PMID- 31417068
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220411
IS  - 2303-9027 (Print)
IS  - 2226-7190 (Electronic)
IS  - 2226-7190 (Linking)
VI  - 8
IP  - 6
DP  - 2019 Nov-Dec
TI  - Recognizing intrapancreatic accessory spleen via EUS: Interobserver variability.
PG  - 392-397
LID - 10.4103/eus.eus_35_19 [doi]
AB  - BACKGROUND AND OBJECTIVE: Accessory spleen (AS) may be encountered as an 
      intrapancreatic lesion on EUS. This can look similar to other pancreatic 
      pathologies and may lead to unnecessary interventions. The goal of this study was 
      to evaluate the accuracy of EUS in distinguishing intrapancreatic AS (IPAS) from 
      other pancreatic lesions. MATERIALS AND METHODS: Twelve sets of endoscopic images 
      of the spleen and various pancreatic lesions confirmed on histology or cytology 
      were gathered. Ten endosonographers were asked to characterize and identify the 
      lesions. The responses were analyzed via Excel and the interobserver agreement 
      was analyzed using Gwet's agreement coefficient statistic via Stata I/C v15. 
      RESULTS: In our sample, the interobserver agreement was 0.37 (-+1-1; 0-0.2 poor, 
      0.2-0.4 fair, 0.4-0.6 moderate, 0.6-0.8 substantial, and 0.8-1.0 almost perfect) 
      for determining whether or not the pancreatic lesion is IPAS. The reviewers were 
      able to correctly determine IPAS endosonographically with a sensitivity of 77%, 
      specificity of 74%, and positive and negative predictive values of 50% and 92%, 
      respectively. CONCLUSION: There is a moderate-to-substantial interobserver 
      agreement in describing the sonographic characteristics of the pancreatic 
      lesions, such as the shape, echogenicity compared to spleen, echotexture, and 
      border of the lesions. However, the interobserver agreement is only fair when 
      deciding if the pancreatic lesion is an IPAS. The similar profile of IPAS and 
      pancreatic neuroendocrine tumor could confound the diagnosis of IPAS, thus 
      contributing to the decreased interobserver agreement. This study demonstrates 
      that EUS criteria alone are not accurate for IPAS diagnosis. Fine-needle 
      aspiration (FNA) may be required for a confirmatory diagnosis.
FAU - Kim, Grace E
AU  - Kim GE
AD  - Department of Internal Medicine, University of Maryland Medical Center, 
      Baltimore, MD, USA.
FAU - Morris, John D
AU  - Morris JD
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, MD, USA.
FAU - Anand, Naveen
AU  - Anand N
AD  - Division of Gastroenterology and Hepatology, Norwalk Hospital, Norwalk, CT, USA.
FAU - DePalma, Fedele
AU  - DePalma F
AD  - Delaware Center for Digestive Care, Newark, DE, USA.
FAU - Greenwald, Bruce D
AU  - Greenwald BD
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, MD, USA.
FAU - Kim, Raymond E
AU  - Kim RE
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, MD, USA.
FAU - Laczek, Jeffery
AU  - Laczek J
AD  - Department of Gastroenterology, Walter Reed National Military Medical Center and 
      Uniformed Services University, Bethesda, MD, USA.
FAU - Lee, Woo Jung
AU  - Lee WJ
AD  - Department of Gastroenterology, Temple University Hospital, Philadelphia, PA, 
      USA.
FAU - Papadopoulas, Ioannis
AU  - Papadopoulas I
AD  - Gastroenterology Service, Madigan Army Medical Center, Tacoma, WA, USA.
FAU - Uradomo, Lance
AU  - Uradomo L
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, MD, USA.
FAU - Young, Patrick
AU  - Young P
AD  - Department of Gastroenterology, Walter Reed National Military Medical Center and 
      Uniformed Services University, Bethesda, MD, USA.
FAU - Darwin, Peter E
AU  - Darwin PE
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Endosc Ultrasound
JT  - Endoscopic ultrasound
JID - 101622292
PMC - PMC6927143
OTO - NOTNLM
OT  - Accessory spleen
OT  - EUS
OT  - interobserver variability
COIS- None
EDAT- 2019/08/17 06:00
MHDA- 2019/08/17 06:01
PMCR- 2019/08/13
CRDT- 2019/08/17 06:00
PHST- 2019/08/17 06:00 [pubmed]
PHST- 2019/08/17 06:01 [medline]
PHST- 2019/08/17 06:00 [entrez]
PHST- 2019/08/13 00:00 [pmc-release]
AID - 264401 [pii]
AID - EUS-8-392 [pii]
AID - 10.4103/eus.eus_35_19 [doi]
PST - ppublish
SO  - Endosc Ultrasound. 2019 Nov-Dec;8(6):392-397. doi: 10.4103/eus.eus_35_19.