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Diagnostics
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Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases
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Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 9082

Special Issue Editor

Prof. Dr. Stefano Francesco Crinò

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Guest Editor
Department of Medicine, Gastroenterol & Digest Endoscopy Unit, Pancreas Institute, GB Rossi University Hospital, University of Verona, Verona, Italy
Interests: pancreatobiliary; endoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With the rapid advancement of technology, the diagnosis of hepatobiliary and pancreatic diseases is becoming more and more precise. The availability of new tools and devices, together with the breakthrough in knowledge of biological behavior of neoplastic diseases, is changing the role of diagnostic imaging and preoperative assessment, which is implemented from pure diagnostic to prognostic and risk stratification. In the era of precision medicine, artificial intelligence, radiomics, advanced endoscopy, and new preoperative tissue acquisition procedures represent the future of hepatobiliary and pancreatic diagnostics.

In this Special Issue, we will highlight current developments, and we invite submissions of original research and comprehensive reviews on recent or new diagnostic methods/devices, or on advancements/new discoveries related to cross-sectional imaging, endoscopy, and pathology of hepatobiliary and pancreatic diseases.

We intend for this Special Issue to be informative for gastroenterologists, endoscopists, radiologists, pathologists, and surgeons.

Prof. Dr. Stefano Francesco Crinò
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endoscopic ultrasound
  • eRCP
  • radiomics
  • tissue acquisition
  • artificial intelligence
  • magnetic resonance imaging
  • cholangioscopy
  • pancreatic cancer
  • pancreatic cysts
  • hepatocellular carcinoma
  • cholangiocarcinoma

Published Papers (6 papers)

