Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Pancreatic Neoplasms: HELP
Articles by Alessia Spada
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, Alessia Spada wrote the following 2 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Article Interobserver agreement in contrast harmonic endoscopic ultrasound. 2012

Fusaroli, Pietro / Kypraios, Dimitrios / Mancino, Maria Grazia / Spada, Alessia / Benini, Maria Chiara / Bianchi, Marco / Bocus, Paolo / De Angelis, Claudio / De Luca, Leonardo / Fabbri, Carlo / Grillo, Antonino / Marzioni, Marco / Reggio, Dario / Togliani, Thomas / Zanarini, Stefano / Caletti, Giancarlo. ·Department of Clinical Medicine, GI Unit, University of Bologna/Imola Hospital, Italy Gastroenterology Unit, Bellaria Hospital, Bologna, Italy. pietro.fusaroli@unibo.it ·J Gastroenterol Hepatol · Pubmed #22414180.

ABSTRACT: BACKGROUND AND AIM: Contrast harmonic endoscopic ultrasound (CH-EUS) was recently introduced to clinical practice; its reproducibility among endosonographers is unknown. Our aim was to assess the interobserver agreement (IA) in CH-EUS. METHODS: Fifteen endosonographers (eight experienced and seven non-experienced) from 11 Italian EUS centers evaluated 80 video-cases (40 solid pancreatic lesions, 20 pancreatic cystic lesions and 20 submucosal lesions) of CH-EUS, according to the degree of enhancement, the pattern of distribution and the washout of the contrast agent. IA within each group and between the two groups of observers was assessed with the Fleiss kappa statistic. RESULTS: Overall IA was moderate for the uptake and fair for the pattern of distribution and the washout. In solid pancreatic lesions, IA was moderate for the uptake and fair for the pattern and the washout. In cystic pancreatic lesions, IA was uniformly moderate for the assessment of uptake, slight for the pattern and fair for the washout. In submucosal tumors, IA was substantial for the uptake, slight for the pattern and fair for the washout. Non-experienced endosonographers demonstrated, in most cases, comparable IA with the experienced ones. CONCLUSIONS: Interobserver agreement among endosonographers for CH EUS was satisfactory. In particular, overall IA varied from slight to substantial, being fair in the majority of cases. Inherent structural features of the lesions, as well as technical differences between the variables assessed, could have accounted for the fluctuation of the results. Outcomes of IA were reproducible between experienced and non-experienced endosonographers.

2 Article Contrast harmonic echo-endoscopic ultrasound improves accuracy in diagnosis of solid pancreatic masses. 2010

Fusaroli, Pietro / Spada, Alessia / Mancino, Maria Grazia / Caletti, Giancarlo. ·Department of Clinical Medicine, GI Unit, University of Bologna/Aziendo Sanitaria Locale of Imola, Imola, Italy. p.fusaroli@ausl.imola.bo.it ·Clin Gastroenterol Hepatol · Pubmed #20417721.

ABSTRACT: BACKGROUND & AIMS: Contrast harmonic echo (CHE) has been developed for endoscopic ultrasound (EUS). This new technique detects echo signals from microbubbles in vessels with very slow flow, without artifacts. We assessed whether CHE-EUS increases the accuracy of diagnosis of pancreatic solid lesions. METHODS: At a tertiary-care EUS center, we examined 90 patients who were suspected of having pancreatic solid neoplasm. Radial and linear echoendoscopes were used with dedicated software for CHE. Sonovue (Bracco International BV, Amsterdam, The Netherlands) uptake, pattern, and washout were studied; data were compared for pancreatic lesions and adjacent parenchyma. The final diagnosis was obtained based on results of surgical pathology and/or EUS-fine needle aspiration (FNA) analyses. RESULTS: The finding of a hypoenhancing mass with an inhomogeneous pattern was a sensitive and accurate identifier of patients with adenocarcinoma (96% and 82%, respectively) (49 of 51 patients with primary pancreatic adenocarcinoma had a hypoenhancing mass that was inhomogeneous and had fast washout). This finding was more accurate in diagnosis than the finding of a hypoechoic lesion using standard EUS (P < .000). Hyperenhancement specifically excluded adenocarcinoma (98%), although sensitivity was low (39%). Of neuroendocrine tumors, 11 of 13 were non-hypo-enhancing (9 hyperenhancing, 2 isoenhancing). Interestingly, CHE-EUS allowed detection of small lesions in 7 patients who had uncertain standard EUS findings because of biliary stents (n = 5) or chronic pancreatitis (n = 2). Targeted EUS-FNA was performed on these lesions. CONCLUSIONS: Detection of a hypoenhancing and inhomogeneous mass accurately identified patients with pancreatic adenocarcinoma. CHE-EUS increased the detection of malignant lesions in difficult cases (patients with chronic pancreatitis or biliary stents) and helped guide EUS-FNA. A hyperenhancing pattern could be used to rule out adenocarcinoma.