Clinical performance of endoscopic ultrasound‐guided tissue acquisition for perivascular soft‐tissue cuffing suspected to be extravascular migratory metastases of pancreatic or bile duct cancer (with video)

作者：Kosuke Maehara, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Daiki Yamashige, Kohei Okamoto, Daiki Agarie, Shin Yagi, Soma Fukuda, Masaru Kuwada, Yasuhiro Komori, Takehiko Koga, Atsushi Kanno, Tsunao Imamura, Yutaka Saito, Takuji Okusaka · 发表于：Digestive Endoscopy · 年份：2024 · DOI：10.1111/den.14983 · 被引用次数：5 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Pancreatic and Hepatic Oncology Research、Amoebic Infections and Treatments

OBJECTIVES: This study aimed to investigate the diagnostic performance and safety of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for perivascular soft-tissue cuffing (PSTC). METHODS: This single-center, retrospective study evaluated patients in whom EUS-TA was performed for PSTC in pancreatic or bile duct cancer lesions between October 2017 and March 2024. PSTC was defined as a perivascular soft-tissue area contiguous with nearby blood vessels from the suspected primary tumor. EUS-TA procedures and outcomes, including technical success, diagnostic performance, adverse events, and comparison with contrast-enhanced computed tomography (CECT), were analyzed. RESULTS: Of 1803 patients, 53 underwent EUS-TA for PSTC. The sensitivity, specificity, and accuracy were 92.1%, 100%, and 92.5%, respectively. The technical success rate was 98.1% (52/53). The adverse event rate was 1.9%. EUS-TA for PSTC was significantly superior to CECT for PSTC in terms of diagnostic accuracy. Furthermore, the diagnostic performance and adverse event rates for EUS-TA for PSTC were comparable to those for TA in solid tumors. Shorter puncture lengths were associated with lower accuracy. CONCLUSION: EUS-TA for PSTC in pancreatic or bile duct cancer demonstrates high diagnostic accuracy and a low rate of adverse events, showing superior diagnostic performance compared to CECT. These findings suggest that EUS-TA for PSTC can be performed safely and is a clinically beneficial procedure. Despite the...