| Abstract: | Background: Imaging criteria by endosonography for assessment of the depth of duodenal invasion of carcinoma of the papilla of Vater (papilla carcinoma) have not been established. Methods: Twelve patients with papilla carcinoma were studied. The endosonographic findings were described in each case and depths were evaluated based on endosonographic images of the normal papilla and by comparison with endosonographic images of gastric carcinoma. The information was compared with the histopathological findings of the resected specimens. Results: Imaging criteria were proposed as follows: In d0 or T1, the papilla swelled preserving the basic structure; in d1 or T2, the papilla presented as a tumor but the non‐thickened duodenal fourth (proper muscle) layer was traceable behind the tumor; in d2 or T2, the papilla presented as a tumor fused with the thickened duodenal fourth layer; in d3 or T3–4, the papilla presented as a tumor and the duodenal fourth layer was partially or entirely untraceable behind the tumor. Accuracy of endosonography was 75% by the Japanese classification and 83.3% by the TNM system. Conclusions: Proposed endosonographic criteria are suitable for clinical application for assessing the depth of duodenal invasion of papilla carcinoma. |
