Value of Endoscopic Ultrasound in Detection of Hepatic Occult Metastasis During Staging of Pancreatic and Upper Gastro Intestinal Malignancies

Younis, Yehia; Okasha, Hussein; Gad, Mohamed; El Shewi, Mohamed

doi:10.21608/bmfj.2021.100234.1498

Value of Endoscopic Ultrasound in Detection of Hepatic Occult Metastasis During Staging of Pancreatic and Upper Gastro Intestinal Malignancies

Document Type : Original Article

Authors

¹ Professor of Gastroenterology, Hepatology& Infectious Diseases Faculty of Medicine - Banha University

² Professor of Internal Medicine Faculty of Medicine - Cairo University

³ MBBCH

⁴ Assistant Professor of Gastroenterology, Hepatology &Infectious Diseases Faculty of Medicine - Banha University

10.21608/bmfj.2021.100234.1498

Abstract

Background: Endoscopic ultrasound (EUS) is a useful tool for detection of liver metastasis with superiority in detecting focal liver lesions as compared to conventional CT scan and ultrasound imaging modalities. We aimed to; assess the value of Endoscopic Ultrasound (EUS) in detection of hepatic occult metastasis during staging of pancreatic and Upper GI malignancies. Methods: we included 150 cases with pancreatic and upper GI malignancies , all patients were subjected to laboratory investigations and abdominal US & CT abdomen +/- MRI. EUS was done to all patients, During EUS examination the liver was examined thoroughly to detect hepatic focal lesions with possible EUS-FNA of any detected lesions. Results: The mean age of the included patients was 57.4 ± 11.2 years and the majority were males. The most common type of tumors was pancreatic cancer. Conventional ultrasound detected 19 cases of metastatic hepatic focal lesions, triphasic CT detected 27 cases, while EUS detected 32 cases. EUS FNA was done for 5 occult small hepatic focal lesions, which were not detected by conventional ultrasound or triphasic CT, and histopathological examination revealed them to be mestastatic in nature. EUS yielded 93% sensitivity and 99% specificity in the detection of small-sized liver metastasis, compared with a 72% sensitivity and 97% specificity through triphasic CT. Conclusion: EUS and EUS-FNA is a useful diagnostic modality for the detecting small-sized liver metastasis that may be missed by other methods during TMN staging of pancreatic and GI malignancy.

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