scholarly journals Endoscopic ultrasonography in pancreatic diseases: advances in tissue acquisition

2019 ◽  
Vol 07 (07) ◽  
pp. E922-E930 ◽  
Author(s):  
Ioannis V. Mitselos ◽  
Ioannis Karoumpalis ◽  
Vasileios I. Theopistos ◽  
Dimitrios Tzilves ◽  
Dimitrios K. Christodoulou
Keyword(s):  
Endoscopic Ultrasonography ◽  
Diagnostic Performance ◽  
Gastrointestinal Diseases ◽  
Needle Aspiration ◽  
Technological Innovations ◽  
Pancreatic Diseases ◽  
Tissue Acquisition ◽  
Eus Elastography ◽  
Histological Architecture

Abstract Background and study aims Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) improved the diagnostic performance and upgraded the role of endoscopic ultrasonography (EUS) into an interventional modality, able to guide patient management and treatment.This review aimed to highlight the advances, emerging practices, procedural techniques and technological innovations in EUS tissue acquisition in pancreatic diseases. Methods A thorough review of the literature was performed using PubMed to identify articles that describe techniques, advances, and practices in EUS tissue acquisition in gastrointestinal diseases. Conclusion Since the first EUS-FNA procedure, EUS guided-tissue acquisition has been evolving continuously. Development of needles with innovative tip design enabled procurement of larger samples with preserved histological architecture. Moreover, sampling techniques and complementary methods, such as contrast harmonic imaging and EUS-elastography, have been introduced in an effort to improve diagnostic performance and sample adequacy.

scholarly journals Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 238
Author(s):  
Yasutaka Ishii ◽  
Masahiro Serikawa ◽  
Tomofumi Tsuboi ◽  
Ryota Kawamura ◽  
Ken Tsushima ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasonography ◽  
Treatment Decision ◽  
Needle Aspiration ◽  
Pancreatic Tumors ◽  
Decision Strategy ◽  
Endoscopic Retrograde ◽  
Small Pancreatic Cancer ◽  
Eus Elastography

Pancreatic cancer has the poorest prognosis among all cancers, and early diagnosis is essential for improving the prognosis. Along with radiologic modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), endoscopic modalities play an important role in the diagnosis of pancreatic cancer. This review evaluates the roles of two of those modalities, endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP), in the diagnosis of pancreatic cancer. EUS can detect pancreatic cancer with higher sensitivity and has excellent sensitivity for the diagnosis of small pancreatic cancer that cannot be detected by other imaging modalities. EUS may be useful for the surveillance of pancreatic cancer in high-risk individuals. Contrast-enhanced EUS and EUS elastography are also useful for differentiating solid pancreatic tumors. In addition, EUS-guided fine needle aspiration shows excellent sensitivity and specificity, even for small pancreatic cancer, and is an essential examination method for the definitive pathological diagnosis and treatment decision strategy. On the other hand, ERCP is invasive and performed less frequently for the purpose of diagnosing pancreatic cancer. However, ERCP is essential in cases that require evaluation of pancreatic duct stricture that may be early pancreatic cancer or those that require differentiation from focal autoimmune pancreatitis.

scholarly journals Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

2020 ◽  
Vol 08 (10) ◽  
pp. E1315-E1320
Author(s):  
Benedetto Mangiavillano ◽  
Leonardo Sosa-Valencia ◽  
Pierre Deprez ◽  
Pierre Eisendrath ◽  
Carlos Robles-Medranda ◽  
...  
Keyword(s):  
Treatment Options ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Fine Needle ◽  
Oncological Treatment ◽  
Pancreatic Masses ◽  
Tissue Acquisition ◽  
Acquisition Technique

Abstract Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.

