Endoscopic Ultrasound in Pancreatic Disease — Its Influence on Surgical Decision-Making An Update 2008

Endoscopic ultrasound and pancreatic applications: what the radiologist needs to know

“…Catalano et al studied 37 patients with EUS evidence of chronic pancreatitis on EUS, but with normal CT studies and secretin function tests. 2/3 of these patients ultimately developed evidence of chronic pancreatitis on either a follow-up CT or secretin function test [7,12].…”

“…Nevertheless, EUS has been shown to be clearly superior to CT in its ability to detect pancreatic cancer, with sensitivities ranging from 96% to 98% [2,12,21,22]. However, given the ability of CT to detect the vast majority of pancreatic cancers in a far less invasive fashion, the primary diagnostic utility of EUS is based upon: (1) the use of EUS in ambiguous cases where a mass is suspected, but cannot be absolutely confirmed on CT, and (2) the ability to perform EUSguided FNA.…”

“…Several studies have shown that EUS has a high negative predictive value, and that a negative EUS in such a setting can reliably exclude the presence of a malignancy [12]. In a study by Klapman et al [25], 155 patients with suspected pancreatic cancer on the basis of clinical and laboratory findings were found to have a negative EUS, and none of these patients ultimately developed pancreatic cancer.…”

Role of pancreatic endoscopic ultrasonography in 2010

“…When EUS is compared to other imaging modalities, although it is not a 100% foolproof method [39][40][41] , it still remains one of the best choices to detect a pancreatic neoplasm [30,35,42] . However, it should be emphasized that many of the studies comparing EUS and other crosssectional imaging techniques are characterized by the absence of blinding amongst examiners, and therefore an objective assessment of the superiority of one test over another is hard [43,44] . In everyday clinical practice, the role of CT, EUS and of other available imaging tests concerning the diagnosis and staging of pancreatic cancer is, in fact, complementary.…”

“…EUS-FNA in diagnosis of pancreatic cancer EUS-FNA has offered new potential to EUS, as it allows for transmural tissue diagnosis with minimum invasion. EUS-FNA can therefore be extremely useful for various indications, such as suspected pancreatic cancer, diagnosis of pancreatic carcinoma, or differential diagnosis of pancreatic mass or smaller lesions [30,36,43,[53][54][55][56][57] . The indications of EUS-FNA are quite controversial, except for cases where chemotherapy or radiotherapy is needed.…”