The role of contrast-enhanced harmonic endoscopic ultrasound-guided fine needle aspiration for evaluation of hepatic lesions

Abstract

Background and Objectives:The role of endoscopic ultrasound (EUS) with contrast agents is accepted in clinical use for diagnostic imaging. We evaluated usefulness of contrast-enhanced harmonic EUS (CEH-EUS)-guided fine-needle aspiration (FNA) for hepatic lesions.Methods:A total of 30 consecutive patients with hepatic mass underwent CEH-EUS-FNA between September 2010 and November 2016.Results:Twenty-eight patients (93.3%) had malignant tumors whereas two patients (6.7%) had benign hepatic masses. Technical success rate was 100%. Obtained sample was adequate in 93.3% (28/30). The median tumor size on EUS and number of needle passes were 24.5 mm (interquartile range [IQR] 14.5–40.8) and 2 (IQR 2–3), respectively. Before contrast enhancement, 80% of hepatic lesions (24/30) were identified on B-mode. After contrast enhancement, 93.3% of hepatic lesions (28/30) were distinguished from liver parenchyma on contrast harmonic mode. Diagnostic accuracy for hepatic mass was 92.9%. There were no procedure-related complications.Conclusions:CEH-EUS-FNA can be a safe and efficient method for the diagnosis of hepatic mass. It can increase the diagnostic accuracy in the setting of poorly visible hepatic lesions.