Endoscopic ultrasound versus ct scan for detection of the metastases to the liver

Results of a prospective comparative study

Pankaj Singh, Phalguni Mukhopadhyay, Bankim Bhatt, Tushar C Patel, Alex Kiss, Rahul Gupta, Sanjay Bhat, Richard A. Erickson

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)367-373
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume43
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

Fingerprint

Tomography
Prospective Studies
Neoplasm Metastasis
Liver
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Biliary Tract
Esophagus
Pancreas
Stomach
Colon
Lung
Neoplasms

Keywords

  • Cancer
  • EUS
  • EUS-FNA
  • FNA
  • Liver
  • Liver cancer
  • Liver secondaries
  • Metastases
  • Metastasis
  • Oncology

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic ultrasound versus ct scan for detection of the metastases to the liver : Results of a prospective comparative study. / Singh, Pankaj; Mukhopadhyay, Phalguni; Bhatt, Bankim; Patel, Tushar C; Kiss, Alex; Gupta, Rahul; Bhat, Sanjay; Erickson, Richard A.

In: Journal of Clinical Gastroenterology, Vol. 43, No. 4, 04.2009, p. 367-373.

Research output: Contribution to journalArticle

Singh, Pankaj ; Mukhopadhyay, Phalguni ; Bhatt, Bankim ; Patel, Tushar C ; Kiss, Alex ; Gupta, Rahul ; Bhat, Sanjay ; Erickson, Richard A. / Endoscopic ultrasound versus ct scan for detection of the metastases to the liver : Results of a prospective comparative study. In: Journal of Clinical Gastroenterology. 2009 ; Vol. 43, No. 4. pp. 367-373.
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abstract = "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.",
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AU - Singh, Pankaj

AU - Mukhopadhyay, Phalguni

AU - Bhatt, Bankim

AU - Patel, Tushar C

AU - Kiss, Alex

AU - Gupta, Rahul

AU - Bhat, Sanjay

AU - Erickson, Richard A.

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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.

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KW - Liver

KW - Liver cancer

KW - Liver secondaries

KW - Metastases

KW - Metastasis

KW - Oncology

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