Abstract
Background
standard B-mode EUS assessment and EUS-guided tissue acquisition present sub-optimal
diagnostic yield in the differential diagnosis of gastric submucosal tumors (SMTs).
Aims
to evaluate the performances of contrast-enhanced harmonic endoscopic ultrasonography
(CH-EUS) to differentiate gastric SMTs and predict malignancy risk of gastrointestinal
stromal tumors (GIST).
Methods
a retrospective analysis was performed retrieving consecutive patients with gastric
SMTs who underwent EUS between 2009 and 2014. Patients with available EUS video recordings
and histological diagnosis were included. De-identified videos were presented to experts
who made a diagnosis on B-mode EUS and CH-EUS.
Results
fifty-four patients (29 female, 64-year-old) were included. Final diagnoses were 40
GISTs (8 high-grade), 9 leiomyomas, 5 rare SMTs. The sensitivity, specificity, and
accuracy of B-mode and CH-EUS for the differential diagnosis of GIST were 95.0% vs.
85.0%, 57.1% for both techniques, and 85.2% vs. 77.8%, respectively. The sensitivity,
specificity, and accuracy of B-mode and CH-EUS for the estimation of the malignancy
GISTs risk were 62.5% vs. 100%, 83.3% vs. 82.1%, and 78.9% vs. 86.1%, respectively.
Conclusions
CH-EUS showed better diagnostic performance than B-mode EUS in differentiating leiomyomas
and risk stratification of GIST. When considering high-grade GISTs, the addition of
CH-EUS allowed an improvement in diagnostic accuracy.
Keywords
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Article info
Publication history
Published online: July 13, 2021
Accepted:
June 12,
2021
Received:
March 30,
2021
Footnotes
With videos.
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
