Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know (original) (raw)
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Digestive Endoscopy, 2015
Endoscopic ultrasonography (EUS) is currently an integral tool for work-up of pancreaticobiliary neoplasms. Tissue acquisition by EUS is possible with fine-needle aspiration (FNA) cytology and histology. However, FNA still carries some limitations and risks of complications. The use of image-enhanced EUS may improve detection and characterization of pancreaticobiliary neoplasms and complement FNA. The present article aims to provide an overview of the current development of contrast-enhanced imaging and elastography in EUS and their potential application in the diagnosis of pancreaticobiliary diseases.
Endoscopic Ultrasound for Solid and Cystic Neoplasms of the Pancreas
intechopen.com
Endoscopic ultrasound (EUS) was introduced in clinical practice in 19801 and during the last few decades the quality of instrumentation has improved significantly. The first commercially available radial echoendoscope was introduced in Japan 2 and then in ...
Endoscopic ultrasound in solid pancreatic masses--current state and review of the literature
Collegium antropologicum, 2010
Some 25 years ago endoscopic ultrasound (EUS) was introduced in clinical practice for better visualization of pancreas. At the time of introduction EUS was superior to other methods in detection of pancreatic masses allowing tissue diagnosis by later introduced EUS-guided fine needle aspiration (FNA). During the time EUS was improved, electronic probes replaced mechanical probes adding ability of color Doppler, power Doppler, contrast enhanced endosonography as well as EUS elastography analysis. Meanwhile, CT technology has also experienced significant improvements raising the question whether EUS has lost ground in diagnostics of solid pancreatic masses. The aim of this review was to discuss the current evidence of clinical impact of EUS and EUS-FNA in evaluation of solid pancreatic masses with special emphasis on differentiation between benign and malignant pancreatic lesions. According to the literature, the detection of small pancreatic tumors, preoperative localization of pancr...
Contribution of Endoscopic Ultrasound in Pancreatic Masses
International Journal of Advanced Research, 2022
Endoscopic ultrasound (EUS) is a method of exploration of the digestive system that combines two techniques: endoscopy and ultrasound. EUS has several applications in digestive pathology. Echo-endoscopic biopsy (EEB) of pancreatic masses is a technique that allows fine needle aspiration to obtain material for cytohistological analysis. It is indicated each time a histological examination can have a diagnostic and/or therapeutic interest.For that we realized a retrospective study between January 2017 and December 2020. All patients referred to the department for a bilio-pancreatic echo-endoscopy in the framework of a pancreatic tumor were included in the study. We collected 90 patients who met our inclusion criteria. We recorded the patients demographics, pathologic history, symptoms, and ultrasound, CT, and EUS. During the echo-endoscopic examination, we always tried to specify some essential data according to the international recommendations, depending on the pathology (benign or ...
Role of Endoscopic Ultrasound in the Diagnosis of Solid Pancreatic Lesions: A Prospective Study
Journal of Advances in Medicine and Medical Research
Background: Endoscopic ultrasonography (EUS) provides high-resolution images of the pancreas, and it is considered one of the most accurate methods for the diagnosis and staging of solid pancreatic lesions (SPL), EUS guided fine-needle aspiration (EUS–FNA) can obtain cytological samples of pancreatic lesions, making a pathologic diagnosis possible, however, it is associated with small, but not insignificant, morbidity. The aim of this work is to determine in a prospective study, the role of EUS in the diagnosis of SPL in comparison with different radiological studies and to determine the diagnostic value of EUS guided FNA and elastography in differentiation between benign and malignant pancreatic lesions. Patients and methods: A total of 50 patients with SPL identified by EUS after imaging studies were enrolled in the study. The qualitative elastography score was done, also the semi quantitative score of elastography was represented by the strain ratio (SR) method where two areas we...
Diagnosis of pancreatic tumors by endoscopic ultrasonography
World Journal of Radiology, 2010
AIM: To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions. METHODS: From January/1997 to December/2006, 611 patients with pancreatic tumors were subjected to EUS-FNA. The final diagnosis was obtained either by surgery (356 cases) or after a mean clinical follow-up of 11.8 mo in the remaining patients. RESULTS: There were 405 solid tumors, 189 cystic lesions and 17 mixed. Pancreatic specimens for cytological assessment were successfully obtained by EUS-FNA in 595 (97.4%) cases. There were 352 (57.6%) malignancies and 259 (42.4%) benign tumors. Among the malignancies, pancreatic adenocarcinomas accounted for 67% of the lesions. Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA were, respectively, 78.4%, 99.2%, 99.3%, 77.2% and 87.2%. Specifically for solid tumors, the same parameters for neoplasms larger and smaller than 3 cm were, respectively, 78.8% vs 82.4%, 100% vs 98.4%, 100% vs 99%, 54.8% vs 74.1% and 83.1% vs 87.8%. For cystic lesions, the values were, respectively, 72.2%, 99.3%, 97.5%, 91% and 92.2%. CONCLUSION: EUS-FNA can be used to sample pancreatic tumors in most patients. Even though the negative predictive value is inadequate for large solid tumors, the results are rather good for small solid tumors, especially concerning the sensitivity, negative predictive value and diagnostic accuracy. Among all pancreatic lesions, EUS-FNA for cystic lesions can reveal the best negative predictive value and diagnostic accuracy, both higher than 90%.
Endosonographic imaging in pancreatic disease
Techniques in Gastrointestinal Endoscopy, 2000
Since its introduction in the early 1980s, endoscopic ultrasound (EUS) has revolutionized the imaging of the pancreas. The technique has proved reliable in the detection and assessment of small pancreatic lesions and accurate in the preoperative staging of pancreatic carcinoma when compared with other techniques such as abdominal ultrasound, endoscopic retrograde cholangiopancreatography, computed tomography, and nuclear magnetic resonance imaging. Other indications in which EUS has shown to be valuable include acute and chronic pancreatitis, tumors of the papilla of Vater, choledocholithiasis, as well as common bile duct tumors. Interventional EUS, including fine-needle aspiration puncture of pancreatic tumors and celiac plexus neurolysis for the palliation of pain in chronic pancreatitis or pancreatic carcinoma, is increasingly being performed. In this article, EUS imaging in pancreatic diseases is described, pointing out its uses and accuracy in various lesions.
2013
Endoscopic ultrasound (EUS) is an indispensable method for detection, characterization, and differential diagnosis of solid pancreatic lesions. Using advanced technologies such as real-time elastography and contrast enhancement, in 90% of cases, pancreatic ductal adenocarcinoma and other solid lesions (including rare neoplasms and benign lesions) may be distinguished. EUS-guided fine-needle aspiration is of vital importance for diagnosis of solid pancreatic lesions other than ductal adenocarcinoma, for staging of suspected or proven pancreatic cancer, and for cytological/histological proof of unresectable pancreatic cancer. For staging and assessment of resectability of pancreatic cancer, EUS is applied supplementary to computed tomography. This article is part of an expert video encyclopedia.