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Pancreatic Neoplasms: HELP
Articles by Michael Hocke
Based on 10 articles published since 2009
(Why 10 articles?)

Between 2009 and 2019, M. Hocke wrote the following 10 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review Serous pancreatic neoplasia, data and review. 2017

Dietrich, Christoph F / Dong, Yi / Jenssen, Christian / Ciaravino, Valentina / Hocke, Michael / Wang, Wen-Ping / Burmester, Eike / Moeller, Kathleen / Atkinson, Nathan Ss / Capelli, Paola / D'Onofrio, Mirko. ·Christoph F Dietrich, Medizinische Klinik 2, Caritas-Krankenhaus Bad Mergentheim, 97980 Bad Mergentheim, Germany. ·World J Gastroenterol · Pubmed #28852316.

ABSTRACT: AIM: To describe the imaging features of serous neoplasms of the pancreas using ultrasound, endoscopic ultrasound, computed tomography and magnetic resonance imaging. METHODS: This multicenter international collaboration enhances a literature review to date, reporting features of 287 histologically confirmed cases of serous pancreatic cystic neoplasms (SPNs). RESULTS: Female predominance is seen with most SPNs presenting asymptomatically in the 5 CONCLUSION: The described ultrasound features can aid differentiation of SPN from other neoplastic lesions under most circumstances.

2 Review [Contrast-enhanced sonography and endoscopic ultrasound for the diagnosis of pancreatic diseases]. 2014

Hocke, M / Dietrich, C. ·Medizinische Klinik II, Klinikum Meiningen GmbH, Meiningen, Deutschland. · Klinik für Innere Medizin 2, Caritas-Krankenhaus, Bad Mergentheim, Deutschland. ·Zentralbl Chir · Pubmed #24132678.

ABSTRACT: Contrast-enhanced ultrasound (CEUS) has increased the diagnostic spectrum of clinical ultrasound. Especially the introduction of specific contrast-enhanced software in connection with the development of second generation contrast enhancers has enabled the development of CEUS to a stage where it sometimes furnishes better diagnostic results than any other cross-sectional diagnostic imaging method. The present article should provide the reader with an overview about the diagnostic possibilities of CEUS including contrast-enhanced endoscopic ultrasound. The reader should then be able to understand the weaknesses and strengths of CEUS in the diagnostic apporach to pancreatic diseases.

3 Review [Contrast-enhanced endoscopic ultrasound in the diagnosis of pancreatic diseases]. 2013

Hocke, M / Dietrich, C F. ·Klinikum Meiningen GmbH, Meiningen. Michael.hocke@klinikum-meiningen.de ·Dtsch Med Wochenschr · Pubmed #23533041.

ABSTRACT: The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recently introduced guidelines on the use of contrast enhanced ultrasound (CEUS). The so-called non-liver guidelines included clinical recommendations on the use of CEUS in pancreatic diseases. This article focuses on the application of endoscopic ultrasound in the evaluation of pancreatic neoplasia to highlight the importance of CEUS in daily routine.

4 Clinical Trial Accuracy of endoscopic ultrasound elastography used for differential diagnosis of focal pancreatic masses: a multicenter study. 2011

Săftoiu, A / Vilmann, P / Gorunescu, F / Janssen, J / Hocke, M / Larsen, M / Iglesias-Garcia, J / Arcidiacono, P / Will, U / Giovannini, M / Dietrich, C / Havre, R / Gheorghe, C / McKay, C / Gheonea, D I / Ciurea, T / Anonymous2510690. ·Gastroenterology Department, University of Medicine and Pharmacy, Craiova, Romania. adry@umfcv.ro ·Endoscopy · Pubmed #21437851.

