Clinical utility of directional eFLOW compared with contrast-enhanced harmonic endoscopic ultrasound for assessing the vascularity of pancreatic and peripancreatic masses

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 22; no. 1; pp. 130 - 135
• Main Authors: Hwang, Jun Seong, Seo, Dong-Wan, So, Hoonsub, Ko, Sung Woo, Joo, Hyun Don, Oh, Dongwook, Song, Tae Jun, Park, Do Hyun, Lee, Sang Soo, Lee, Sung Koo, Kim, Myung-Hwan
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01.01.2022; Elsevier Limited
• Subjects: Adult; Aged; Blood flow; Contrast Media; Contrast-enhanced harmonic endoscopic ultrasound; Cysts; Differential diagnosis; Directional eFLOW; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endoscopy; Endosonography - methods; Female; Flow velocity; Humans; Kidney cancer; Lesions; Magnetic resonance imaging; Male; Metastasis; Microcirculation; Microvasculature; Middle Aged; Neuroendocrine tumors; Pancreas; Pancreas - blood supply; Pancreas - diagnostic imaging; Pancreatic cancer; Pancreatic Cyst - blood supply; Pancreatic Cyst - diagnostic imaging; Pancreatic Diseases - diagnostic imaging; Pancreatic mass; Pancreatitis; Patients; Retrospective Studies; Spleen; Statistical analysis; Tumors; Ultrasonic imaging; Ultrasound; United States > US; Italy; Japan; Pancreatic mass; Contrast-enhanced harmonic endoscopic ultrasound; Directional eFLOW
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2021.11.002

Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) can be used for the differential diagnosis of pancreatic lesions by evaluating microvascular circulation and patterns of contrast enhancement. However, routine use of CEH-EUS is limited by its high cost, the lack of contrast agent availability and the absence of expertise with this technique. Directional eFLOW (D-eFLOW) (Aloka Co., Ltd., Tokyo, Japan) was introduced as a new high-definition modality that detects blood flow in microvessels. Because it uses built-in functions, it entails no additional cost and reduces time for examination. The present study compared the usefulness of D-eFLOW and CEH-EUS for differential diagnosis of pancreatic and peripancreatic lesions. This retrospective study analyzed 130 patients who underwent EUS and D-eFLOW examinations from January 2016 to March 2020 to evaluate pancreatic and peripancreatic masses. All 130 patients underwent D-eFLOW and CEH-EUS examinations. Histological diagnoses were confirmed in 130 patients by EUS-FNA and/or surgery. D-eFLOW and CEH-EUS showed good correlation in evaluating the vascularity of pancreatic and peripancreatic tumors (Fisher's exact test, p < 0.05). In evaluating the characteristics of tumorous lesions, vascularity detected by D-eFLOW showed good correlation with enhancement patterns of CEH-EUS. D-eFLOW can be considered a good alternative to CEH-EUS in diagnosing pancreatic and peripancreatic masses.