Endoscopic Ultrasound versus Triphasic Computed Tomography for Detection of Hepatic Metastasis during Staging of Pancreaticobiliary and Upper Gastrointestinal Malignancies

Abstract Background Endoscopic ultrasound (EUS) is a useful tool for detection of liver metastasis compared with Triphasic CT scan. We aimed to assess the value of Endoscopic Ultrasound (EUS) in detection of missed hepatic focal lesions during staging of pancreatic and Upper GI malignancies. Methods we included 90 cases with pancreatic and upper GI malignancies, all patients were subjected to laboratory investigations and CT abdomen. 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 in our study was 58.02 ± 11.9 years and the majority of the patients were males. In the present study, the most common type of tumors was pancreatic cancer. Triphasic CT detected 25 cases of metastatic hepatic focal lesions, while EUS detected 29 cases. EUS FNA was done for 4 small hepatic focal lesions, which were not detected by triphasic CT, and histopathological examination revealed them to be metastatic in nature. EUS yielded 100% sensitivity and 97.3% specificity in the detection of small-sized liver metastasis, compared with a 96.7% sensitivity and 93.8% 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.