ABSTRACT: BACKGROUND AND STUDY AIMS: Endoscopic ultrasound (EUS) elastography represents a new imaging procedure that might characterize the differences of hardness and strain between diseased tissue and normal tissue. The aim of this study was to assess the efficiency of EUS elastography for the differentiation of focal masses in chronic pancreatitis and pancreatic cancer. PATIENTS AND METHODS: The study group comprised 258 patients with focal pancreatic masses included prospectively at 13 participating centers. Qualitative analysis of the diagnoses made by two expert doctors using all recorded video clips was performed in order to test the interobserver variability. A post-processing software analysis was used to examine the EUS elastography videos by calculating average-hue histograms of individual elastography images. The quantitative information was used to calculate intra-observer variability and the accuracy of the method. RESULTS: Qualitative analysis of the recorded videos revealed a kappa value of 0.72. Intra-observer variability analysis revealed that the single measure intraclass correlation ranged between 0.86 and 0.94. The average-hue histogram analysis of the data indicated a sensitivity of 93.4 %, a specificity of 66.0 %, a positive predictive value of 92.5 %, a negative predictive value of 68.9 %, and an overall accuracy of 85.4 %, based on a cut-off value of 175. Area under the receiver operating characteristic curve (AUROC) was 0.854 ( P < 0.0001) with a confidence interval of 0.804 - 0.894. CONCLUSION: The value of quantitative analysis of EUS elastography recordings was proven by good reproducibility of the videos, as well as good parameters of the AUROC analysis. (Clinical Trials.gov identifier: CT00909103).

5 Clinical Trial Contrast enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance. 2010

Beyer-Enke, Stefan A / Hocke, Michael / Ignee, Andre / Braden, Barbara / Dietrich, Christoph F. ·Medical and Imaging Department, Caritas-Krankenhaus, Bad Mergentheim, Germany. christoph.dietrich@ckbm.de ·JOP · Pubmed #20818109.

ABSTRACT: CONTEXT: Contrast enhanced ultrasound (CEUS) has been established for detection and characterisation of liver tumours and differential diagnosis of solid pancreatic lesions. The role of transabdominal CEUS in cystic pancreatic disease is less obvious. OBJECTIVE: We prospectively evaluated CEUS for characterization of undetermined cystic pancreatic lesions with respect to the differential diagnosis of pseudocysts and cystic neoplasia and differentiation between benign and malignant disease (gold standard: histology or cytology). PATIENTS: One-hundred and fourteen patients (63 males, 51 females; median age: 62 years, range: 33-87 years) were prospectively examined. INVESTIGATIONS: Conventional B-mode and transabdominal CEUS. MAIN OUTCOME MEASURES: Conventional B-mode (criteria: solid nodules, septae), and contrast enhancing features of cystic pancreatic lesions (microperfusion of solid nodules) were analysed. Final diagnoses were made by surgery (47 patients) or histology/cytology and follow-up of at least one year (67 patients). RESULTS: Fifty patients proved to have neoplastic lesions (37 malignant, 13 of benign origin). Sixty-four patients had pseudocysts caused by acute (27 patients) or chronic pancreatitis (37 patients). Conventional B-mode had a sensitivity of 94% and a low specificity of 44% in the differentiation of pseudocysts versus neoplasia. CEUS had a higher specificity of 77% with the same sensitivity of conventional B-mode ultrasound. The combination of conventional ultrasound and CEUS improved the specificity even more to 97% with an unchanged sensitivity. CEUS was not reliable in the differentiation of benign and malignant neoplasia. CONCLUSION: CEUS improves the differentiation between pseudocysts and pancreatic neoplasia in comparison to the conventional B-mode imaging. The microvascularisation visualised using CEUS even in small nodules (with or without septae) associated with cystic lesions is an indicator for cystic pancreatic neoplasia.

