Detection of occult liver metastases during EUS for staging of malignancies

Prasad, Priyajit; Schmulewitz, Nathan; Patel, Alpesh; Varadarajulu, Shyam; Wildi, Stephan M.; Roberts, Stacey; Tutuian, Radu; King, Peter; Hawes, Robert H.; Hoffman, Brenda J.; Wallace, Michael B.

doi:10.1016/s0016-5107(03)02378-2

Cited by 106 publications

(48 citation statements)

References 11 publications

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“…Unfortunately, pooled data from this survey revealed a 1% risk of major complication (death in one patient with an occluded stent, biliary sepsis, bleeding, and fever). Another retrospective database review of 222 patients who had both EUS (performed mostly for staging of upper gastrointestinal and pulmonary malignancies and other sporadic cancers) and noninvasive liver imaging within 6 weeks revealed EUS abnormalities in only 12.2% of patients and a diagnostic FNA in only 6.8% [29]. The lower yield from this series might be attributable to the use of a radial echoendoscope in nearly half the cases.…”

Section: Occult Liver Lesionsmentioning

confidence: 73%

Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree

Mishra

Conway²

2009

Curr Gastroenterol Rep

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Gastroenterologists increasingly find themselves in the un-enviable position of having to choose the optimal radiographic test to visualize the biliary tree and the liver. This dilemma is compounded by the rapid evolution of the available technologies and their ever-increasing resolution capabilities. Endoscopic ultrasound (EUS) has shown itself to be equally capable of providing detailed imaging of the biliary tree and of surrounding structures; its potential for evaluating liver lesions is just now being realized. EUS-fine needle aspiration (FNA) may supplant some of the existing technologies as it offers a way to sample masses, strictures, lymph nodes, and now certain segments of the liver and periportal regions. This review takes an in-depth look at the role of EUS in evaluating bile duct dilatation, suspected choledocholithiasis, biliary strictures, and polyps and masses of the gallbladder. It also reviews the literature on the exciting and rapidly evolving role of EUS-FNA evaluation of occult, metastatic, and primary hepato-cellular malignancies, as well as periportal lesions. Technologies such as EUS elastography may completely obviate FNA of liver lesions.

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Section: Occult Liver Lesionsmentioning

confidence: 73%

Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree

Mishra

Conway²

2009

Curr Gastroenterol Rep

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“…EUS's ability to M stage is limited to assessing for disease in the left lobe of the liver, the left adrenal gland, the presence of ascites or pleural effusion, and mediastinal lymphadenopathy. EUS may detect radiographically occult liver metastases, though this is uncommon [68]. For the detection of ascites, EUS has been reported to be more sensitive than either laparoscopy/laparotomy or combined CT and ultrasound in an Asian study [69].…”

Section: T3mentioning

confidence: 99%

Endoscopy and Endoscopic Ultrasound Examination of the Stomach

Schattner

Wong

2015

Gastric Cancer

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“…Malignant focal/metastatic liver lesions EUS can provide high resolution imaging of the left hepatic lobe to detect unsuspected metastatic disease during staging and may deter from unnecessary surgery [7,8] . EUS-FNA of liver lesions can provide useful information for future management.…”

Section: Feasibility Of Endoscopic Ultrasound-guided Fine Needle Aspimentioning

confidence: 99%

“…Hepatic metastasis is generally echopoor without a distinct border such as the one seen in pancreatic and colon metastasis (Figure 3) or echo-rich such as seen in metastatic neuroendocrine tumors and renal cell carcinoma ( Figure 4). EUS-FNA can detect tumors less than 3 mm in size [7] . Solid liver lesions accessible by EUS may be safely sampled by EUS-FNA.…”

Section: Feasibility Of Endoscopic Ultrasound-guided Fine Needle Aspimentioning

confidence: 99%

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

Hammoud

Almashhrawi

Ibdah

2014

WJGO

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cholangiocarcinoma" and "EUS and gallbladder" to retrieve articles published between 1999 to 2014.Hammoud GM, Almashhrawi A, Ibdah JA. Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions. World J Gastrointest Oncol 2014; 6(11): 420-429 Available from: URL: http://www.wjgnet.com/1948-5204/full/v6/i11/420.htm DOI: http://dx.doi.org/10.4251/wjgo.v6.i11.420 INTRODUCTIONEndoscopic ultrasonography (EUS) has become an indispensable diagnostic and therapeutic procedure in the field of gastroenterology coupling endoscopy with high frequency echo sonography. Endoscopic ultrasoundguided fine needle aspiration (EUS-FNA) is performed using the curved linear array echoendoscope (Figure 1) using various needles (Figure 2). The recently introduced forward viewing linear echoendoscope is gaining momentum in endoscopic ultrasound-guided interventions (Figure 1). EUS-FNA is minimally invasive that is utilized for procurement of tissue from unresectable tumors. EUS-guided fine needle aspiration is used increasingly for the diagnosis of mediastinal, pancreatic and gastric tumors, however, not much is known about EUS-FNA in hepatic lesions. EUS imaging of the liver is currently limited to the left lobe, the proximal right lobe, the hilum and part of the intrahepatic biliary tract. EUS-FNA may be considered as an alternative to liver percutaneous biopsy in patients at high risk of bleeding or with small lesions of the liver uncharacterized by cross-sectional abdominal imaging. EUS-guided biliary drainage (EUS-BD) was developed using a curved linear array echoendoscope for cases with failed endoscopic biliary drainage. Table 1 AbstractEndoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of the liver is a safe procedure in the diagnosis and staging of hepatobiliary malignancies with a minimal major complication rate. EUS-FNA is useful for liver lesions poorly accessible to other imaging modalities of the liver. EUS-guided FNA of biliary neoplasia and malignant biliary stricture is superior to the conventional endoscopic brushing and biopsy.

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Detection of occult liver metastases during EUS for staging of malignancies

Cited by 106 publications

References 11 publications

Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree

Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree

Endoscopy and Endoscopic Ultrasound Examination of the Stomach

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

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