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In contrast\u2010enhanced harmonic EUS<\/jats:styled-content> (CH\u2010EUS<\/jats:styled-content>), diffuse homogeneous enhancement is obtained in normal parenchyma of the pancreas. The bile duct and pancreatic duct are depicted as non\u2010enhanced ductal structures with strong contrast in comparison to the surrounding parenchyma. CH\u2010EUS<\/jats:styled-content> identifies pancreatic adenocarcinomas as solid lesions exhibiting hypo\u2010enhancement with a sensitivity and specificity of 88\u201396% and 88\u201394%, respectively. In particular, 80\u2013100% of false\u2010negative cases in endoscopic ultrasound\u2010guided fine\u2010needle aspiration (EUS\u2010FNA<\/jats:styled-content>) are correctly classified by CH\u2010EUS<\/jats:styled-content>, suggesting CH\u2010EUS<\/jats:styled-content> complements EUS\u2010FNA<\/jats:styled-content>. Moreover, CH\u2010EUS<\/jats:styled-content> improves depiction of some subtle lesions in conventional EUS<\/jats:styled-content>, thus facilitating EUS\u2010FNA<\/jats:styled-content>. For quantitative perfusion analysis, a time\u2013intensity curve (TIC<\/jats:styled-content>) for the region of interest can be generated during CH\u2010EUS<\/jats:styled-content>. The maximum intensity gain and the echo intensity reduction rate from the peak at 1\u2009min obtained by TIC<\/jats:styled-content> can be used for differentiation of pancreatic adenocarcinoma from other tumors. CH\u2010EUS<\/jats:styled-content> is also useful for differentiation of invasive intraductal papillary mucinous neoplasms (IPMN<\/jats:styled-content>) from non\u2010invasive IPMN<\/jats:styled-content>, identification of malignant lesions in the gallbladder, and T<\/jats:styled-content>\u2010 and N<\/jats:styled-content>\u2010staging of pancreatobiliary tumors.<\/jats:p>","DOI":"10.1111\/den.12454","type":"journal-article","created":{"date-parts":[[2015,1,30]],"date-time":"2015-01-30T09:19:14Z","timestamp":1422609554000},"page":"60-67","source":"Crossref","is-referenced-by-count":46,"title":["Contrast\u2010enhanced harmonic endoscopic ultrasonography for pancreatobiliary diseases"],"prefix":"10.1111","volume":"27","author":[{"given":"Masayuki","family":"Kitano","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kinki University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Kamata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kinki University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kinki University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kinki University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Yasukawa","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Kudo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kinki University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-4-431-65904-4_7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.029934"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10396-007-0167-6"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/b138764"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2007.07.045"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000323493"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.04.012"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.354"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1364969"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2012.02.051"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255537"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2012.07115.x"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.09.014"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"A328","DOI":"10.1016\/j.gie.2009.03.945","article-title":"FNA guided by contrast\u2010enhanced harmonic EUS in pancreatic tumors","volume":"69","author":"Kitano M","year":"2009","journal-title":"Gastrointest. 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