Diagnostic Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration of Gallbladder Lesions

2012 ◽  
Author(s):  
Hong-Jun Kim ◽  
Sung-Koo Lee ◽  
Ji Woong Jang ◽  
Tae Gyoon Kim ◽  
Choong Heon Ryu ◽  
...  
Keyword(s):  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Diagnostic Role

S1301 Role of Repeat Endoscopic Ultrasonography with Fine Needle Aspiration in the Diagnosis of Indeterminant Pancreatic Cysts

2009 ◽  
Vol 136 (5) ◽  
pp. A-232-A-233
Author(s):  
Tarun K. Narang ◽  
Neal J. Schamberg ◽  
Ketan Kulkarni ◽  
Savreet Sarkaria ◽  
Mark B. Pochapin ◽  
...  
Keyword(s):  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Pancreatic Cysts ◽  
Fine Needle

scholarly journals The Role of EUS-Guided FNA and FNB in Autoimmune Pancreatitis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1653
Author(s):  
Nicolò de Pretis ◽  
Stefano Francesco Crinò ◽  
Luca Frulloni
Keyword(s):  
Pancreatic Cancer ◽  
Autoimmune Pancreatitis ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Tissue Architecture ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Histological Confirmation

Autoimmune pancreatitis (AIP) is an increasingly recognized disease classified into two different subtypes based on histology. According to the International Diagnostic Criteria (ICDC), the diagnosis is achieved using a combination of different criteria. In patients presenting with a typical imaging appearance, the diagnosis may be straightforward, and steroid treatment is recommended, even without histological confirmation. In patients with atypical imaging or mass-forming appearance, the differential diagnosis with pancreatic cancer is challenging and crucial for treatment strategy. Endoscopic ultrasound (EUS)-guided tissue acquisition has been proposed to achieve a histological diagnosis. Fine-needle aspiration (FNA) was first proposed to aspirate cells from pancreatic lesions. Despite excellent results in terms of sensitivity for pancreatic cancer, the data are disappointing regarding the diagnosis of AIP. The recent development of new needles allowing fine-needle biopsy (FNB) has been associated with improved diagnostic accuracy based on preserving the tissue architecture, which is necessary to detect the typical histological features of AIP. However, the published literature on the role of EUS-guided FNA and FNB is limited and mainly focused on type 1 AIP. The present study aimed to review the available literature on the role of EUS-guided FNA and FNB in the diagnosis of AIP.

scholarly journals A beneficial role of computer-aided diagnosis system for less experienced physicians in the diagnosis of thyroid nodule on ultrasound

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sunyoung Kang ◽  
Eunjung Lee ◽  
Chae Won Chung ◽  
Han Na Jang ◽  
Joon Ho Moon ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Computer Aided Diagnosis ◽  
Cad System ◽  
The Us ◽  
Computer Aided ◽  
Needle Aspiration Cytology ◽  
Aided Diagnosis

AbstractUltrasonography (US) is the primary diagnostic tool for thyroid nodules, while the accuracy is operator-dependent. It is widely used not only by radiologists but also by physicians with different levels of experience. The aim of this study was to investigate whether US with computer-aided diagnosis (CAD) has assisting roles to physicians in the diagnosis of thyroid nodules. 451 thyroid nodules evaluated by fine-needle aspiration cytology following surgery were included. 300 (66.5%) of them were diagnosed as malignancy. Physicians with US experience less than 1 year (inexperienced, n = 10), or more than 5 years (experienced, n = 3) reviewed the US images of thyroid nodules with or without CAD assistance. The diagnostic performance of CAD was comparable to that of the experienced group, and better than those of the inexperienced group. The AUC of the CAD for conventional PTC was higher than that for FTC and follicular variant PTC (0.925 vs. 0.499), independent of tumor size. CAD assistance significantly improved diagnostic performance in the inexperienced group, but not in the experienced groups. In conclusion, the CAD system showed good performance in the diagnosis of conventional PTC. CAD assistance improved the diagnostic performance of less experienced physicians in US, especially in diagnosis of conventional PTC.

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