Beyond conventional endoscopic ultrasound

Gheonea, Dan-Ionuţ; Săftoiu, Adrian

doi:10.1097/mog.0b013e328349cfab

Cited by 20 publications

(5 citation statements)

References 41 publications

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“…Among various imaging modalities, EUS is gaining popularity for: accurately judging deep tumors; EUS-guided fine-needle aspiration, which obtains biopsies of affected tissue by extracting a small number of cells with a very fine needle and has a high diagnostic accuracy (92%) [28]; the ability to detect pancreatic lesions and intraductal papillary mucinous neoplasms <1 cm with a sensitivity greater than that of transabdominal US, CT scan or MRI; and improved sensitivity in detecting lymph node metastasis and vascular infiltration as compared with CT imaging. Further advancement in EUS, including contrast-enhanced EUS (for improved characterization of vessels in the desired lesions, improved differential diagnosis and accurate staging or follow-up of tumor), EUS elastography (for real-time evaluation of tissue stiffness) and hybrid imaging (CT/US, CT/US/MRI) can potentially help improve detection and characterization of focal lesions [29]. In addition to EUS, other imaging modalities, such as CT, MRI and MRCP, are being used either in combination with each other or alongside EUS for screening asymptomatic high-risk cases of PC (discussed in the previous section).…”

Section: Screening Strategiesmentioning

confidence: 99%

Early Diagnosis of Pancreatic Cancer: Challenges and New Developments

et al. 2012

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Pancreatic cancer is a lethal malignancy with its incidence almost equivalent to mortality. The complex pathophysiology, absence of early diagnostic and prognostic markers and unresponsiveness to radiation and chemotherapies are major barriers against successful therapy. Poor performance of therapeutic agents, even in the initial stage of invasive cases, emphasizes the importance of early detection for improved survival. The present review discusses the challenges and advances in biomarkers including serological signatures, circulating tumor cells, autoantibodies, epigenetic markers and miRNAs that are being explored to detect this cancer at early stages. Considering the long time gap between the development of malignant lesions and full-blown primary and metastatic pancreatic cancer, unique opportunities are being contemplated for the development of potential diagnostic and prognostic markers.

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Section: Screening Strategiesmentioning

confidence: 99%

Early Diagnosis of Pancreatic Cancer: Challenges and New Developments

et al. 2012

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“…Because of the accuracy of the method for discriminating of liver lesions [51–54] and similarly good results for the discrimination of pancreatic lesions [55–58] in percutaneous ultrasound, there was hope that the method could increase the efficacy of endoscopic ultrasound for the discrimination of chronic pancreatitis from pancreatic carcinoma even further (see Figure 3). Initial experiences showed a reliable display of microvessel perfusions down to a size of a single contrast enhancer bubble [59–61]. However, Doppler analysis in combination with this method is not available so far and this makes the differentiation of arterial and venous microvessels impossible.…”

Section: Perfusion Studies Using Contrast-enhanced Low Mechanical mentioning

confidence: 99%

Vascularisation Pattern of Chronic Pancreatitis Compared with Pancreatic Carcinoma: Results from Contrast-Enhanced Endoscopic Ultrasound

Hocke¹,

Dietrich

2012

International Journal of Inflammation

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Discriminating between focal chronic pancreatitis and pancreatic cancer is always a challenge in clinical medicine. Contrast-enhanced endoscopic ultrasound using Doppler techniques can uniquely reveal different vascularisation patterns in pancreatic tissue alterated by chronic inflammatory processes and even allows a discrimination from pancreatic cancer. This paper will describe the basics of contrast-enhanced high mechanical index endoscopic ultrasound (CEHMI EUS) and contrast enhanced low mechanical index endoscopic ultrasound (CELMI EUS) and explain the pathophysiological differences of the vascularisation of chronic pancreatitis and pancreatic carcinoma. Furthermore it will discuss how to use these techniques in daily clinical practice.

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“…With this technique, the real-time visualization of the calculated strain value can provide information on tissue hardness at the area of interest and the distribution pattern of tissue hardness as well. In addition to EUS image, these information can guide to select the most probable malignant lymph node to approach for EUS-FNA 15,16…”

Section: Advancement Of Techniques In Eusmentioning

confidence: 99%

Endoscopic Ultrasound, Where Are We Now in 2012?

Kim

2012

Clin Endosc

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Topics related with endoscopic ultrasound (EUS) made up considerable portion among many invited lectures presented in International Digestive Endoscopy Network 2012 meeting. While the scientific programs were divided into the fields of upper gastrointestinal (UGI), lower gastrointestinal, and pancreato-biliary (PB) categories, UGI and PB parts mainly dealt with EUS related issues. EUS diagnosis in subepithelial lesions, estimation of the invasion depth of early gastrointestinal cancers with EUS, and usefulness of EUS in esophageal varices were discussed in UGI sessions. In the PB part, pancreatic cystic lesions, EUS-guided biliopancreatic drainage, EUS-guided tissue acquisition, and improvement of diagnostic yield in indeterminate biliary lesions by using intraductal ultrasound were discussed. Advanced techniques such as contrast-enhanced EUS, EUS elastography and forward-viewing echoendoscopy were also discussed. In this paper, I focused mainly on topics of UGI and briefly mentioned about advanced EUS techniques since more EUS related papers by other invited speakers were presented afterwards.

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Beyond conventional endoscopic ultrasound

Abstract: Despite its advantages in assessing the organs situated near the gastrointestinal tract, EUS is still an operator-dependent technique. The new EUS examination modalities incorporated in modern ultrasound systems allow a highly accurate diagnosis.

Cited by 20 publications

References 41 publications

Early Diagnosis of Pancreatic Cancer: Challenges and New Developments

Early Diagnosis of Pancreatic Cancer: Challenges and New Developments

Vascularisation Pattern of Chronic Pancreatitis Compared with Pancreatic Carcinoma: Results from Contrast-Enhanced Endoscopic Ultrasound

Endoscopic Ultrasound, Where Are We Now in 2012?

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