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Research

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16 pages, 918 KiB  
Article
EUS-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis: Results of a Nationwide Study with Long-Term Follow-Up
by Cecilia Binda, Andrea Anderloni, Edoardo Forti, Pietro Fusaroli, Raffaele Macchiarelli, Mauro Manno, Alessandro Fugazza, Alessandro Redaelli, Giovanni Aragona, Mauro Lovera, Thomas Togliani, Elia Armellini, Arnaldo Amato, Mario Luciano Brancaccio, Roberta Badas, Nicola Leone, Germana de Nucci, Benedetto Mangiavillano, Monica Sbrancia, Valeria Pollino, Andrea Lisotti, Marcello Maida, Emanuele Sinagra, Marco Ventimiglia, Alessandro Repici, Carlo Fabbri and Ilaria Tarantinoadd Show full author list remove Hide full author list
Diagnostics 2024, 14(4), 413; https://doi.org/10.3390/diagnostics14040413 - 13 Feb 2024
Viewed by 755
Abstract
Background: Although endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using lumen-apposing metal stents (LAMS) has become one of the treatments of choice for acute cholecystitis (AC) in fragile patients, scant data are available on real-life settings and long-term outcomes. Methods: We performed a multicenter retrospective [...] Read more.
Background: Although endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using lumen-apposing metal stents (LAMS) has become one of the treatments of choice for acute cholecystitis (AC) in fragile patients, scant data are available on real-life settings and long-term outcomes. Methods: We performed a multicenter retrospective study including EUS-guided GBD using LAMS for AC in 19 Italian centers from June 2014 to July 2020. The primary outcomes were technical and clinical success, and the secondary outcomes were the rate of adverse events (AE) and long-term follow-up. Results: In total, 116 patients (48.3% female) were included, with a mean age of 82.7 ± 11 years. LAMS were placed, transgastric in 44.8% of cases, transduodenal in 53.3% and transjejunal in 1.7%, in patients with altered anatomy. Technical success was achieved in 94% and clinical success in 87.1% of cases. The mean follow-up was 309 days. AEs occurred in 12/116 pts (10.3%); 8/12 were intraprocedural, while 1 was classified as early (<15 days) and 3 as delayed (>15 days). According to the ASGE lexicon, two (16.7%) were mild, three (25%) were moderate, and seven (58.3%) were severe. No fatal AEs occurred. In subgroup analysis of 40 patients with a follow-up longer than one year, no recurrence of AC was observed. Conclusions: EUS-GBD had high technical and clinical success rates, despite the non-negligible rate of AEs, thus representing an effective treatment option for fragile patients. Full article
(This article belongs to the Special Issue Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases)
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10 pages, 589 KiB  
Article
Pancreatic Juice Cytology Evaluations Using Synthetic Secretin and Serial Pancreatic Juice Aspiration Cytological Examination for the Diagnosis of Pancreatic Ductal Adenocarcinoma
by Yohei Takeda, Kazuya Matsumoto, Takumi Onoyama, Taro Yamashita, Hiroki Koda, Wataru Hamamoto, Yuri Sakamoto, Takuya Shimosaka, Shiho Kawahara, Yuta Seki, Hiroki Kurumi, Yasushi Horie, Hajime Isomoto and Naoyuki Yamaguchi
Diagnostics 2023, 13(9), 1536; https://doi.org/10.3390/diagnostics13091536 - 25 Apr 2023
Viewed by 1361
Abstract
Pathological examination by endoscopic ultrasound–fine needle aspiration is not possible in approximately 10% of pancreatic tumor cases. Pancreatic juice cytology (PJC) is considered an alternative diagnostic method. However, its diagnostic capability is insufficient, and PJC has been repeatedly redevised. Serial pancreatic juice aspiration [...] Read more.
Pathological examination by endoscopic ultrasound–fine needle aspiration is not possible in approximately 10% of pancreatic tumor cases. Pancreatic juice cytology (PJC) is considered an alternative diagnostic method. However, its diagnostic capability is insufficient, and PJC has been repeatedly redevised. Serial pancreatic juice aspiration cytological examination (SPACE) and secretin-loaded PJC (S-PJC) have been recently introduced as alternative diagnostic methods. This study aimed to determine the diagnostic capacity and safety of SPACE and S-PJC using a propensity score-matched analysis. The sensitivity, specificity, and accuracy were 75.0%, 100%, and 92.3% for S-PJC, respectively, and 71.4%, 100%, and 92.3% for SPACE, respectively, meaning that there was no significant difference between the groups. Four patients (15.4%) each in the S-PJC and SPACE groups experienced complications, including postendoscopic retrograde cholangiopancreatography, pancreatitis, and cholangitis. Overall, there was no difference in efficacy and safety between the SPACE and S-PJC groups. Full article
(This article belongs to the Special Issue Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases)
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10 pages, 2294 KiB  
Article
Diagnostic Dilemma of Biliopancreatic Contrast-Enhanced Harmonic Endoscopic Ultrasonography
by Keisuke Kanazawa, Masafumi Chiba, Masayuki Kato, Yuji Kinoshita, Takafumi Akasu, Hiroaki Matsui, Nana Shimamoto, Youichi Tomita, Takahiro Abe, Shintaro Tsukinaga, Masanori Nakano, Yuichi Torisu, Hirobumi Toyoizumi and Kazuki Sumiyama
Diagnostics 2022, 12(8), 1983; https://doi.org/10.3390/diagnostics12081983 - 16 Aug 2022
Viewed by 1287
Abstract
Background: The utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) alone in the biliopancreatic region appears to be limited because it is highly dependent on the experience and skill of the endoscopist. Therefore, the present study aimed to validate the efficacy of CH-EUS in [...] Read more.
Background: The utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) alone in the biliopancreatic region appears to be limited because it is highly dependent on the experience and skill of the endoscopist. Therefore, the present study aimed to validate the efficacy of CH-EUS in clinical practice. Methods: Between January 2018 and March 2019, 301 consecutive patients who underwent CH-EUS were prospectively enrolled in this study. The diagnostic performance of CH-EUS was compared with that of dynamic computed tomography (CT), magnetic resonance imaging (MRI), and all combinations (i.e., CH-EUS, dynamic CT, and MRI) using a Bonferroni correction. A multiple logistic regression analysis was performed to extract each disease that allowed the CH-EUS diagnosis to be consistent with the final diagnosis. Results: In multiple comparisons of diagnostic performance, no significant differences were observed among dynamic CT, MRI, and CH-EUS (p = 1.00), but the diagnostic performance was significantly higher when all modalities were combined (p < 0.001). Moreover, only intraductal papillary mucinous neoplasm comprising adenoma or carcinoma (IPMN, n = 161) showed significance with respect to the agreement with the final diagnosis (p = 0.006). Conclusions: Our results showed that CH-EUS-based diagnosis of IPMN may be possible in clinical practice. On the contrary, to accurately diagnose biliopancreatic diseases other than IPMN, comprehensive diagnosis using multiple modalities may be necessary, rather than relying on CH-EUS alone. Full article
(This article belongs to the Special Issue Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases)
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9 pages, 1143 KiB  
Article
Endoscopic Management of Biliary Strictures after Orthotopic Liver Transplantation: A Single Center Experience Study
by Vasile Sandru, Madalina Stan-Ilie, Oana-Mihaela Plotogea, Catalina Vladut, Bogdan Silviu Ungureanu, Gheorghe G. Balan, Dan Ionut Gheonea and Gabriel Constantinescu
Diagnostics 2022, 12(5), 1221; https://doi.org/10.3390/diagnostics12051221 - 13 May 2022
Cited by 1 | Viewed by 1739
Abstract
Background and Aim. Endoscopic therapy is the method of choice in the management of biliary strictures after orthotopic liver transplantation (OLT). Even though the mainstay approach for OLT stricture complications is represented by consecutive procedures of multiple plastic stents (MPS) insertion, a valuable [...] Read more.
Background and Aim. Endoscopic therapy is the method of choice in the management of biliary strictures after orthotopic liver transplantation (OLT). Even though the mainstay approach for OLT stricture complications is represented by consecutive procedures of multiple plastic stents (MPS) insertion, a valuable alternative is the use of fully covered self-expandable metal stents (FCSEMS). The aim of the study was to compare MPS with FCSEMS used in the management of OLT biliary strictures, in terms of clinical outcomes and complications. Material and Methods. This is a retrospective, single-center study conducted between February 2014 and November 2019 in the Clinical Emergency Hospital of Bucharest, Romania. We enrolled all consecutive patients who developed biliary strictures after OLT and were treated by endoscopic retrograde cholangiopancreatography (ERCP) either with MPS or FCSEMS. Results. Thirty-six patients were included in the study, 27 patients had MPS and nine patients had FCSEMS. 106 ERCP procedures were performed and 159 stents were inserted. The mean number of ERCP procedures required per patient was significantly higher for MPS than for FCSEMS (3.34 ± 1.46 vs. 2.11 ± 0.33, p < 0.001). In the FCSEMS group only one patient had three procedures, due to stent migration. Difficult cannulation was encountered in 22 patients, 18 patients from MPS group and four patients from FCSEMS group. Dilation was performed in 20 (77%) MPS patients and in four FCSEMS patients (44%). Overall, we used 159 stents for stricture resolution, 149 plastic stents and 10 FCSEMS. Mean number of stents inserted was significantly lower in the FCSEMS group compared to MPS group (1.16 ± 0.40 vs. 5.73 ± 2.64, p < 0.001). Conclusions. Stricture resolution using FCSEMS is comparable to MPS and even has some advantages. In line with prior studies, FCSEMS are effective, with fewer complications and similar outcome compared to plastic stents. Other particular aspects should be further assessed, especially long-term follow up of FCSEMS and their cost efficiency. Full article
(This article belongs to the Special Issue Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases)
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Review

