Gut Liver.  2019 Mar;13(2):161-168. 10.5009/gnl18185.

Predicting Malignancy Risk in Gastrointestinal Subepithelial Tumors with Contrast-Enhanced Harmonic Endoscopic Ultrasonography Using Perfusion Analysis Software

Affiliations
  • 1Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea. cmcho@knu.ac.kr

Abstract

BACKGROUND/AIMS
Contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) is a promising imaging modality that can differentiate subepithelial tumors (SETs) by detecting the degree of enhancement. However, whether CEH-EUS alone can predict the malignancy risk of gastrointestinal stromal tumors (GISTs) remains unclear. This study aimed to evaluate the feasibility of CEH-EUS by using perfusion analysis software for distinguishing among SETs and predicting the malignancy risk of GISTs.
METHODS
We retrospectively included patients with SETs who underwent preoperative CEH-EUS. In this study, 44 patients with histologically proven GISTs and benign SETs were enrolled. Perfusion analysis was performed using perfusion quantification software. Peak enhancement (PE), wash-in rate (WiR), wash-in perfusion index (WiPI), and wash-in and wash-out areas under the time-intensity curve (WiWoAUC) were calculated and compared between the GISTs and benign SETs.
RESULTS
When we allocated the enrolled patients into the leiomyoma group and low- and high-grade malignancy GIST groups, significant statistical differences in PE (p<0.001), WiR (p=0.009), WiPI (p<0.001), and WiWoAUC (p<0.001) were identified in the high-grade malignancy group compared with the leiomyoma group.
CONCLUSIONS
CEH-EUS with perfusion analysis using perfusion analysis software could be a quantitative and independent method for predicting malignancy risk in gastrointestinal SETs.

Keyword

Endosonography; Gastrointestinal stromal tumors; Contrast agent; Perfusion

MeSH Terms

Endosonography*
Gastrointestinal Stromal Tumors
Humans
Leiomyoma
Methods
Perfusion*
Retrospective Studies
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