title: Contrast-enhanced harmonic endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic lesions: a retrospective study.
abstract: BACKGROUND
  The negative predictive value of endoscopic ultrasonography-guided fine needle aspiration for the diagnosis of solid pancreatic lesions remains low, and the biopsy specimens are sometimes inadequate for appropriate pathological diagnosis.
  
  
  OBJECTIVE
  To evaluate the usefulness of a novel method of contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration for the differential diagnosis and adequate sampling of solid pancreatic lesions.
  
  
  METHODS
  Patients with a diagnosis of solid pancreatic lesions who underwent fine-needle aspiration guided by contrast-enhanced harmonic endoscopic ultrasonography or by endoscopic ultrasonography from October 2010 to July 2013 were retrospectively identified and classified into the CH-EUS or EUS group, respectively. Surgical pathology and/or follow-up results were defined as the final diagnosis. Operating characteristics and adequacy of biopsy specimens by fine-needle aspiration were compared between the two groups.
  
  
  RESULTS
  Operating characteristics for contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration in solid pancreatic lesions were as follows: area under the curve = 0.908, sensitivity = 81.6%, specificity = 100%, positive predictive value = 100%, negative predictive value = 74.1%, and accuracy = 87.9%. The percentage of adequate biopsy specimens in the CH-EUS group (96.6%) was greater than that in the EUS group (86.7%).
  
  
  CONCLUSIONS
  Simultaneous contrast-enhanced harmonic endoscopic ultrasonography during fine-needle aspiration is useful for improving the diagnostic yield and adequate sampling of solid pancreatic lesions.
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Xiaojia
authors: X
authors: Hou
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Zhendong
authors: Z
authors: Jin
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Can
authors: C
authors: Xu
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Minmin
authors: M
authors: Zhang
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Jianwei
authors: J
authors: Zhu
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Fei
authors: F
authors: Jiang
authors: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors: Zhaoshen
authors: Z
authors: Li
mesh_terms: D003362:Cost-Benefit Analysis; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000191:economics / Q000473:pathology / Q000601:surgery; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies