Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
© 2024 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
Dr. Mizuno reports the following grants, none of which are connected to the submitted work: grants from Yakult Honsha, Novartis, MSD, ASLAN Pharmaceuticals, Incyte, Ono Pharmaceutical, Seagen, Taiho Pharmaceutical, and Dainippon Sumitomo Pharma; and personal fees from Yakult Honsha, AstraZeneca, Novartis, FUJIFILM Toyama Chemical, MSD, and Taiho Pharmaceutical. The other authors have no potential conflicts of interest.
Funding
None.
Acknowledgments
The authors thank all patients who participated in this study and the investigators involved.
Author Contributions
Conceptualization: MY, KH; Date curation: MY; Formal analysis: MY; Investigation: MY, KH, NM, SH, TK, NO, YK; Methodology: MY, KH, NM, SH, TK, NO, YK; Resources: MY, TY, SI, TY, TF; Supervision: MY, KH; Writing–original draft: YM, KH; Writing–review & editing: all authors.
Variable | Number | Accuracy (%) | p-value |
---|---|---|---|
Location of tumor | 0.68 | ||
Head | 9 | 77.8 | |
Body/tail | 21 | 66.7 | |
Size of tumor (mm) | 1 | ||
<10 | 15 | 66.7 | |
≥10 | 15 | 73.3 | |
Cystic component | 0.39 | ||
Absent | 23 | 65.2 | |
Present | 7 | 85.7 | |
CE-CT | 0.14 | ||
Early enhancement | 25 | 76.0 | |
Others | 5 | 40.0 | |
MRI-T2 WIa) | 0.01 | ||
High intensity | 13 | 92.3 | |
Low-iso intensity | 12 | 41.7 | |
CE-EUSb) | 1 | ||
Hyper vascularity | 19 | 68.4 | |
Hypo-iso vascularity | 6 | 66.7 |
Characteristic | Value |
---|---|
Age (yr) | 60 (38–76) |
Sex (male/female) | 15/15 |
Location of tumor | |
Head | 9 (30.0) |
Body | 13 (43.3) |
Tail | 8 (26.7) |
Size of tumor (mm) | 10.0 (5.3–60.0) |
Cystic component | |
Absent | 23 (76.7) |
Present | 7 (23.3) |
Final diagnosis achieved | |
Surgical resection | 19 (63.3) |
EUS-FNA | 11 (36.7) |
WHO grade (2019) | |
G1 | 25 (83.3) |
G2 | 2 (6.7) |
Unclassified | 3 (10.0) |
Details of procedure | Value |
---|---|
Needle type of EUS-FNA | |
FNA needle | 10 (33.3) |
FNB needle | 20 (66.7) |
No. of punctures | 2 (1–5) |
Acquisition times for nCLE (s) | 269 (90–640) |
Accuracy of EUS-FNA | 28 (93.3) |
FNA needle (n=10) | 9 (90.0) |
FNB needle (n=20) | 19 (95.0) |
Accuracy of nCLE | 21 (70.0) |
Accuracy of EUS-FNA+nCLE | 29 (96.7) |
Adverse events | 0 (0) |
Case | Age (yr) | Sex | Location | Size (mm) | Cystic component | nCLE diagnosis | Final diagnosis achieved |
---|---|---|---|---|---|---|---|
1 | 59 | Female | Tail | 8.5 | − | No typical finding | Surgical resection |
2 | 73 | Female | Body | 10.2 | − | SCN | EUS-FNA |
3 | 47 | Male | Head | 56.7 | − | No typical finding | Surgical resection |
4 | 70 | Female | Head | 8.2 | − | No typical finding | EUS-FNA |
5 | 60 | Female | Body | 6.4 | − | No typical finding | Surgical resection |
6 | 60 | Female | Tail | 40.1 | − | SPN | Surgical resection |
7 | 76 | Male | Body | 10.4 | + | SCN | EUS-FNA |
8 | 42 | Male | Body | 7.0 | − | No typical finding | EUS-FNA |
9 | 54 | Female | Body | 8.3 | − | No typical finding | EUS-FNA |
Variable | Number | Accuracy (%) | p-value |
---|---|---|---|
Location of tumor | 0.68 | ||
Head | 9 | 77.8 | |
Body/tail | 21 | 66.7 | |
Size of tumor (mm) | 1 | ||
<10 | 15 | 66.7 | |
≥10 | 15 | 73.3 | |
Cystic component | 0.39 | ||
Absent | 23 | 65.2 | |
Present | 7 | 85.7 | |
CE-CT | 0.14 | ||
Early enhancement | 25 | 76.0 | |
Others | 5 | 40.0 | |
MRI-T2 WI |
0.01 | ||
High intensity | 13 | 92.3 | |
Low-iso intensity | 12 | 41.7 | |
CE-EUS |
1 | ||
Hyper vascularity | 19 | 68.4 | |
Hypo-iso vascularity | 6 | 66.7 |
Variable | Number | Accuracy (%) | p-value |
---|---|---|---|
Clear border | 0.21 | ||
Absent | 1 | 0 | |
Present | 18 | 83.3 | |
Intraductal pancreatic extension | 0.21 | ||
Absent | 18 | 83.3 | |
Present | 1 | 0 | |
Cystic component | 0.60 | ||
Absent | 11 | 72.7 | |
Present | 8 | 87.5 | |
Stromal fibrosis | 0.10 | ||
<30 | 8 | 100 | |
≥30 | 11 | 63.6 | |
Grading | 0.04 | ||
G1 | 17 | 88.2 | |
G2 | 2 | 0 |
Values are presented as median (range) or number (%). EUS-FNA, endoscopic ultrasound-guided fine-needle aspiration; WHO, World Health Organization.
Values are presented as number (%) or median (range). EUS-FNA, endoscopic ultrasound-guided fine-needle aspiration; nCLE, needle-based confocal laser endomicroscopy; FNA, fine-needle aspiration; FNB, fine-needle biopsy.
nCLE, needle-based confocal laser endomicroscopy; SCN, serous cystic neoplasm; EUS-FNA, endoscopic ultrasound-guided fine-needle aspiration; SPN, solid pseudopapillary neoplasm; −, absence of cystic components.
nCLE, needle-based confocal laser endomicroscopy; CE-CT, contrast-enhanced computed tomography; MRI-T2 WI, magnetic resonance imaging–T2-weighted imaging; CE-EUS, contrast-enhanced endoscopic ultrasound. Five cases had not undergone MRI. Five cases had not undergone CE-EUS.