scholarly journals A Comprehensive Narrative Review on the Evolving Role of Endoscopic Ultrasound in Focal Solid Liver Lesions Diagnosis and Management

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 688
Author(s):  
Wisam Sbeit ◽  
Anas Kadah ◽  
Amir Mari ◽  
Mahmud Mahamid ◽  
Tawfik Khoury
Keyword(s):  
Endoscopic Ultrasound ◽  
Unmet Need ◽  
Needle Aspiration ◽  
Therapeutic Interventions ◽  
Therapeutic Modality ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Diagnosis And Management ◽  
Contrast Enhanced ◽  
Excellent Spatial Resolution

The implications of endoscopic ultrasound (EUS) have expanded considerably in recent years to cover more fields in invasive gastroenterology practice, as both an investigative and therapeutic modality. The utility of EUS in the diagnosis and management of focal liver lesions has gained a special attractiveness recently. The EUS probe proximity to the liver and its excellent spatial resolution enables real-time images coupled with several enhancement techniques, such as contrast-enhanced (CE) EUS. Aside from its notable capability to execute targeted biopsies and therapeutic interventions, EUS has developed into a hopeful therapeutic tool for the management of solid liver lesions. Herein, we provide a comprehensive state-of-the-art review on the efficacy and safety of EUS in the diagnosis and management of focal solid liver lesions. Medline/PubMed and Embase database searches were conducted by two separate authors (T.K. and W.S.), all relevant studies were assessed, and relevant data was extracted and fully reported. EUS-guided diagnosis of focal liver lesions by sonographic morphologic appearance and cytological and histopathological finding of biopsies obtained via fine needle aspiration/biopsy have been shown to significantly improve the diagnosis of solid liver lesions compared with traditional imaging tools. Similarly, EUS-guided treatment has been shown to consistently have excellent technical success, high efficacy, and minor adverse events. The evolving valuable evidences of EUS utility might satisfy the unmet need of optimizing management of focal solid liver lesions.

scholarly journals Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 888
Author(s):  
Masahiro Itonaga ◽  
Reiko Ashida ◽  
Masayuki Kitano
Keyword(s):  
Image Enhancement ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Liver Lesions ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Eus Elastography ◽  
Enhancement Technologies

Although endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is useful in the differential diagnosis of solid pancreatic lesions, lymph nodes, and liver lesions, inadequate sampling may result in an incorrect pathological diagnosis. The accuracy of EUS for the evaluation of pancreatobiliary lesions may be increased by image enhancement technologies, including contrast-enhanced harmonic (CH)-EUS and EUS-elastography. These methods can provide information that complement EUS-FNA for the diagnosis and staging of pancreatobiliary cancer, and can help to identify the EUS-FNA target, reducing the requirement for repeat FNA.

scholarly journals Diagnostic yield of endoscopic ultrasound-guided biopsy of focal liver lesions

2019 ◽  
Vol 92 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Vlad Andrei Ichim ◽  
Romeo Ioan Chira ◽  
Petru Adrian Mircea
Keyword(s):  
Endoscopic Ultrasonography ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Ultrasound Guided ◽  
Clinical Role ◽  
Fine Needle

Endoscopic ultrasonography (EUS) has become an indispensable method for diagnosis and therapeutic procedures in gastroenterology. As experience with this technique grows, new indications continue to emerge. Due to the vicinity of the transducer to the liver, endoscopic ultrasonography provides detailed images of the liver segments and its vascular and biliary structures. Endosonographers have made an effort to define a clinical role for endoscopic ultrasound in liver diseases; however, not much is known about endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in hepatic focal lesions. This review summarizes the available evidence regarding the usefulness of endoscopic ultrasound-guided fine needle aspiration in patients with focal liver lesions.  

scholarly journals Accuracy of endoscopic ultrasound-guided biopsy of focal liver lesions

