An international, multi-institution survey on performing EUS-FNA and fine needle biopsy

Guo, Jintao; Sahai, Anand V.; Teoh, Anthony Y.; Arcidiacono, Paolo Giorgio; Larghi, Alberto; Săftoiu, Adrian; Siddiqui, Ali A.; Arias, Brenda Lucía Arturo; Jenssen, Christian; Adler, Douglas G.; Lakhtakia, Sundeep; Seo, Dong–Wan; Itokawa, Fumihide; Giovannini, Marc; Mishra, Girish; Sabbagh, Luis; Irisawa, Atsushi; Iglesias‐García, Julio; Poley, Jan Werner; Vila, Juan J.; Lachter, Jesse; Kubota, Kensuke; Kalaitzakis, Evangelos; Kida, Mitsuhiro; Elnady, Mohamed; Mukai, Sh Untaro; Ogura, Takeshi; Fusaroli, Pietro; Vilmann, Peter; Rai, Praveer; Nguyen, Nam Q.; Ponnudurai, Ryan; Achanta, Chalapathi Rao; Baron, Todd H.; Yasuda, Ichiro; Wang, Hsiu-Po; Hu, Jinlong; Duan, Bowen; Bhutani, Manoop S.; Sun, Siyu

doi:10.4103/eus.eus_56_20

Cited by 21 publications

(8 citation statements)

References 55 publications

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“…They are well-established techniques for tissue acquisition in lesions in and around the GI tract and considered safe and effective methods to achieve definitive cytological diagnoses and to plan therapeutic decisions. [ 22 ] EUS-FNA has a sensitivity and specificity of up to 85% and 100%, respectively, and is the preferred method for making a definitive cytology diagnosis of a pancreatic mass, when other modalities could not confirm diagnosis. Immediate evaluation and feedback from an on-site expert cytopathologist during sampling increases a diagnostic yield by 10%–15%.…”

Section: Discussionmentioning

confidence: 99%

Role of EUS in detection of liver metastasis not seen by computed tomography or magnetic resonance imaging during staging of pancreatic, gastrointestinal, and thoracic malignancies

et al. 2021

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Background and Objectives: Liver metastases might not be detected by computed tomography (CT) and magnetic resonance imaging (MRI) due to their small size, but they can be detected by EUS. Furthermore, EUS-FNA has a significant impact on improving the diagnostic accuracy of EUS. The purpose of this study was to assess the feasibility of EUS in detection of occult small hepatic focal lesions at the time of primary tumor staging, not seen by CT or MRI. Methods: This prospective study included 730 patients who underwent EUS for staging or sampling of gastrointestinal, pancreatic, or thoracic malignancy. The liver was examined thoroughly for detection of occult lesions. CT or MRI was done within 1 week of EUS examination. Results: EUS examination of the liver detected focal lesions in 150 patients (20.5%) and metastases in 118 patients (16.2%); meanwhile, CT and MRI detected focal lesions in 99 patients (13.6%) and metastases in 82 patients (11.2%). EUS missed focal lesions in 7 patients, 6 of which were liver metastases (1.0% and 0.8%, respectively), while CT and MRI missed focal lesions in 58 patients, 42 of which were metastases (7.9% and 5.8%, respectively), which were detected by EUS. Conclusion: Thorough dedicated EUS examination of the liver is a feasible useful tool for detection of small hepatic lesions missed by CT and MRI. It is not considered an extra financial burden to the patient or health-care system because those patients are indicated for EUS examination for evaluation of their original lesion in the first place. Furthermore, EUS-FNA can add another advantage in diagnosing the etiology of such lesions.

