Endoscopic Ultrasound–Guided Fine Needle Aspiration Biopsy of Patients With Suspected Pancreatic Cancer: Diagnostic Accuracy and Acute and 30-Day Complications

Eloubeidi, Mohamad A.; Chen, Victor K.; Eltoum, Isam A.; Jhala, Darshana; Chhieng, David C.; Jhala, Nirag; Vickers, Selwyn M.; Wilcox, C. Mel

doi:10.1111/j.1572-0241.2003.08666.x

Cited by 373 publications

(221 citation statements)

References 21 publications

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“…EUS has already been shown to be very effective in diagnosing pancreatic adenocarcinoma and pancreatic cystic neoplasms. 18,19 We could not find any previous study that evaluated patients with both a dilated PD and CBD and correlated this with EUS.…”

Section: Discussionmentioning

confidence: 75%

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Carriere¹,

Conway²,

Evans³

et al. 2012

jig

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Background:Patients with dilated common bile duct (CBD) (>7mm) and/or pancreatic duct (PD) on abdominal imaging are often referred for endoscopic ultrasound (EUS). In many cases, the EUS shows no obvious etiology for the dilated ducts. Objective: Find clinical factors that may predict which patients are more likely to have positive findings on EUS to explain the etiologies for the dilated ducts. Design: Retrospective database analysis. Setting: Tertiary-care university hospital. Patients: Patients referred for EUS for dilated CBD and/or PD from January 2004 to February 2010 were included in this study. Only patients without an obvious etiology for the dilated ducts on abdominal imaging were included. Interventions: An EUS was performed by using either a radial echoendoscope or a linear endoscope to evaluate the common bile duct and/or the pancreatic duct. When appropriate fine needle aspiration of the mass or cyst was performed. Main Outcome Measurements: The characteristics of patients who had positive findings on EUS to explain the etiology of their dilated PD and/or CBD. Results: A total of 140 patients were included in the study with a mean age of 64 years, 51 (36%) male and 115 (82%) white. The majority of our patients had a presenting symptom of abdominal pain 105 (75%). 49 (36%) had elevated AST or ALT, 25 (8%) had an elevated bilirubin and 13 (23%) had an elevated lipase. EUS findings explained the dilated ducts in 54 (39%) of our patients, most common diagnoses included: CBD stone in 11 (8%), non-calcific chronic pancreatitis in 9 (6%), pancreatic mass in 8 (6%), IPMN in 7 (5%). On bivarate analysis patients who were older (p = 0.006), male (p = 0.001), had elevated LFTs (p = <0.001), had elevated lipase (p = 0.021) or had dilated CBD and PD (p = 0.007) were more likely to have an etiology for their dilated duct(s) discovered on EUS. Limitations: A retrospective study with a small number of patients. Conclusion: Older patients, males and those patients presenting with concurrent elevations in the AST/ALT and/or lipase were more likely to have an underlying etiology discovered on EUS. Furthermore, EUS may detect an undiagnosed pancreatic malignancy in patients presenting with unexplained duct dilation.

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Section: Discussionmentioning

confidence: 75%

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Carriere¹,

Conway²,

Evans³

et al. 2012

jig

View full text Add to dashboard Cite

show abstract

“…120 Several studies have assessed EUS-FNA receiver operating characteristics by including only pancreatic cancer patients. [121][122][123][124][125][126][127][128][129][130][131][132] The initial reports showed a sensitivity of 85-95%, with a specificity close to 100%. 3, [121][122][123][124][125] The reports from the past 5 years also showed a high sensitivity of the procedure between 80% and 95%, with a specificity of 100%.…”

Section: Eus-fnamentioning

confidence: 99%

“…157,158 Mild or moderate acute pancreatitis has been described, especially when EUS-FNA of the pancreas is performed in patients with benign pancreatic diseases. [159][160][161] Tumor cell seeding has been reported in only 2 cases. 162,163 EUS-FNA has a lower risk of peritoneal contamination with malignancy than CT-guided FNA (2.2% versus 16.3%), respectively.…”

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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“…This may ultimately lead to the possibility of using this method to replace current biopsy procedures that are more invasive and associated with side effects 3,13 . Modifications of this method, such as peripheral intravenous blood collection, would be expected to utilize it in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Isolation and Propagation of Circulating Tumor Cells from a Mouse Cancer Model

Das

Naidoo

Ilboudo

et al. 2015

JoVE

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Cancer metastasis is the foremost cause of cancer-associated deaths. Recent studies have shown that circulating tumor cells (CTCs) are important in cancer metastasis. Indeed, the number of CTCs correlates with tumor size. Here, a detailed description is provided of a methodology for isolation and propagation of CTCs from a syngeneic mouse model of hepatocellular carcinoma (HCC) which allows for downstream analysis of potentially important molecular mechanisms of solid organ tumor metastasis. This method is efficient and reproducible. It is a non-invasive technique and, therefore, has potential to replace the invasive biopsy of tissues from humans which may be associated with complications. Therefore, the method discussed here allows for the isolation and propagation of CTCs from whole blood samples such that they can be examined and characterized. This has potential for future adaptation for clinical applications such as diagnosis, and personalized targeted therapy. Video LinkThe video component of this article can be found at

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Endoscopic Ultrasound–Guided Fine Needle Aspiration Biopsy of Patients With Suspected Pancreatic Cancer: Diagnostic Accuracy and Acute and 30-Day Complications

Cited by 373 publications

References 21 publications

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Isolation and Propagation of Circulating Tumor Cells from a Mouse Cancer Model

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