Minerva Gastroenterologica e Dietologica 2020 Dec 18

DOI: 10.23736/S1121-421X.20.02789-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Early detection of pancreatic tumors by advanced EUS imaging

Christoph F. DIETRICH ¹ ✉, Long SHI ², Jonas KOCH ¹, Axel LÖWE ¹, Yi DONG ³, Xin-wu CUI ⁴, Mathias WORNI ^{5, 6, 7}, Christian JENSSEN ⁸

¹ Department Allgemeine Innere Medizin, Kliniken Hirslanden, Beau Site, Salem und Permanence, Bern, Switzerland; ² Department of Ultrasound, Jingmen No. 2 People's Hospital, Jingmen, Hubei, China; ³ Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China; ⁴ Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; ⁵ Department of Visceral Surgery, Clarunis, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland; ⁶ Swiss Institute for Translational and Entrepreneurial Medicine, Stiftung Lindenhof, Campus SLB, Bern, Switzerland; ⁷ Department of Surgery, Clinic Beau Site, Bern, Switzerland; ⁸ Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen

The early detection of pancreatic ductal adenocarcinoma (PDAC) dramatically improves outcome. All available state-of-the-art imaging methods allow early detection with EUS being the best technique for exclusion of PDAC and detection of very early PDAC. Etiological differentiation of small SPL is important to guide individually tailored patients management including radical surgery in resectable PDAC, medical (neoadjuvant or palliative intended) treatment in patients with non-resectable malignancy, pancreatic parenchyma saving strategies in some non-PDAC, and follow-up in particular in low-grade PanNEN or other small benign lesions. Multimodality EUS imaging including B-Mode assessment, elastography, contrast-enhancement and EUS-guided sampling is the most appropriate technique for diagnosis and risk assessment of small SPL. Herewith we present a review discussing modern (endoscopic) ultrasound imaging techniques including contrast enhanced ultrasound and elastography for the early detection and characterization of solid pancreatic lesions.

KEY WORDS: Transcutaneous ultrasound; Endoscopic ultrasound; Elastography, contrast-enhanced ultrasound; EUS-guided tissue sampling; Pancreatic ductal adenocarcinoma; Pancreatic neuroendocrine neoplasia, pancreatic cysts