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Diagnostics
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The Advanced Role of Diagnostic Endoscopic Ultrasonography
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The Advanced Role of Diagnostic Endoscopic Ultrasonography

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 50540

Special Issue Editor

Prof. Dr. Atsushi Irisawa

E-Mail Website
Guest Editor
Department of Gastroenterology, Dokkyo Medical University, 880, Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
Interests: endoscopic ultrasound (EUS); interventional EUS; endoscopic retrograde cholangiopancreatography (ERCP); pancreatobiliary disease; portal hypertention; GI-subeputherial lesion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Endoscopic ultrasound (EUS) is recognized for its usefulness not only for diagnosing pancreatobiliary disease but also for assessing various lesions located in the gastrointestinal tract, liver, mediastinum, and retroperitoneum. In recent years, although the progress in therapeutic interventional EUS has been a hot topic, there is still a lot of work being done with diagnostic EUS, especially using new techniques (elastography, contrast enhancement, EUS-guided fine-needle aspiration biopsy, etc.). Its diagnostic role is still large and EUS is still an indispensable tool for the management of various diseases. Moreover, EUS diagnosis using artificial intelligence has been an exciting topic. This Special Issue features the progress of diagnostic EUS. We are looking forward to the submission of many papers including original articles and reviews on the hot topic of diagnostic EUS in a wide range of fields. We hope that this Special Issue will contribute to the further development of diagnostic EUS in the future.

Prof. Atsushi Irisawa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Endoscopic ultrasound
  • Chronic pancreatitis
  • Pancreatic cancer
  • Bile cancer
  • Portal hypertension
  • Gastrointestinal subepitherial lesion
  • Gastrointestinal stromal tumor (GIST)
  • Intraductal papillary mucinous neoplasm (IPMN)
  • Esophageal cancer
  • Gastric cancer
  • EUS-guided fine-needle aspiration (EUS-FNA)
  • Intraductal ultrasound (IDUS)
  • Artificial intelligence

Published Papers (15 papers)