6 Article Endoscopic ultrasound elastography of small solid pancreatic lesions: a multicenter study. 2018

Ignee, Andre / Jenssen, Christian / Arcidiacono, Paolo G / Hocke, Michael / Möller, Kathleen / Saftoiu, Adrian / Will, Uwe / Fusaroli, Pietro / Iglesias-Garcia, Julio / Ponnudurai, Ryan / Petrone, Maria C / Braden, Barbara / Burmester, Eike / Dong, Yi / Atkinson, Nathan S / Dietrich, Christoph F. ·Medical Department 2, Caritas-Krankenhaus, Bad Mergentheim, Germany. · Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany. · Pancreato-Biliary Endoscopy and Endosonography Division, Vita Salute San Raffaele University, Milan, Italy. · Department of Internal Medicine 2, Helios Hospital Meiningen GmbH, Meiningen, Germany. · Medical Department I/Gastroenterology, SANA Hospital Lichtenberg, Berlin, Germany. · Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania. · SRH Wald Klinikum Gera, Germany. · Gastroenterology Unit, Department of Medical and Surgical Sciences University of Bologna, Hospital of Imola, Italy. · Gastroenterology and Hepatology Department, University Hospital, Santiago de Compostela, Spain. · Division of Gastroenterology, Prince Court Medical Centre, Kuala Lumpur, Malaysia. · Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. · Medical Department I, Sana Hospital Lübeck, Germany. · Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China. · Ultrasound Department of the First Affiliated Hospital of Zhengzhou, Zhengzhou University, China. ·Endoscopy · Pubmed #29689572.

ABSTRACT: BACKGROUND: The prevalence of malignancy in patients with small solid pancreatic lesions is low; however, early diagnosis is crucial for successful treatment of these cases. Therefore, a method to reliably distinguish between benign and malignant small solid pancreatic lesions would be highly desirable. We investigated the role of endoscopic ultrasound (EUS) elastography in this setting. METHODS: Patients with solid pancreatic lesions ≤ 15 mm in size and a definite diagnosis were included. Lesion stiffness relative to the surrounding pancreatic parenchyma, as qualitatively assessed and documented at the time of EUS elastography, was retrospectively compared with the final diagnosis obtained by fine-needle aspiration/biopsy or surgical resection. RESULTS: 218 patients were analyzed. The average size of the lesions was 11 ± 3 mm; 23 % were ductal adenocarcinoma, 52 % neuroendocrine tumors, 8 % metastases, and 17 % other entities; 66 % of the lesions were benign. On elastography, 50 % of lesions were stiffer than the surrounding pancreatic parenchyma (stiff lesions) and 50 % were less stiff or of similar stiffness (soft lesions). High stiffness of the lesion had a sensitivity of 84 % (95 % confidence interval 73 % - 91 %), specificity of 67 % (58 % - 74 %), positive predictive value (PPV) of 56 % (50 % - 62 %), and negative predictive value (NPV) of 89 % (83 % - 93 %) for the diagnosis of malignancy. For the diagnosis of pancreatic ductal adenocarcinoma, the sensitivity, specificity, PPV, and NPV were 96 % (87 % - 100 %), 64 % (56 % - 71 %), 45 % (40 % - 50 %), and 98 % (93 % - 100 %), respectively. CONCLUSIONS: In patients with small solid pancreatic lesions, EUS elastography can rule out malignancy with a high level of certainty if the lesion appears soft. A stiff lesion can be either benign or malignant.

