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Pancreatic Neoplasms: HELP
Articles by Uwe Will
Based on 4 articles published since 2008
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Between 2008 and 2019, U. Will wrote the following 4 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 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).

2 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.

3 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.

4 Article Value of endoscopic ultrasonography-guided fine needle aspiration (FNA) in the diagnosis of neoplastic tumor(-like) pancreatic lesions in daily clinical practice. 2010

Will, U / Mueller, A / Topalidis, T / Meyer, F. ·Department of Gastroenterology, Municipal Hospital. ·Ultraschall Med · Pubmed #19899026.

ABSTRACT: PURPOSE: To investigate the value of EUS-guided FNA in the diagnosis of solid and cystic pancreatic tumor(-like) lesions as well as metastatic tumor growth within peripancreatic lymph nodes and its impact on therapeutic decision-making. The results of the cytologic and pathohistological investigation were compared with i) each other and ii) the detection rates of various imaging procedures. PATIENTS AND METHODS: Overall, 153 patients (mean age, 56.9 years) underwent EUS-guided FNA from I/ 2000 - III/ 2003. RESULTS: Comparing various imaging procedures such as CT scan (80 %), MRI (57.1 %) and abdominal US (88.8 %), EUS achieved the highest diagnostic accuracy: 100 %. For EUS-based T-staging in 26 patients with malignant tumor lesions undergoing surgical intervention, there was a sensitivity of 73.3 % (specificity, 85.9 %; PPV, 69.2 %; NPV, 84.4 %), while the parameters for N-staging (n = 25) were: sensitivity, 61.5 %; specificity, 75 %; NPV, 64.3 %; PPV, 72.7 %. While the sensitivity of EUS-guided FNA in the group of patients who underwent surgical intervention (n = 55) was 81.4 % (specificity, 75 %; PPV, 92.1 %; NPV, 52.9 %), the parameters were as follows in the subgroup of individuals with chronic pancreatitis (n = 30): sensitivity in detecting a malignant pancreatic tumor lesion, 50 %; specificity, 91.7 %; PPV, 60 %; NPV, 88 %. Based on preoperative characteristics such as suspected diagnosis, TNM stage and tumor entity, a surgical intervention could be avoided in 29 / 153 patients (19 %). CONCLUSION: EUS-guided FNA allows more precise diagnosis clarification (malignant tumor growth and tumor entity) in solid and cystic pancreatic tumor(-like) lesions, which may assist in early and sufficient therapeutic decision-making.