Guidelines for credentialing and granting privileges for endoscopic ultrasound

Eisen, Glenn M.; Dominitz, Jason A.; Faigel, Douglas O.; Goldstein, Jay A.; Petersen, Bret T.; Raddawi, Hareth M.; Ryan, Michael E.; Vargo, John J.; Young, Harvey; Wheeler-Harbaugh, Jo; Hawes, Robert H.; Brugge, William R.; Carrougher, John G.; Chak, Amitabh; Kochman, Michael L.; Savides, Thomas J.; Wallace, Michael B.; Wiersema, Maurits J.; Erickson, Richard A.

doi:10.1016/s0016-5107(01)70082-x

Cited by 210 publications

(141 citation statements)

References 15 publications

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“…This result is consistent with those of Western surveys that have also reported that a shortage of endosonographers is the main barrier to wider use of EUS (1,2). Although the American Society for Gastrointestinal Endoscopy has published guidelines for training, credentialing, and granting privileges for EUS (23,24), this is not the case for KSGE or for many national associations of gastrointestinal endoscopy. Moreover, data that are focused on the amount and type of training needed are scarce (25,26).…”

Section: Discussionsupporting

confidence: 86%

South Korean endoscopists’ attitudes toward endoscopic ultrasound for the evaluation of gastrointestinal diseases

Lee

Kim²,

Kim³

et al. 2014

Turk J Gastroenterol

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Section: Discussionsupporting

confidence: 86%

South Korean endoscopists’ attitudes toward endoscopic ultrasound for the evaluation of gastrointestinal diseases

Lee

Kim²,

Kim³

et al. 2014

Turk J Gastroenterol

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“…The definition of complications followed the same criteria used by the American Society for Gastrointestinal Endoscopy (ASGE) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines 7,8 .…”

Section: Rapid On-site Cytopathological Examination (Rose) Performed mentioning

confidence: 99%

“…As previous articles demonstrated, EUS-FNA is a safe procedure with a complication rate of approximately 1-2%. Major complications include infection, bleeding, and acute pancreatitis and are more frequent for EUS-FNA of cystic compared with solid lesions 7,8,21 .…”

Section: Rapid On-site Cytopathological Examination (Rose) Performed mentioning

confidence: 99%

Rapid on-site cytopathological examination (ROSE) performed by endosonagraphers and its improvement in the diagnosis of pancreatic solid lesions

Ganc¹,

Carbonari²,

Colaiácovo³

et al. 2015

Acta Cir. Bras.

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PURPOSE:To evaluate the diagnosis improvement of EUS-FNA when using ROSE performed by the endosonographer. METHODS:A retrospective study was conducted. A total of 48 pancreatic solid masses EUS-FNA were divided into two groups according to the availability of on-site cytology (ROSE) -the first 24 patients (group A-without ROSE) and the latter 24 cases (group B-with ROSE). Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, complications and inadequacy rate of EUS-FNA were determined and compared. RESULTS:Among the 48 EUS-FNA, the overall performance was: sensitivity 82%; specificity 100%; positive predictive value (PPV) 100%; negative predictive value (NPV) 70% and accuracy 87%. The sensitivity of the Group A was 71%, versus 94% in-group B (p=0.61). Moreover, the negative predictive value was 58% versus 87% (p=0.72). The accuracy rate increased from 79% to 96% (p=0.67) in the ROSE group. The number of punctures was similar between the groups. No major complications were reported. CONCLUSION:Rapid on-site cytopathological examination, even when performed by the endosonographer, may improve the diagnostic performance in the diagnosis of solid pancreatic lesions, regardless of the slight increase in the number of punctures.

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“…The intensity and length of training, the requisite curriculum and the minimum number of procedures required to ensure competency are not well-defined [158] . Some experts recommend a minimum of 75 pancreatobiliary procedures and 25 cases of pancreatic FNA [159] , others suggest a minimum of 30 supervised EUS-FNA on pancreatic lesions [160] while someones believe that the majority of trainees will require double the number of proposed procedures to achieve competency in EUS [161,162] . An extensive use of CT or ERCP should be avoided in screening programs that require repeated exams in healthy individuals who have only a statistical risk of cancer.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

Lami

Biagini

Galli

2014

WJGE

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Pancreatic cancer is a highly lethal disease with a genetic susceptibility and familial aggregation found in 3%-16% of patients. Early diagnosis remains the only hope for curative treatment and improvement of prognosis. This can be reached by the implementation of an intensive screening program, actually recommended for individuals at high-risk for pancreatic cancer development. The aim of this strategy is to identify premalignant precursors or asymptomatic pancreatic cancer lesions, curable by surgery. Endoscopic ultrasound (EUS) with or without fine needle aspiration (FNA) seems to be the most promising technique for early detection of pancreatic cancer. It has been described as a highly sensitive and accurate tool, especially for small and cystic lesions. Pancreatic intraepithelial neoplasia, a precursor lesion which is highly represented in highrisk individuals, seems to have characteristics chronic pancreatitis-like changes well detected by EUS. Many screening protocols have demonstrated high diagnostic yields for pancreatic pre-malignant lesions, allowing prophylactic pancreatectomies. However, it shows a high interobserver variety even among experienced endosonographers and a low sensitivity in case of chronic pancreatitis. Some new techniques such as contrast-enhanced harmonic EUS, computer-aided diagnostic techniques, confocal laser endomicroscopy miniprobe and the detection of DNA abnormalities or protein markers by FNA, promise improvement of the diagnostic yield of EUS. As the resolution of imaging improves and as our knowledge of precursor lesions grows, we believe that EUS could become the most suitable method to detect curable pancreatic neoplasms in correctly identified asymptomatic at-risk patients.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Endoscopic ultrasonography; Pancreatic cancer; SurveillanceCore tip: In the era of early diagnosis and screening programs, endoscopic ultrasound (EUS) represents the most promising tool able to identify pancreatic precursor neoplasms in high risk individuals. If compared to other imaging techniques, it is highly accurate to diagnose small pancreatic cancer and pre-malignant lesions, with very low rate of complications and limitations. Here are reported the current role of EUS in various international screening programs and its future possible developments.

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Guidelines for credentialing and granting privileges for endoscopic ultrasound

Cited by 210 publications

References 15 publications

South Korean endoscopists’ attitudes toward endoscopic ultrasound for the evaluation of gastrointestinal diseases

South Korean endoscopists’ attitudes toward endoscopic ultrasound for the evaluation of gastrointestinal diseases

Rapid on-site cytopathological examination (ROSE) performed by endosonagraphers and its improvement in the diagnosis of pancreatic solid lesions

Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

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