7 Article Differential diagnosis of small solid pancreatic lesions. 2016

Dietrich, Christoph Frank / Sahai, Anand Vasante / D'Onofrio, Mirko / Will, Uwe / Arcidiacono, Paolo Giorgio / Petrone, Maria Chiara / Hocke, Michael / Braden, Barbara / Burmester, Eike / Möller, Kathleen / Săftoiu, Adrian / Ignee, Andre / Cui, Xin-Wu / Iordache, Sevastita / Potthoff, Andrej / Iglesias-Garcia, Julio / Fusaroli, Pietro / Dong, Yi / Jenssen, Christian. ·Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, China; Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany. · Division of Gastroenterology, CHUM, Hopital Saint Luc, Montreal, Quebec, Canada. · Department of Radiology, G.B. Rossi University Hospital, University of Verona, Verona, Italy. · SRH Wald Klinikum Gera, Germany. · PancreatoBiliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy. · Medical Department, Helios Klinikum Meiningen, Meiningen, Germany. · Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, United Kingdom. · Medical Department I, Sana Hospital Lübeck, Lübeck, Germany. · Medical Department I/Gastroenterology; SANA Hospital Lichtenberg, Berlin, Germany. · Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania; Endoscopy Department, Gastrointestinal Unit, Copenhagen University Hospital Herlev, Herlev, Denmark. · Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany. · Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania. · Gastroenterology, Hepatology und Endocrinology, Hannover Medical School, Hannover, Germany. · Gastroenterology and Hepatology Department, Foundation for Research in Digestive Diseases, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. · Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Bologna and Hospital of Imola, Imola, Italy. · Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany; Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China. · Medical Department, Krankenhaus Maerkisch-Oderland, Strausberg, Germany. ·Gastrointest Endosc · Pubmed #27155592.

ABSTRACT: BACKGROUND AND AIMS: Pancreatic ductal adenocarcinoma (PDAC) is typically diagnosed at a late stage. Little is known about the incidental finding of early-stage PDAC. The aim of the current study was to determine the etiology of small solid pancreatic lesions (≤15 mm) to optimize clinical management. METHODS: Inclusion criterion for the retrospective study analysis was the incidental finding of primarily undetermined small solid pancreatic lesions ≤15 mm in 394 asymptomatic patients. Final diagnoses were based on histology or cytology obtained by imaging-guided biopsy (and at least 12-month follow-up) and/or surgery. Contrast-enhanced US or contrast-enhanced EUS was performed in 219 patients. RESULTS: The final diagnoses of 394 patients were as follows: 146 PDACs, 156 neuroendocrine tumors, 28 metastases into the pancreas from other primary sites, and 64 various other etiologies. Contrast-enhanced US allowed differential diagnosis of PDAC and non-PDAC in 189 of 219 patients (86%). CONCLUSIONS: Approximately 40% of patients with small solid pancreatic lesions had very early stage PDAC. Approximately 60% of small solid pancreatic lesions ≤15 mm are not PDAC and, therefore, do not require radical surgery. Without preoperative diagnosis, an unacceptably large proportion of patients would be exposed to radical surgery with significant morbidity and mortality.

8 Article Quantitative contrast-enhanced harmonic EUS in differential diagnosis of focal pancreatic masses (with videos). 2015

Săftoiu, Adrian / Vilmann, Peter / Dietrich, Christoph F / Iglesias-Garcia, Julio / Hocke, Michael / Seicean, Andrada / Ignee, Andre / Hassan, Hazem / Streba, Costin Teodor / Ioncică, Ana Maria / Gheonea, Dan Ionuţ / Ciurea, Tudorel. ·Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy, Craiova, Romania; Endoscopy Department, Copenhagen University Hospital, Herlev, Denmark. · Endoscopy Department, Copenhagen University Hospital, Herlev, Denmark. · Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical D 2, Caritas-Krankenhaus Bad, Mergentheim, Germany. · Gastroenterology Department, University Hospital Santiago de Compostela, Coruña, Spain. · Internal Medicine II, Hospital Meiningen, Meiningen, Germany. · Regional Institute of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Iuliu Haţieganu" Cluj-Napoca, Romania. · Medical D 2, Caritas-Krankenhaus Bad, Mergentheim, Germany. · Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy, Craiova, Romania. ·Gastrointest Endosc · Pubmed #25792386.