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Section: Discussionmentioning

confidence: 99%

Role of EUS in detection of liver metastasis not seen by computed tomography or magnetic resonance imaging during staging of pancreatic, gastrointestinal, and thoracic malignancies

et al. 2021

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“…While the histopathological examination is considered the gold standard of disease diagnosis, direct acquisition of pancreatic tissue is limited due to the retroperitoneal location of the organ. Tissue acquisition with EUS (EUS-TA) can be used to obtain pancreatic tissue samples for microscopic analysis and establish a cytopathological diagnosis of the gastrointestinal tract or adjacent lesions[ 82 ]. In patients with suspected pseudo tumoural masses or cystic lesions in the setting of CP, a histopathological examination is necessary to eliminate malignant lesions from the differential diagnosis[ 72 , 82 ].…”

Section: Histological Evaluationmentioning

confidence: 99%

“…Tissue acquisition with EUS (EUS-TA) can be used to obtain pancreatic tissue samples for microscopic analysis and establish a cytopathological diagnosis of the gastrointestinal tract or adjacent lesions[ 82 ]. In patients with suspected pseudo tumoural masses or cystic lesions in the setting of CP, a histopathological examination is necessary to eliminate malignant lesions from the differential diagnosis[ 72 , 82 ]. EUS-TA can be achieved via EUS fine-needle aspiration (EUS-FNA) and EUS-fine needle biopsy (EUS-FNB), which is the current gold standard for tissue acquisition from solid masses.…”

Section: Histological Evaluationmentioning

confidence: 99%

Comprehensive review of diagnostic modalities for early chronic pancreatitis

Ge¹,

Dietrich²,

Bhutani³

et al. 2021

WJG

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Chronic pancreatitis (CP) is a progressive condition caused by several factors and characterised by pancreatic fibrosis and dysfunction. However, CP is difficult to diagnose at an early stage. Various advanced methods including endoscopic ultrasound based elastography and confocal laser endomicroscopy have been used to diagnose early CP, although no unified diagnostic standards have been established. In the past, the diagnosis was mainly based on imaging, and no comprehensive evaluations were performed. This review describes and compares the advantages and limitations of the traditional and latest diagnostic modalities and suggests guidelines for the standardisation of the methods used to diagnose early CP.

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“…Introduced as a diagnostic examination to overcome the existing barriers for pancreatic examination, EUS has evolved due to unrelenting scientific and technological advancements [ 3 ]. The major advancements of the technique have been electronic scanning with color Doppler [ 4 , 5 ] fine needle aspiration/biopsy (FNA/B), allowing tissue sampling [ 6 , 7 ], and image enhancement techniques with ultrasound contrast agents and elastography, allowing better detection and characterization of the lesions of interest [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions

Fusaroli

Lisotti

2021

Medicina

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Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and stone extraction is the treatment of choice for choledocholithiasis, reaching a successful clearance of the common bile duct (CBD) in up to 90% of the cases. Endoscopic ultrasound (EUS) has the best diagnostic accuracy for CBD stones, its sensitivity and specificity range being 89–94% and 94–95%, respectively. Traditionally seen as two separate entities, the two worlds of EUS and ERCP have recently come together under the new discipline of bilio-pancreatic endoscopy. Nevertheless, the complexity of both EUS and ERCP led the European Society of Gastrointestinal Endoscopy to identify quality in endoscopy as a top priority in its recent EUS and ERCP curriculum recommendations. The clinical benefits of performing EUS and ERCP in the same session are several, such as benefiting from real-time information from EUS, having one single sedation for both the diagnosis and the treatment of biliary stones, reducing the risk of cholangitis/acute pancreatitis while waiting for ERCP after the EUS diagnosis, and ultimately shortening the hospital stay and costs while preserving patients’ outcomes. Potential candidates for the same session approach include patients at high risk for CBD stones, symptomatic individuals with status post-cholecystectomy, pregnant women, and those unfit for surgery. This narrative review discusses the main technical aspects and evidence from the literature about EUS and ERCP in the management of choledocholithiasis.

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An international, multi-institution survey on performing EUS-FNA and fine needle biopsy

Cited by 21 publications

References 55 publications

Role of EUS in detection of liver metastasis not seen by computed tomography or magnetic resonance imaging during staging of pancreatic, gastrointestinal, and thoracic malignancies

Role of EUS in detection of liver metastasis not seen by computed tomography or magnetic resonance imaging during staging of pancreatic, gastrointestinal, and thoracic malignancies

Comprehensive review of diagnostic modalities for early chronic pancreatitis

EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions

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