contrast agents has made contrast harmonic imaging with EUS possible. The aim of our study was to evaluate the utility of contrast-enhanced harmonic EUS (CH-EUS) for the differential diagnosis of GB wall thickening. METHODS: Thirty-six consecutive patients with GB wall thickening imaged by CH-EUS and then underwent surgery were enrolled in this study. After the lesions were observed with conventional harmonic EUS (H-EUS), CH-EUS was performed with intravenous injection of 0.015 ml/kg of Sonazoid. Three reviewers with various levels of experience of EUS (Reviewer A: experienced endosonographer, B: EUS trainee, C: experienced gastroenterologist with expertise in transabdominal ultrasound but no EUS experience) were blinded to findings of recorded video of H-EUS and CH-EUS. The diagnostic accuracy of H-EUS and CH-EUS for malignant GB wall thickening was compared. RESULTS: Final diagnoses based on surgical histology were GB carcinoma in 16, cholecystitis in 11, adenomyomatosis in 6 and cholesterolosis in 3. Overall sensitivity, specificity and accuracy for diagnosing malignant GB wall thickening of H-EUS and CH-EUS were 83.3 versus 89.6, 65 versus 98% (p < 0.001) and 73.1 versus 94.4% (p < 0.001). The inter-observer agreement for H-EUS was moderate (κ = 0.51), whereas that for CH-EUS was substantial (κ = 0.77). The inhomogeneous enhanced pattern on CH-EUS was a strong predictive factor of malignant GB wall thickening. CONCLUSION:CH-EUS has the potential to improve the preoperative diagnostic accuracy and inter-observer agreement in the differential diagnosis of GB wall thickening.
Authors: F Piscaglia; C Nolsøe; C F Dietrich; D O Cosgrove; O H Gilja; M Bachmann Nielsen; T Albrecht; L Barozzi; M Bertolotto; O Catalano; M Claudon; D A Clevert; J M Correas; M D'Onofrio; F M Drudi; J Eyding; M Giovannini; M Hocke; A Ignee; E M Jung; A S Klauser; N Lassau; E Leen; G Mathis; A Saftoiu; G Seidel; P S Sidhu; G ter Haar; D Timmerman; H P Weskott Journal: Ultraschall Med Date: 2011-08-26 Impact factor: 6.548
Authors: Ijin Joo; Jae Young Lee; Jung Hoon Kim; Soo Jin Kim; Min A Kim; Joon Koo Han; Byung Ihn Choi Journal: Eur Radiol Date: 2012-12-18 Impact factor: 5.315
Authors: B Napoleon; M V Alvarez-Sanchez; R Gincoul; B Pujol; C Lefort; V Lepilliez; M Labadie; J C Souquet; P E Queneau; J Y Scoazec; J A Chayvialle; T Ponchon Journal: Endoscopy Date: 2010-06-30 Impact factor: 10.093
Authors: Hyun Kyung Yang; Jeong Min Lee; Mi Hye Yu; Sang Min Lee; Jinyoung Park; Na Young Han; Kyoungbun Lee; Jin-Young Jang; Joon Koo Han Journal: Eur Radiol Date: 2018-04-09 Impact factor: 5.315
Authors: Sarah Z Wennmacker; Mark P Lamberts; Marcello Di Martino; Joost Ph Drenth; Kurinchi Selvan Gurusamy; Cornelis Jhm van Laarhoven Journal: Cochrane Database Syst Rev Date: 2018-08-15