ABSTRACT: BACKGROUND: The role of EUS with contrast agents can be expanded through the use of time-intensity curve (TIC) analysis and computer-aided interpretation. OBJECTIVE: To validate the use of parameters derived from TIC analysis in an artificial neural network (ANN) classification model designed to diagnose pancreatic carcinoma (PC) and chronic pancreatitis (CP). SETTING: Prospective, multicenter, observational trial-endoscopy units from Romania, Denmark, Germany, and Spain. PATIENTS: A total of 167 consecutive patients with PC or CP. INTERVENTIONS: Contrast-enhanced harmonic EUS (CEH-EUS) and EUS-guided FNA (EUS-FNA), TIC analysis, and ANN processing. MAIN OUTCOME MEASUREMENTS: Sensitivity, specificity, positive and negative predictive values (PPV, NPV) for EUS-FNA, CEH-EUS, and the ANN. RESULTS: After excluding all of the recordings that did not meet the technical and procedural criteria, 112 cases of PC and 55 cases of CP were included. EUS-FNA was performed in 129 patients, and the diagnosis was confirmed by surgery (n = 15) or follow-up (n = 23) in the remaining cases. Its sensitivity and specificity were 84.82% and 100%, respectively, whereas the PPV and NPV were 100% and 76.63%, respectively. The sensitivity of real-time quantitative assessment of CEH-EUS was 87.5%, specificity 92.72%, PPV 96.07%, and NPV 78.46%. Peak enhancement, wash-in area under the curve, wash-in rate, and the wash-in perfusion index were significantly different between the groups. No significant differences were found between rise time, mean transit time, and time to peak. For the ANN, sensitivity was 94.64%, specificity 94.44%, PPV 97.24%, and NPV 89.47%. LIMITATIONS: Only PC and CP lesions were included. CONCLUSION: Parameters obtained through TIC analysis can differentiate between PC and CP cases and can be used in an automated computer-aided diagnostic system with good diagnostic results. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01315548.).

9 Article Advanced endosonographic diagnostic tools for discrimination of focal chronic pancreatitis and pancreatic carcinoma--elastography, contrast enhanced high mechanical index (CEHMI) and low mechanical index (CELMI) endosonography in direct comparison. 2012

Hocke, M / Ignee, A / Dietrich, C F. ·Department of Internal Medicine II, Hospital Meiningen, Bergstrasse 3, Bad Meiningen, Germany. Michael.hocke@klinikum-meiningen.de ·Z Gastroenterol · Pubmed #22298098.

ABSTRACT: New tools have recently emerged that further improve the diagnostic performance of high-end endosonography. Whilst elastography has been available for a while, contrast-enhancing techniques are still very young with little experience existing in this field. The latest development is contrast enhanced low mechanical index endosonography (CELMI-EUS) which became commercially available at the beginning of 2010. This technique requires contrast-specific software whereas the pre-existing technique of contrast-enhanced high mechanical index endosonography (CEHMI-EUS) does not. The aim of this study was to compare these techniques in discriminating between focal chronic pancreatitis and pancreatic carcinoma. Included in the study were 58 patients with a pancreatic lesion (19 pancreatic cancer and 39 chronic pancreatitis) with a mean age of 60±15 years. All patients were examined by one investigator (MH). All methods were performed within one examination and the result of each technique was noted before using the next. The gold standard was pathology following surgery, endoscopic fine-needle puncture, or one-year follow-up when chronic pancreatitis was suspected. The consecutive results of specificity and sensitivity were 73.7% and 61.5% for B-mode endosonography; 94.7% and 33.4% for elastography; 84.2% and 76.9% for CELMI-EUS; and 89.5% and 92.3% for CEHMI-EUS. A combination of 3 of those methods could not improve on the result of CEHMI-EUS alone. This study shows that, despite the availability of new technologies, CEHMI-EUS is still the most reliable method for the differentiation of focal chronic pancreatitis and pancreatic carcinoma. However, understanding the advantages of the different methods might help to find the optimal indications for the use of the new techniques.

10 Minor New technology--combined use of 3D contrast enhanced endoscopic ultrasound techniques. 2011

Hocke, Michael / Dietrich, Christoph F. · ·Ultraschall Med · Pubmed #21667410.

ABSTRACT: -- No abstract --