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Research

Jump to: Review

9 pages, 399 KiB  
Article
Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
by Kosuke Takahashi, Ichiro Yasuda, Tatsuyuki Hanaoka, Yuka Hayashi, Yasuhiro Araki, Iori Motoo, Shinya Kajiura, Takayuki Ando, Haruka Fujinami, Kazuto Tajiri, Masami Minemura and Terumi Takahara
Diagnostics 2021, 11(1), 27; https://doi.org/10.3390/diagnostics11010027 - 25 Dec 2020
Cited by 13 | Viewed by 1944
Abstract
Background and aim: During endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNB), Franseen needles can help collect sufficient tissue to permit histopathological assessment. However, its efficacy might be limited by the size of the targeted lesion. This study aimed to evaluate the feasibility of [...] Read more.
Background and aim: During endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNB), Franseen needles can help collect sufficient tissue to permit histopathological assessment. However, its efficacy might be limited by the size of the targeted lesion. This study aimed to evaluate the feasibility of histopathological assessment of small solid pancreatic lesions using a 22-gauge Franseen needle during EUS-FNB. Methods: This retrospective study evaluated data from all patients who underwent EUS-FNB using a Franseen needle for solid pancreatic lesions at the University of Toyama Hospital between June 2018 and April 2020. Results: The study included 159 patients who had 152 malignant lesions and 7 benign lesions. The malignant lesions included pancreatic cancers (n = 134), neuroendocrine neoplasms (n = 15), metastatic tumors (n = 2), and a solid pseudopapillary neoplasm (n = 1). The diagnostic accuracy of EUS-FNB (combining histology and cytology) was 98.7%. However, the histopathological diagnosis was only confirmed for 64.3% of small lesions (<10 mm), relative to 97.2% for larger lesions. Multivariate analysis also revealed that lesion size of <10 mm predicted a less accurate histopathological diagnosis (odds ratio: 6.97, 95% confidence interval: 1.02–47.67; p = 0.041). Further analyses revealed a failed histological diagnosis in 4 patients with lesions of <5 mm in size and accurate diagnoses in 9 out of 10 patients with lesions of 5–10 mm in size. Conclusions: The diagnostic accuracy for small lesions (<10 mm), especially for lesions of <5 mm, based on histological examination alone, was significantly lower than that for others (>10 mm). Furthermore, multivariate analysis revealed that only lesion size was an independent predictor of histopathological diagnosis accuracy. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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9 pages, 1116 KiB  
Article
Endoscopic Ultrasonography Diagnosis of Early Pancreatic Cancer
by Keisuke Kurihara, Keiji Hanada and Akinori Shimizu
Diagnostics 2020, 10(12), 1086; https://doi.org/10.3390/diagnostics10121086 - 14 Dec 2020
Cited by 16 | Viewed by 2847
Abstract
Early diagnosis of pancreatic cancer (PC) can improve patients’ prognosis. We aimed to investigate the utility of endoscopic ultrasonography (EUS) for the early diagnosis of PC. This study included 64 patients with PC at an early stage treated at Onomichi General Hospital between [...] Read more.
Early diagnosis of pancreatic cancer (PC) can improve patients’ prognosis. We aimed to investigate the utility of endoscopic ultrasonography (EUS) for the early diagnosis of PC. This study included 64 patients with PC at an early stage treated at Onomichi General Hospital between January 2007 and January 2020. Diagnostic procedures included contrast computed tomography (CT), magnetic resonance cholangiopancreatography, EUS fine-needle aspiration, and endoscopic retrograde cholangiopancreatography (ERCP) for pancreatic juice cytology. The mean age was 71.3 years. In all, 32 patients were stage 0, and 32 were stage I. As for image findings, the main pancreatic duct (MPD) stenosis was detected in several cases, although CT and MRCP seldom detected tumors. EUS had a high detection rate for stage 0 tumor lesions. The median observation period was 3.9 years. In cases with stage 0, the 1 year and 5 year survival rates were 100% and 78.9%, respectively. In cases with stage I, the 1 year and 5 year survival rates were 96.4% and 66.7%, respectively. EUS has the highest sensitivity among all imaging modalities for detecting small pancreatic tumors. Cases with MPD dilation or stenosis, especially with tumors that cannot be identified on CT and MRI, should have EUS performed. In some cases, EUS was not able to detect any tumor lesions, and ERCP-based pancreatic juice cytology should be useful for pathological diagnosis. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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9 pages, 3193 KiB  