2020 ◽  
Vol 1 (1) ◽  
pp. 20 ◽  
Author(s):  
Vlad Andrei Ichim ◽  
Romeo Ioan Chira ◽  
Petru Adrian Mircea ◽  
Georgiana Anca Nagy ◽  
Doinita Crisan ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Primary Tumor ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Fine Needle ◽  
Guided Biopsy ◽  
Common Diagnosis

Aim: Endoscopic ultrasound (EUS) has become an indispensable method for diagnosis in gastroenterology and new indications for EUS continue to emerge. However, there are limited data regarding the accuracy of EUS-guided biopsy of hepatic focal lesions. The aim of this study was to assess the diagnostic yield of EUS-guided fine needle aspiration (FNA) of focal liver lesions.Material and methods: We conducted a prospective study in which patients with focal liver lesions, detected by transabdominal ultrasound and computed tomography or magnetic resonance imaging, underwent EUS-guided FNA to determine the diagnostic yield of the procedure.Results: In 47/48 of patients, the results of EUS-FNA were positive for malignancy, while in one case the acquired fragment was insufficient for appropriate histological analysis. Diagnostic yield was 0.98. In 83% of the cases biopsies were taken from the left lobe and in 17% from the right lobe with the same technical success rate. The most common diagnosis was metastatic adenocarcinoma of the pancreas (26% cases) followed by cholangiocarcinoma (17% cases). Concurrent sampling of other sites in addition to the liver and/or primary tumor was realized in 35% of the cases, with results that correlated with the liver biopsy and with the primary tumor biopsy. We reported no immediate or long-term complications in any of the patients.Conclusions: EUS guided fine needle aspiration/biopsy of focal liver lesions is safe, provides a very high diagnostic accuracy and should not be considered only as a rescue method after failure of percutaneous guided biopsies.

scholarly journals Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1244
Author(s):  
Sonja Schwarz ◽  
Dirk-André Clevert ◽  
Michael Ingrisch ◽  
Thomas Geyer ◽  
Vincent Schwarze ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diagnostic Accuracy ◽  
Late Phase ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Malignant Lesions ◽  
Benign Liver ◽  
Benign Liver Lesions

Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.

scholarly journals Evaluation of Peritoneal Deposits in Undiagnosed Ascites by Advanced Endoscopic Ultrasound Imaging Techniques

2021 ◽  
Vol 12 (01) ◽  
pp. 049-050
Author(s):  
Surinder Singh Rana ◽  
Ravi Sharma ◽  
Rajesh Gupta
Keyword(s):  
Ascitic Fluid ◽  
Endoscopic Ultrasound ◽  
Imaging Techniques ◽  
Needle Aspiration ◽  
Enhancement Pattern ◽  
Etiological Diagnosis ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Biochemical Evaluation ◽  
Repeat Sampling

AbstractEtiology of ascites can be usually determined with ascitic fluid cytological and biochemical evaluation. Occasionally, the cause of ascites cannot be determined despite repeated ascitic fluid evaluations. These patients with undiagnosed ascites usually undergo diagnostic laparotomy/laparoscopy for etiological diagnosis. Endoscopic ultrasound (EUS) can help in resolving the diagnostic conundrum of undiagnosed ascites by visualizing as well as sampling peritoneal and omental deposits/thickening. However, rarely fine-needle aspiration from deposits may be falsely negative and patient may need repeat sampling. Newer EUS imaging techniques such as elastography and contrast-enhanced harmonic EUS by providing additive information on stiffness and enhancement pattern of the lesion can help in differential diagnosis.

Mo1935 Using Contrast-Enhanced Ultrasonography (CEUS) Time-Intensity Curves (TICs) as Classifiers in Neural Network Diagnosis of Focal Liver Lesions

2012 ◽  
Vol 142 (5) ◽  
pp. S-1004 ◽  
Author(s):  
Costin T. Streba ◽  
Dan Ionut Gheonea ◽  
Larisa D. Sandulescu ◽  
Liliana Streba ◽  
Tudorel Ciurea ◽  
...  
Keyword(s):  
Neural Network ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Network Diagnosis
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