Endosonography in solid and cystic pancreatic tumors

Abstract

Pancreatic tumors being either benign or malignant can be solid or cystic. Although diverse in presentation, their imaging features share commonalities and it is often difficult to distinguish these tumors. Endoscopic ultrasonography (EUS) is the most sensitive of the imaging procedures currently available for characterizing pancreatic tumors, and is especially good in identifying the smaller sized tumors. Additional applications inclusive of EUS-guided fine needle aspiration (EUS-FNA) are useful in tissue sampling and preoperative staging of pancreatic tumors.Although diagnostic capabilities have greatly evolved with advances in EUS and tissue processing technology (cytology, tumor markers, DNA analysis), differentiation of benign and malignant neoplasms, neoplastic and non-neoplastic (chronic pancreatitis) conditions, continues to be challenging.Recent innovative applications include contrast-enhanced EUS with Doppler mode, contrast-enhanced harmonic EUS, 3-dimensinal EUS, and EUS elastography. Incorporation of these methods has improved the differential diagnosis of pancreatic tumors. Finally, a multi-disciplinary approach involving radiology, gastroenterology and surgical specialties is often necessary for accurate diagnosis and management of solid and cystic pancreatic tumors.

Mini‐probe ultrasonography for the staging of colon cancer: a systematic review and meta‐analysis

“…Endoscopic ultrasound is now standard practice in the staging of oesophageal, gastric and pancreatic cancers . More recently, it has been widely used in the staging of rectal cancer with an accuracy of detecting intestinal wall penetration of 94.8% and an accuracy in the diagnosis of perirectal metastatic lymphadenopathies of 68.9% .…”

Tumor size as measured at initial X-ray examination, not length of bile duct stricture, predicts survival in patients with unresectable pancreatic cancer

“…EUS can also be combined with fine needle aspiration (FNA) and has a sensitivity of 85–95% and a specificity of 97–100% [14]. Newer modalities in conjunction with EUS are contrast-enhanced EUS and tridimensional EUS, but all are operator dependent.…”