TY - JOUR
T1 - Endoscopic ultrasound versus ct scan for detection of the metastases to the liver
T2 - Results of a prospective comparative study
AU - Singh, Pankaj
AU - Mukhopadhyay, Phalguni
AU - Bhatt, Bankim
AU - Patel, Tushar
AU - Kiss, Alex
AU - Gupta, Rahul
AU - Bhat, Sanjay
AU - Erickson, Richard A.
PY - 2009/4
Y1 - 2009/4
N2 - BACKGROUND: Computed tomography (CT) scan is a standard test for the detection of the liver metastases; however, metastases are often missed on the CT scan. OBJECTIVE: To compare the accuracy of the endoscopic ultrasound (EUS)/endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with CT scan for detection of the liver metastases. DESIGN: Prospective study. PATIENTS: Subjects with newly diagnosed tumors of the lung, pancreas, biliary tree, esophagus, stomach, and colon were enrolled. INTERVENTIONS: A CT scan and EUS examination of the liver was performed. EUS-FNA was performed on noncystic liver lesions. RESULTS: One hundred thirty-two cases were enrolled. The presence of liver metastasis was established in 26 cases. The diagnostic accuracy of EUS/EUS-FNA and CT scan was 98% and 92%, respectively (P=0.0578). In comparison to CT scan, EUS detected significantly higher number of metastatic lesions in the liver (40 vs.19; P=0.008). CT scan detected lesions in liver that were too small to be characterized in 8 cases (malignant-3; benign-5). Of these, EUS-FNA correctly characterized the lesion to be malignant in 3/3 cases and benign in 4/5 cases. No complications were observed as a result of EUS-FNA. LIMITATIONS: Endoscopist was not blinded to the findings of the CT scan. CONCLUSIONS: In comparison with the CT scan, there was trend in favor of EUS/EUS-FNA for the superior diagnostic accuracy. EUS was distinctly superior to the CT scan in detecting the number of metastatic lesions. EUS-FNA was also useful to identify the nature of lesions that were too small to be characterized on the CT scan.
AB - BACKGROUND: Computed tomography (CT) scan is a standard test for the detection of the liver metastases; however, metastases are often missed on the CT scan. OBJECTIVE: To compare the accuracy of the endoscopic ultrasound (EUS)/endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with CT scan for detection of the liver metastases. DESIGN: Prospective study. PATIENTS: Subjects with newly diagnosed tumors of the lung, pancreas, biliary tree, esophagus, stomach, and colon were enrolled. INTERVENTIONS: A CT scan and EUS examination of the liver was performed. EUS-FNA was performed on noncystic liver lesions. RESULTS: One hundred thirty-two cases were enrolled. The presence of liver metastasis was established in 26 cases. The diagnostic accuracy of EUS/EUS-FNA and CT scan was 98% and 92%, respectively (P=0.0578). In comparison to CT scan, EUS detected significantly higher number of metastatic lesions in the liver (40 vs.19; P=0.008). CT scan detected lesions in liver that were too small to be characterized in 8 cases (malignant-3; benign-5). Of these, EUS-FNA correctly characterized the lesion to be malignant in 3/3 cases and benign in 4/5 cases. No complications were observed as a result of EUS-FNA. LIMITATIONS: Endoscopist was not blinded to the findings of the CT scan. CONCLUSIONS: In comparison with the CT scan, there was trend in favor of EUS/EUS-FNA for the superior diagnostic accuracy. EUS was distinctly superior to the CT scan in detecting the number of metastatic lesions. EUS-FNA was also useful to identify the nature of lesions that were too small to be characterized on the CT scan.
KW - Cancer
KW - EUS
KW - EUS-FNA
KW - FNA
KW - Liver
KW - Liver cancer
KW - Liver secondaries
KW - Metastases
KW - Metastasis
KW - Oncology
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UR - http://www.scopus.com/inward/citedby.url?scp=65549110299&partnerID=8YFLogxK
U2 - 10.1097/MCG.0b013e318167b8cc
DO - 10.1097/MCG.0b013e318167b8cc
M3 - Article
C2 - 18981929
AN - SCOPUS:65549110299
SN - 0192-0790
VL - 43
SP - 367
EP - 373
JO - Journal of clinical gastroenterology
JF - Journal of clinical gastroenterology
IS - 4
ER -