Article
Morphometric Assessment of Confocal Laser Endomicroscopy for Pancreatic Ductal Adenocarcinoma, an Ex-Vivo Pilot Study
by Bogdan Silviu Ungureanu, Daniel Pirici, Simona Olimpia Dima, Irinel Popescu, Gheorghe Hundorfean, Valeriu Surlin and Adrian Saftoiu
Diagnostics 2020, 10(11), 923; https://doi.org/10.3390/diagnostics10110923 - 10 Nov 2020
Cited by 2 | Viewed by 1603
Abstract
Ex-vivo freshly surgical removed pancreatic ductal adenocarcinoma (PDAC) specimens were assessed using pCLE and then processed for paraffin embeding and histopathological diagnostic in an endeavour to find putative image analysis algorithms that might recognise adenocarcinoma. Methods: Twelve patients diagnosed with PDAC on endoscopic [...] Read more.
Ex-vivo freshly surgical removed pancreatic ductal adenocarcinoma (PDAC) specimens were assessed using pCLE and then processed for paraffin embeding and histopathological diagnostic in an endeavour to find putative image analysis algorithms that might recognise adenocarcinoma. Methods: Twelve patients diagnosed with PDAC on endoscopic ultrasound and FNA confirmation underwent surgery. Removed samples were sprayed with acriflavine as contrast agent, underwent pCLE with an experimental probe and compared with previous recordings of normal pancreatic tissue. Subsequently, all samples were subjected to cross-sectional histopathology, including surgical resection margins for controls. pCLE records, as well as corespondant cytokeratin-targeted immunohistochemistry images were processed using the same morphological classifiers in the Image ProPlus AMS image analysis software. Specific morphometric classifiers were automatically generated on all images: Area, Hole Area (HA), Perimeter, Roundness, Integrated Optical Density (IOD), Fractal Dimension (FD), Ferret max (Fmax), Ferret mean (Fmean), Heterogeneity and Clumpiness. Results: After histopathological confirmation of adenocarcinoma areas, we have found that the same morphological classifiers could clearly differentiate between tumor and non-tumor areas on both pathology and correspondand pCLE (area, roundness, IOD, ferret and heterogeneity (p < 0.001), perimeter and hole area (p < 0.05). Conclusions: This pilot study proves that classical morphometrical classifiers can clearly differentiate adenocarcimoma on pCLE data, and the implementation in a live image-analysis algorithm might help in improving the specificity of pCLE in vivo diagnostic. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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10 pages, 718 KiB  
Article
The Utility of Endoscopic Ultrasound Fine Needle Aspiration in Pancreatic Cystic Lesions Diagnosis
by Tawfik Khoury, Anas Kadah, Amir Mari, Bahir Sirhan, Mahmud Mahamid and Wisam Sbeit
Diagnostics 2020, 10(8), 507; https://doi.org/10.3390/diagnostics10080507 - 22 Jul 2020
Cited by 2 | Viewed by 2403
Abstract
The yield of biochemical analysis of pancreatic cysts fluid obtained via fine needle aspiration (FNA) is limited. We aimed to assess whether biochemical cyst analysis correlates with the endoscopic ultra-sonographic (EUS) diagnosis. A retrospective study including patients who underwent EUS-FNA was performed. Agreement [...] Read more.
The yield of biochemical analysis of pancreatic cysts fluid obtained via fine needle aspiration (FNA) is limited. We aimed to assess whether biochemical cyst analysis correlates with the endoscopic ultra-sonographic (EUS) diagnosis. A retrospective study including patients who underwent EUS-FNA was performed. Agreement level between EUS diagnosis and biochemical analysis was reported. One-hundred-and-eleven patients were included. For cyst CEA level, 42.4% of patients with endoscopic diagnosis of pancreatic mucinous cystic neoplasm (intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasms (MCN)) had CEA level >192 ng/mL vs. 15.8% of patients who had another endoscopic diagnosis (chi square = 0.03) with poor agreement level (Kappa = 0.130). For the serous cystadenoma (SCA), the levels of amylase and CEA were defined as <250 unit/L and <5 ng/mL, respectively. Eight patients (57.1%) had amylase of <250 unit/L, while 42.9% had >250 unit/L (chi square = 0.007). The agreement level between EUS diagnosis of SCA and amylase level was poor (Kappa = 0.231). For cyst CEA level, 71.4% had CEA level <5 ng/mL vs. 28.6% who had CEA >5 ng/mL (chi square < 0.001) with fair agreement level (Kappa = 0.495). EUS-FNA for pancreatic cystic lesions poorly correlated with the EUS diagnosis. FNA should be considered in the setting of EUS worrisome findings. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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Review

