Dr Joo Ha Hwang and colleagues prospectively evaluated the performance characteristics of endoscopy and endoscopic ultrasonography in the diagnosis of gastrointestinal subepithelial masses.
The researchers included a total of 100 consecutive patients referred for the evaluation of a suspected gastrointestinal subepithelial lesion.
The patients were prospectively studied with endoscopy followed by endoscopic ultrasonography.
Size, color, mobility, intramural or extramural location, consistency that was solid, cystic, or vascular, and presumptive diagnosis were recorded.
The team made the recordings at the time of endoscopy.
The researchers then performed endoscopic ultrasonography, and size, echogenicity, location, and determined presumptive diagnosis.
|Endoscopy had 98% sensitivity in identifying intramural lesions|
A total of 100 subepithelial lesions were evaluated.
The researchers found that endoscopy had 98% sensitivity and 64% specificity in identifying intramural lesions.
Size measurement by endoscopy correlated with size measurement by endoscopic ultrasonography.
The research team obtained histology in 23 cases, reporting that the presumptive endoscopic ultrasonography diagnosis was correct in only 48% of cases.
The team noted that most incorrect endoscopic ultrasonography diagnoses occurred with hypoechoic 3rd and 4th layer masses.
Dr Hwang's team concludes, “Endoscopy has high sensitivity but low specificity in identifying the location of subepithelial lesions.”
“In addition, endoscopic ultrasonography imaging alone is insufficient to accurately diagnose 3rd and 4th layer hypoechoic masses.”
“Histologic confirmation should be obtained whenever possible.”