EUS-guided tissue acquisition of liver and hepatobiliary masses

Ge, Phillip S.; Ryou, Marvin

doi:10.1016/j.tgie.2017.11.003

Cited by 1 publication

(1 citation statement)

References 40 publications

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“…A study evaluating 574 consecutive patients undergoing EUS with a history or suspicion of primary gastrointestinal or metastatic pulmonary tumor to the liver found that EUS could not only identify small focal lesions not detected by CT but also change the treatment course by making the cytologic diagnosis of malignancy in patients who previously did not have evidence of metastatic disease – thus avoiding unnecessary surgery [4]. However, it is important to note that EUS is limited in its ability to visualize the entire liver, and should therefore not be considered appropriate as a screening tool for metastatic disease [5].…”

Section: Introductionmentioning

confidence: 99%

Endohepatology – current status

Edelson

Mitchell

Rockey

2022

Current Opinion in Gastroenterology

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Purpose of reviewThis article discusses the most recent studies regarding the emerging field of endohepatology – the use of diagnostic and therapeutic endoscopic tools for the management of patients with liver disease and portal hypertension.Recent findingsNew research has shown that liver biopsy specimens obtained by each Endoscopic ultrasound (EUS)-guidance, the percutaneous approach, and the transjugular approach contained sufficient portal triads to adequately analyzed by experienced pathologists – suggesting that any of these routes of liver biopsy is clinically acceptable; further, all had similar rates of adverse events. An initial prospective study showed that EUS guided portal pressure measurement was safe, effective, and accurate. A recent metanalysis showed that EUS-guided cyanoacrylate injection and coil embolization was statistically more efficacious and with less complications than EUS guided cyanoacrylate injection and EUS guided coil injection alone, suggesting that combination therapy appears to be the preferred approach for gastric varices (GV) bleeding. A prospective study evaluating focal liver lesions showed that the use of artificial intelligence had up to 100% sensitivity and 81% specificity for identifying malignant focal liver lesions.SummaryEUS guided liver biopsy is safe and enables accurate diagnosis of underlying liver disease. EUS guided portal pressure measurement is also safe and is accurate. Combination therapy of EUS guided cyanoacrylate injection and coil embolization is more efficacious and has less complications than injection or coil therapy alone when used for GV bleeding. Artificial intelligence is highly sensitive and specific when used in conjunction with EUS in the diagnosis of malignant focal liver lesions. Endohepatology is a rapidly expanding field with great potential.

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Section: Introductionmentioning

confidence: 99%