The Role of EUS and EUS-FNA in Detection of Small Sized Liver Metastatic Lesions in Patients with Pancreatic and Gastro-Intestinal Primary Malignancy | ||||
| The Medical Journal of Cairo University | ||||
| Article 28, Volume 88, June, June 2020, Page 1219-1225 PDF (246.7 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2020.110872 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| HANAN ABDEL HAFEZ, M.D.; HUSSEIN HASSAN OKASHA, M.D.; AHMED MOHAMED HASHEM, M.Sc.; MOHAMED HASSANY, M.D.; SAEED M. EL-NAHAAS, M.D. | ||||
| Endemic Medicine Department and Hepatology Unit*, Internal Medicine Department**, Faculty of Medicine, Cairo University and National Hepatology & Tropical Medicine Research Institute***, Cairo, Egypt | ||||
| Abstract | ||||
| Abstract Background: Liver is common site of metastasis. Small liver masses (<2cm) are not easily detected by ultrasound or computed tomography. Endosonography allows visualization of liver anatomy. Aim of Study: To assess usefulness of endosonography and EUS-FNA in detecting small sized liver metastasis; not diagnosed by CT scan during TMN staging of gastro-intestinal and pancreatic malignancy. Patients and Methods: This prospective comparative study included 92 cases with pancreatic, peri-ampullary and GI malignancies. Patients undergone: CBC, serum bilirubin, AST, ALT, ALP, GGT, serum protocol albumin, prothrombin concentration, creatinine, AFP and CA19.9, abdominal ultrasound, pancreatic computed tomography scan and endosonography. EUS-FNA and cyto-logical examination were performed in 23 patients. Results: CT scan detected 27 patients with liver focal lesions, one patient was missed. While EUS detected 27 cases, and also one patient was missed. Among cases diagnosed by EUS, 4 cases were cholangitic abcesses, EUS-FNA was performed in 23 cases, revealing metastatic lesions in 21 patients, benign lesions in 2 patients (focal fat depletion). EUS had 95.45% sensitivity, 97.14% specificity, 91.3% positive predictive value (PPV), 98.55% negative predictive value (NPV) and 96.74% accuracy. CT had 95.45% sensitivity, 91.43% specificity, 77.78% PPV, 98.46% NPV and 92.39% accuracy. EUS-FNA, had 95.45% sensitivity, 100% specificity, 100% PPV, 98.5% NPV and 98.91% accuracy. Conclusions: EUS and EUS-FNA play a significant role in detecting small sized liver metastasis, where EUS and EUS-FNA showed a higher diagnostic accuracy compared to that of CT scan. | ||||
| Keywords | ||||
| Endosonography; Liver metastasis; Pancreatic malignancy; Gastro-intestinal malignancy | ||||
|
Statistics Article View: 218 PDF Download: 243 |
||||