Jump to: Research

13 pages, 301 KiB  
Review
Endoscopic Ultrasound-Guided Sampling for Personalized Pancreatic Cancer Treatment
by Eisuke Iwasaki, Seiichiro Fukuhara, Masayasu Horibe, Shintaro Kawasaki, Takashi Seino, Yoichi Takimoto, Hiroki Tamagawa, Yujiro Machida, Atsuto Kayashima, Marin Noda, Hideyuki Hayashi and Takanori Kanai
Diagnostics 2021, 11(3), 469; https://doi.org/10.3390/diagnostics11030469 - 8 Mar 2021
Cited by 3 | Viewed by 2368
Abstract
Pancreatic cancer is the most lethal solid malignancy, and the number of patients with pancreatic cancer is increasing. Systemic chemotherapies are often ineffective for such patients, and there is an urgent need for personalized medicine. Unlike other types of cancer, personalized treatments for [...] Read more.
Pancreatic cancer is the most lethal solid malignancy, and the number of patients with pancreatic cancer is increasing. Systemic chemotherapies are often ineffective for such patients, and there is an urgent need for personalized medicine. Unlike other types of cancer, personalized treatments for pancreatic cancer are still in development. Consequently, pancreatic cancer is less sensitive to anticancer drugs and is often refractory to common treatments. Therefore, advances in personalized medicine for pancreatic cancer are necessary. This review examined advances in personalized medicine for pancreatic cancer, including the use of endoscopic ultrasound (EUS)-guided sampling. EUS-guided sampling is widely used for diagnosing pancreatic tumors and is expected to be applied to sampled tissues. Additionally, there has been an increase in clinical research using EUS-guided sampling. The combination of precision medicine using genomic testing and pharmacological profiles based on high-throughput drug sensitivity testing using patient-derived organoids is expected to revolutionize pancreatic cancer treatment. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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19 pages, 4276 KiB  
Review
Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms
by Tatsuya Ishii, Akio Katanuma, Haruka Toyonaga, Koki Chikugo, Hiroshi Nasuno, Toshifumi Kin, Tsuyoshi Hayashi and Kuniyuki Takahashi
Diagnostics 2021, 11(2), 316; https://doi.org/10.3390/diagnostics11020316 - 15 Feb 2021
Cited by 15 | Viewed by 2679
Abstract
Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can now be detected with endoscopic ultrasound (EUS). Contrast-enhanced [...] Read more.
Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can now be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection has become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also be used to evaluate the grade of malignancy. Pooling the data of the studies that compared the PNENs grading between EUS-FNA samples and surgical specimens showed a concordance rate of 77.5% (κ-statistic = 0.65, 95% confidence interval = 0.59–0.71, p < 0.01). Stratified analysis for small tumor size (2 cm) showed that the concordance rate was 84.5% and the kappa correlation index was 0.59 (95% confidence interval = 0.43–0.74, p < 0.01). The evolution of ultrasound imaging technologies such as contrast-enhanced and elastography and the artificial intelligence that analyzes them, the evolution of needles, and genetic analysis, will further develop the diagnosis and treatment of PNENs in the future. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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17 pages, 3198 KiB  
Review
The Role of Artificial Intelligence in Endoscopic Ultrasound for Pancreatic Disorders
by Ryosuke Tonozuka, Shuntaro Mukai and Takao Itoi
Diagnostics 2021, 11(1), 18; https://doi.org/10.3390/diagnostics11010018 - 24 Dec 2020
Cited by 19 | Viewed by 4049
Abstract
The use of artificial intelligence (AI) in various medical imaging applications has expanded remarkably, and several reports have focused on endoscopic ultrasound (EUS) images of the pancreas. This review briefly summarizes each report in order to help endoscopists better understand and utilize the [...] Read more.
The use of artificial intelligence (AI) in various medical imaging applications has expanded remarkably, and several reports have focused on endoscopic ultrasound (EUS) images of the pancreas. This review briefly summarizes each report in order to help endoscopists better understand and utilize the potential of this rapidly developing AI, after a description of the fundamentals of the AI involved, as is necessary for understanding each study. At first, conventional computer-aided diagnosis (CAD) was used, which extracts and selects features from imaging data using various methods and introduces them into machine learning algorithms as inputs. Deep learning-based CAD utilizing convolutional neural networks has been used; in these approaches, the images themselves are used as inputs, and more information can be analyzed in less time and with higher accuracy. In the field of EUS imaging, although AI is still in its infancy, further research and development of AI applications is expected to contribute to the role of optical biopsy as an alternative to EUS-guided tissue sampling while also improving diagnostic accuracy through double reading with humans and contributing to EUS education. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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12 pages, 987 KiB  
