Background: Endoscopic ultrasound (EUS) is a useful tool for detection of liver metastasis as compared to conventional CT scan and ultrasound imaging modalities. This study aimed to; assess the value of Endoscopic Ultrasound (EUS) in detection of hepatic occult metastasis during staging of pancreatic and Upper gastro intestinal (GI) malignancies. Methods: this study included 150 cases with pancreatic and upper GI malignancies; all patients were subjected to laboratory investigations and abdominal US & CT abdomen. EUS was done to all these cases who were admitted at Maadi military hospital in the period from April 2020 to march 2021, During EUS examination the liver was examined thoroughly to detect hepatic focal lesions with fine needle aspiration (EUS FNA) of hepatic occult metastasis which were not discovered by conventional ultrasound or CT. Results: The mean age of the included patients was 57.4 ± 11.2 years and the majority were males. The most common type of primary tumors among the studied patients was pancreatic cancer. Conventional ultrasound detected 19 cases of metastatic hepatic focal lesions, triphasic CT detected 27 cases, while EUS detected 32 cases. EUS FNA was done for 5 occult small hepatic focal lesions, which were not detected by conventional ultrasound or triphasic CT, and histopathological examination revealed them to be metastatic in nature. EUS yielded 93% sensitivity and 99% specificity in the detection of small-sized liver metastasis, compared with a72% sensitivity and 97% 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 TNM staging of pancreatic and upper GI malignancy. |
