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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Role of endoscopic ultrasound and endoscopic ultrasound-guided tissue acquisition in diagnosing hepatic focal lesions
Hussein Hassan Okasha, Hanane Delsa, Abdelmoneim Alsawaf, Ahmed Morad Hashim, Hani M Khattab, Dalia Abdelfatah, Abeer Abdellatef, Amr Albitar
Hussein Hassan Okasha, Ahmed Morad Hashim, Abeer Abdellatef, Amr Albitar, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11451, Egypt
Hanane Delsa, Department of Gastroenterology and Hepatology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health, Casablanca 82403, Morocco
Hanane Delsa, Research Unit, Mohammed VI Center for Research and Innovation, Rabat 10100, Morocco
Abdelmoneim Alsawaf, Department of Gastroenterology, Barnsley NHS Foundation Trust, Barnsley S75 2EP, United Kingdom
Hani M Khattab, Department of Pathology, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11451, Egypt
Dalia Abdelfatah, Department of Cancer Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo 11451, Egypt
Author contributions: Okasha HH was the main EUS endoscopist; Delsa H and Alsawaf A collected the data; Abdellatef A revised and submitted the manuscript; Khattab HM was the main pathologist; Abdelfatah D wrote the statistics; Albitar A wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the Cairo University Institutional Review Board, 15/8/2018.
Clinical trial registration statement: This study is registered at Pan African Clinical Trials Registry.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: The authors report having no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Data sharing statement: Author(s) grant permission to BPG to publish manuscript-related documents (e.g., peer review report, answers to reviewers, CrossCheck report, signed copyright license agreement, etc) at the same time that the manuscript is published online.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hussein Hassan Okasha, MD, Professor, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini School of Medicine, Cairo University, Kasr Al-Aini Street, Cairo 11451, Egypt. okasha.hussein@gmail.com
Received: June 9, 2023
Peer-review started: June 9, 2023
First decision: July 7, 2023
Revised: July 23, 2023
Accepted: August 29, 2023
Article in press: August 29, 2023
Published online: September 20, 2023
Processing time: 102 Days and 17.7 Hours
BACKGROUND
Endoscopic ultrasonography (EUS) has become an established method in diagnostic and therapeutic procedures in gastroenterology; however, it has recently gained a growing role in hepatology.
AIM
To evaluate the role of EUS features, strain elastography (SE), and EUS-tissue acquisition in diagnosing hepatic focal lesions (HFLs) that could affect further management.
METHODS
This cross-sectional study included 215 patients with pancreatic, biliary, or gastrointestinal malignancies referred for EUS examination. HFLs were identified in 43 patients (20%), and EUS-guided tissue acquisition was performed from these lesions.
RESULTS
EUS features were highly sensitive (100%) but much less specific (57%) in diagnosing HFLs; the overall accuracy was 94%. Real-time elastography was also very sensitive (97%) but less specific (67%) in diagnosing HFLs; however, the overall accuracy was 92%. EUS tissue acquisition was extremely sensitive (100%) and specific (100%), with a 100% overall diagnostic accuracy.
CONCLUSION
The diagnostic utility of EUS-guided tissue acquisition was extremely accurate in diagnosing HFLs. EUS characteristics and real-time SE accurately predicted the histological diagnosis of both benign and malignant HFLs.
Core Tip: This cross-sectional study included 43 patients with hepatic focal lesions among 215 pancreatic, biliary, or gastrointestinal malignant lesions referred for Endoscopic ultrasonography (EUS) examination. EUS tissue acquisition was highly sensitive (100%) and specific (100%), with an overall diagnostic accuracy of 100%.
