Introduction The detection and diagnosis of pNETs remains challenging. EUS and EUS-FNA has a significant role in the detection, precise localisation and cytological confirmation of pNETs.
Methods A retrospective review of all pNET patients undergoing EUS-FNA between April 2003 and September 2011 was carried out to determine the efficacy of EUS-FNA in confirming pNETs and compare performance over two consecutive 4 year period.
Results 10 patients (3% of EUS procedures for cystic lesions) with cystic pNETs and 44 (4% of EUS procedures for solid lesions) with solid pNETs were identified. Table 1 compares the size, demographics and diagnostic performance of radiology, EUS & cytology in solid and cystic pNETs. 17 and 5 solid and cystic pNETs respectively were diagnosed between 2003 and 2007 while 27 and 5 solid and cystic pNETs were diagnosed between 2008 and 2011. EUS-FNA diagnosis of cystic and solid pNETs has improved from 20% and 59% respectively between 2003 and 2007 to 100% and 81% respectively between 2008 and 2011. Overall, sensitivity of EUS cytology has improved from 50% to 84.4% (p = 0.015) during this period. Malignant potential of solid pNETs was higher (54.5% vs 20%) compared to cystic pNETs. Curative resection was higher in patients with cystic pNETs (80% vs 68%) compared to solid pNETs.
Conclusion EUS & EUS-FNA is a useful test in diagnosing pNETs. Overall, the sensitivity of combined EUS imaging and cytology was significantly better compared to CT/MRI (p < 0.05) in detecting pNETs across all groups. Sensitivity of combined EUS imaging and cytology was significantly better compared to EUS imaging alone (p < 0.05) in the solid and combined pNET cohort of patients. Sensitivity of EUS cytology was significantly better compared to EUS imaging (p < 0.05) in the solid and combined pNET cohort of patients. Comparing the first 4 years to the second, there has been an increase in the number of cases of pNETs and statistically significant improvement in the diagnostic performance of cytology.
Disclosure of Interest None Declared.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.