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14 pages, 3089 KiB  
Review
Contrast Enhanced EUS for Predicting Solid Pancreatic Neuroendocrine Tumor Grade and Aggressiveness
by Gianluca Franchellucci, Marta Andreozzi, Silvia Carrara, Luca De Luca, Francesco Auriemma, Danilo Paduano, Federica Calabrese, Antonio Facciorusso, Valeria Poletti, Alessandro Zerbi, Andrea Gerardo Lania, Alexia Francesca Bertuzzi, Paola Spaggiari, Vittorio Pedicini, Marcello Rodari, Pietro Fusaroli, Andrea Lisotti, Andrew Ofosu, Alessandro Repici and Benedetto Mangiavillano
Diagnostics 2023, 13(2), 239; https://doi.org/10.3390/diagnostics13020239 - 09 Jan 2023
Cited by 3 | Viewed by 1656
Abstract
Pancreatic neuroendocrine tumor (PNET) behavior assessment is a daily challenge for physicians. Modern PNET management varies from a watch-and-wait strategy to surgery depending on tumor aggressiveness. Therefore, the aggressiveness definition plays a pivotal role in the PNET work-up. The aggressiveness of PNETs is [...] Read more.
Pancreatic neuroendocrine tumor (PNET) behavior assessment is a daily challenge for physicians. Modern PNET management varies from a watch-and-wait strategy to surgery depending on tumor aggressiveness. Therefore, the aggressiveness definition plays a pivotal role in the PNET work-up. The aggressiveness of PNETs is mainly based on the dimensions and histological grading, with sometimes a lack of specificity and sensibility. In the last twenty years, EUS has become a cornerstone in the diagnostic phase of PNET management for its high diagnostic yield and the possibility of obtaining a histological specimen. The number of EUS applications in the PNET work-up has been rapidly increasing with new and powerful possibilities. The application of contrast has led to an important step in PNET detection; in recent years, it has been gaining interesting applications in aggressiveness assessment. In this review, we underline the latest experiences and opportunities in the behavior assessment of PNETs using contact-enhanced EUS and contested enhanced harmonic EUS with a particular focus on the future application and possibility that these techniques could provide. Full article
(This article belongs to the Special Issue Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases)
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Other