Review
Endoscopic Ultrasonography Findings of Early and Suspected Early Chronic Pancreatitis
by Yusuke Takasaki, Shigeto Ishii, Toshio Fujisawa, Mako Ushio, Sho Takahashi, Wataru Yamagata, Koichi Ito, Akinori Suzuki, Kazushige Ochiai, Ko Tomishima, Hiroaki Saito and Hiroyuki Isayama
Diagnostics 2020, 10(12), 1018; https://doi.org/10.3390/diagnostics10121018 - 27 Nov 2020
Cited by 10 | Viewed by 3432
Abstract
Chronic pancreatitis (CP) is associated with a risk of pancreatic cancer and is characterized by irreversible morphological changes, fibrosis, calcification, and exocrine and endocrine insufficiency. CP is a progressive disease with a poor prognosis and is typically diagnosed at an advanced stage. The [...] Read more.
Chronic pancreatitis (CP) is associated with a risk of pancreatic cancer and is characterized by irreversible morphological changes, fibrosis, calcification, and exocrine and endocrine insufficiency. CP is a progressive disease with a poor prognosis and is typically diagnosed at an advanced stage. The Japan Pancreas Society proposed criteria for early CP in 2009, and their usefulness has been reported. Recently, a mechanism definition was proposed by the International Consensus Guidelines and early CP was defined as a disease state that is not based on disease duration. CP is diagnosed by computed tomography, magnetic resonance imaging, and endoscopic cholangiopancreatography, which can detect calcification and dilation of the pancreatic ducts; however, detecting early CP with these modalities is difficult because subtle changes in early CP occur before established CP or end-stage CP. Endoscopic ultrasonography (EUS) is useful in the diagnosis of early CP because it allows high-resolution, close-up observation of the pancreas. In addition to imaging findings, EUS with elastography enables measurement of the stiffness of the pancreas, an objective diagnostic measure. Understanding the EUS findings of early CP is important because a histological diagnosis is problematic, and other modalities are not capable of detecting subtle changes in early CP. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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12 pages, 1709 KiB  
Review
The Role of Endoscopic Ultrasound for Esophageal Varices
by Kazunori Nagashima, Atsushi Irisawa, Keiichi Tominaga, Ken Kashima, Yasuhito Kunogi, Takahito Minaguchi, Naoya Izawa, Akira Yamamiya, Akane Yamabe, Koki Hoshi, Kenichi Goda and Makoto Iijima
Diagnostics 2020, 10(12), 1007; https://doi.org/10.3390/diagnostics10121007 - 25 Nov 2020
Cited by 10 | Viewed by 8475
Abstract
Esophageal varices are caused by the development of collateral circulation in the esophagus as a result of portal hypertension. It is important to administer appropriate preventive treatment because bleeding varices can be fatal. Esophageal varices have complex and diverse hemodynamics, and there are [...] Read more.
Esophageal varices are caused by the development of collateral circulation in the esophagus as a result of portal hypertension. It is important to administer appropriate preventive treatment because bleeding varices can be fatal. Esophageal varices have complex and diverse hemodynamics, and there are various variations for each case. Endoscopic ultrasound (EUS) can estimate the hemodynamics of each case. Therefore, observation by EUS in esophageal varices provides useful information, such as safe and effective treatment selection, prediction of recurrence, and appropriate follow-up after treatment. Although treatment for the esophagogastric varices can be performed without EUS imaging, understanding the local hemodynamics of the varices using EUS prior to treatment will lead to more safe and effective treatment. EUS observation is an indispensable tool for thorough variceal care. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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13 pages, 1559 KiB  
Review
The Diagnosis of Autoimmune Pancreatitis Using Endoscopic Ultrasonography
by Atsushi Kanno, Eriko Ikeda, Kozue Ando, Hiroki Nagai, Tetsuro Miwata, Yuki Kawasaki, Yamato Tada, Kensuke Yokoyama, Norikatsu Numao, Jun Ushio, Kiichi Tamada, Alan Kawarai Lefor and Hironori Yamamoto
Diagnostics 2020, 10(12), 1005; https://doi.org/10.3390/diagnostics10121005 - 25 Nov 2020
Cited by 7 | Viewed by 2837
Abstract
Autoimmune pancreatitis (AIP) is characterized by enlargement of the pancreas and irregular narrowing of the main pancreatic duct. It is often associated with IgG4-related sclerosing cholangitis (IgG4-SC), in which the bile duct narrows. Although characteristic irregular narrowing of the pancreatic duct caused by [...] Read more.
