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• W2922321061 abstract "Outcomes in the treatment of pancreatic cancer heavily depends on early detection. CT and MRI scans are common modalities employed in the initial diagnosis of pancreatic tumors. EUS has emerged as a valuable tool to aid in the early diagnosis of pancreatic malignancy and to detail their resectability. We present three patients with MRI and MRCP negative but EUS positive pancreatic cancer. All three patients presented with biliary dilatation where MRI/MRCP failed to detect any discrete pancreatic lesions. Subsequent EUS with core needle biopsy revealed pancreatic adenocarcinoma. The largest lesion was 3.4 cm in size. Two of these lesions resided in the head of pancreas and one in the uncinate process. EUS was performed using a linear array echo endoscope. All cases were performed by a single operator, who is a board certified gastroenterologist and fellowship trained in advanced interventional endoscopy. The mass/lesions were evaluated for its size, echogenicity, lymph node involvement, loco regional extension, ductal size, and major vessel abutment. Tissue samples from these pancreatic masses were harvested via a 22g Shark Core Fine Needle Biopsy (CNB). MRI/MRCP was performed using Philips Ingenia 1.5T MR system. Two of the three cases were presented at tumor board and images were reviewed at tumor board by a second radiologist. The primary impact of endosonography on the management of pancreatic cancer is in detection and cytologic diagnosis. The accuracy of EUS for T staging of pancreatic cancer is reported to be 80-85%, which is similar to that of MRI. The degree of certainty is dependent on the experience of the endoscopist. Most of the T1 lesions are < 2 cm and difficult to image by cross sectional methods. Unfortunately these are the patients who can have a favorable treatment outcome if instituted early in the course of the disease. EUS offer the advantage of detecting pancreatic masses earlier than cross sectional imaging in patients with early features of biliary obstruction. The ampulla and pancreatic portion of the CBD is very well visualized by EUS. More over EUS can provide an overall accuracy of 93% for vascular invasion thus defining resectability. We suggest a low threshold for EUS evaluation of patients with appropriate clinical symptoms in the setting of a negative cross sectional imaging for pancreatic cancer, than the practice of surveillance imaging which may widen the lag time and lead to an unfavorable outcome.1311_A.tif Figure 1: Patient and Imaging characteristics1311_B.tif Figure 2: tumor characteristics" @default.
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• W2922321061 date "2018-10-01" @default.
• W2922321061 modified "2023-09-26" @default.
• W2922321061 title "When the Sound Surmounts the Magnet: Pancreatic Cancer Imaging" @default.
• W2922321061 doi "https://doi.org/10.14309/00000434-201810001-01311" @default.
• W2922321061 hasPublicationYear "2018" @default.
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