Utility of endoscopic ultrasound and endoscopic ultrasound‐guided fine‐needle aspiration for the diagnosis and management of pancreatic cystic lesions: Differences between the guidelines

Abstract

Recent advances and frequent use of cross‐sectional imaging studies have increased opportunities for incidental diagnoses of pancreatic cystic lesions (PCL). In the management of PCL, distinguishing between mucinous versus non‐mucinous and malignant versus benign cysts is important to diagnose pancreatic cancer in its early stage. For this reason, there have been several guidelines to manage PCL. Endoscopic ultrasound (EUS) and EUS‐guided fine‐needle aspiration (FNA) play important roles in the guidelines, although there are some differences in their roles. In this review, we aimed to evaluate the current status of EUS and EUS‐FNA in the management of PCL and the status of these procedures in the guidelines.

Micro-RNA Analysis of Pancreatic Cyst Fluid for Diagnosing Malignant Transformation of Intraductal Papillary Mucinous Neoplasm by Comparing Intraductal Papillary Mucinous Adenoma and Carcinoma

“…These include cytology using EUS-FNA and the value of CEA and DNA mutation analyses from cyst fluid; however, the diagnostic performance has been found to be inadequate [ 11 , 12 , 13 , 14 ]. Therefore, development of appropriate diagnostic biomarkers is needed for the management of IPMNs [ 2 ]. The present study demonstrated a potential diagnostic approach by using miRNA in pancreatic cyst fluid as a marker for evaluating malignant transformation of IPMN.…”

“…It is, however, not straightforward malignant alternation of IPMN even with standard axial imaging studies, such as computed tomography or magnetic resonance imaging, or cyst fluid analysis including the carcinoembryonic antigen (CEA) level or cytology. Therefore, development of appropriate diagnostic biomarkers is needed for the management of IPMNs [ 2 ].…”

Contributions from Japan to gastrointestinal endoscopy training and development: Special report

“…Much of this progress took place in Japan. As the technology advanced, so too did the sophistication and variety of endoscopic treatment, with new techniquessuch as biopsy, polypectomy, papillotomy, laparoscopic cholecystectomy, laser endoscopy, EUS, 22,23 endoscopic surgical techniques such as EMR, ESD 24,25 and AI-assisted endoscopyappearing in rapid succession 26 .…”

Automatic Segmentation of Pancreatic Tumors Using Deep Learning on a Video Image of Contrast-Enhanced Endoscopic Ultrasound

“…Endoscopic ultrasound (EUS) is an imaging technique that enables the evaluation of pancreatic lesions with high spatial resolution images from the upper intestine by using a special endoscope equipped with a high-frequency transducer at the tip [16]. Recently, developments made to several techniques of image enhanced EUS have further improved the diagnostic accuracy [12,17].…”