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11 pages, 1353 KiB  
Systematic Review
Needle Tract Seeding after Endoscopic Ultrasound Tissue Acquisition of Pancreatic Lesions: A Systematic Review and Meta-Analysis
by Antonio Facciorusso, Stefano Francesco Crinò, Paraskevas Gkolfakis, Daryl Ramai, Benedetto Mangiavillano, Juliana Londoño Castillo, Saurabh Chandan, Babu P. Mohan, Francesca D’Errico, Francesco Decembrino, Viktor Domislovic and Andrea Anderloni
Diagnostics 2022, 12(9), 2113; https://doi.org/10.3390/diagnostics12092113 - 31 Aug 2022
Cited by 9 | Viewed by 1559
Abstract
There is limited evidence on the incidence of needle tract seeding (NTS) in patients undergoing endoscopic ultrasound (EUS) tissue acquisition (TA) of pancreatic lesions. This meta-analysis aimed to assess the incidence of NTS after EUS-TA. With a search of the literature up until [...] Read more.
There is limited evidence on the incidence of needle tract seeding (NTS) in patients undergoing endoscopic ultrasound (EUS) tissue acquisition (TA) of pancreatic lesions. This meta-analysis aimed to assess the incidence of NTS after EUS-TA. With a search of the literature up until April 2022, we identified 10 studies (13,238 patients) assessing NTS incidences in patients undergoing EUS-TA. The primary outcome was NTS incidence. The secondary outcome was a comparison in terms of peritoneal carcinomatosis incidence between patients who underwent EUS-TA and non-sampled patients. Results were expressed as pooled rates or odds ratio (OR) and 95% confidence intervals (CI). The pooled rate of NTS was 0.3% (95% CI 0.2–0.4%), with no evidence of heterogeneity (I2 = 0%). Subgroup analysis based on the type of sampled lesion confirmed this finding both in patients with pancreatic adenocarcinoma (0.4%, 0.2–0.6%) and in patients with cystic pancreatic lesions (0.3%, 0.1–0.5%). No difference in terms of metachronous peritoneal dissemination was observed between patients who underwent EUS-TA and non-sampled patients (OR 1.02, 0.72–1.46; p = 0.31), with evidence of low heterogeneity (I2 = 16%). Rates of NTS after EUS-TA are very low; therefore, EUS-TA could be safely performed in a pre-operative setting. Full article
(This article belongs to the Special Issue Endoscopy and Diagnostic Tools in Hepatobiliary and Pancreatic Diseases)
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