Emori T, Nuta J, Kawaji Y, et al. - According to this single-center prospective study, endoscopic ultrasonography (EUS) combined with contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) has advantages over contrast-enhanced computed tomography (CE-CT) and EUS alone in terms of detecting left hepatic lobe metastases, especially small hepatic metastases, and accurate staging.

• Thirty-one patients were found to have metastases in the left hepatic lobe.

• EUS with CH-EUS provided a considerably greater overall detection accuracy of left hepatic lobe metastases than CE-CT and EUS alone.

• EUS with CH-EUS outperformed CE-CT and EUS alone in detecting left hepatic lobe metastases < 10 mm.

• After CH-EUS, the stage and/or treatment approach of pancreatic adenocarcinoma were modified in 5 of the 11 patients in whom only CH-EUS allowed detection of hepatic metastases.