Autoimmune pancreatitis (AIP) is characterized by enlargement of the pancreas and irregular narrowing of the main pancreatic duct. It is often associated with IgG4-related sclerosing cholangitis (IgG4-SC), in which the bile duct narrows. Although characteristic irregular narrowing of the pancreatic duct caused by endoscopic retrograde cholangiopancreatography is noted in AIP, it is difficult to differentiate between localized AIP and pancreatic carcinoma based on imaging of the pancreatic duct. While stenosis of the bile duct in IgG4-SC is characterized by longer-length stenosis than in cholangiocarcinoma, differentiation based on bile duct imaging alone is challenging. Endoscopic ultrasound (EUS) can characterize hypoechoic enlargement of the pancreas or bile duct wall thickening in AIP and IgG4-SC, and diagnosis using elastography and contrast-enhanced EUS are being evaluated. The utility of EUS-guided fine needle aspiration for the histological diagnosis of AIP has been reported and is expected to improve diagnostic performance for AIP. Findings in the bile duct wall from endoscopic retrograde cholangiopancreatography followed by intraductal ultrasonography are useful in differentiating IgG4-SC from cholangiocarcinoma. Diagnoses based on endoscopic ultrasonography play a central role in the diagnosis of AIP. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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24 pages, 350 KiB  
Review
Complications of Endoscopic Ultrasound-Guided Fine Needle Aspiration: A Narrative Review
by Masafumi Mizuide, Shomei Ryozawa, Akashi Fujita, Tomoya Ogawa, Hiromune Katsuda, Masahiro Suzuki, Tatsuya Noguchi and Yuki Tanisaka
Diagnostics 2020, 10(11), 964; https://doi.org/10.3390/diagnostics10110964 - 17 Nov 2020
Cited by 31 | Viewed by 4122
Abstract
Considerable progress has been made recently in the use of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to diagnose intra-luminal gastrointestinal lesions and extra-luminal lesions near the gastrointestinal tract. Numerous reports have indicated that EUS-FNA has high diagnostic performance and safety, which has led to [...] Read more.
Considerable progress has been made recently in the use of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to diagnose intra-luminal gastrointestinal lesions and extra-luminal lesions near the gastrointestinal tract. Numerous reports have indicated that EUS-FNA has high diagnostic performance and safety, which has led to the routine use of EUS-FNA and an increasing number of cases. Thus, while EUS-FNA has a low rate of complications, endoscopists may encounter these complications as the number of cases increases. Infrequent reports have also described life-threatening complications. Therefore, endoscopists should possess a comprehensive understanding of the complications of EUS-FNA, which include hemorrhage, perforation, infection, and acute pancreatitis, as well as their management. This review examines the available evidence regarding the complications associated with EUS-FNA, and the findings will be useful for ensuring that endoscopists perform EUS-FNA safely and appropriately. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
13 pages, 293 KiB  
Review
Interobserver Reliability of Endoscopic Ultrasonography: Literature Review
by Akira Yamamiya, Atsushi Irisawa, Ken Kashima, Yasuhito Kunogi, Kazunori Nagashima, Takahito Minaguchi, Naoya Izawa, Akane Yamabe, Koki Hoshi, Keiichi Tominaga, Makoto Iijima and Kenichi Goda
Diagnostics 2020, 10(11), 953; https://doi.org/10.3390/diagnostics10110953 - 15 Nov 2020
Cited by 8 | Viewed by 2048
Abstract
Endoscopic ultrasonography (EUS) has been applied to the diagnosis of various digestive disorders. Although it has been widely accepted and its diagnostic value is high, the dependence of EUS diagnosis on image interpretation done by the endosonographer has persisted as an important difficulty. [...] Read more.
Endoscopic ultrasonography (EUS) has been applied to the diagnosis of various digestive disorders. Although it has been widely accepted and its diagnostic value is high, the dependence of EUS diagnosis on image interpretation done by the endosonographer has persisted as an important difficulty. Consequently, high interobserver reliability (IOR) in EUS diagnosis is important to demonstrate the reliability of EUS diagnosis. We reviewed the literature on the IOR of EUS diagnosis for various diseases such as chronic pancreatitis, pancreatic solid/cystic mass, lymphadenopathy, and gastrointestinal and subepithelial lesions. The IOR of EUS diagnosis differs depending on the disease; moreover, EUS findings with high IOR and those with IOR that was not necessarily high were used as diagnostic criteria. Therefore, to further increase the value of EUS diagnosis, EUS diagnostic criteria with high diagnostic characteristics based on EUS findings with high IOR must be established. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
14 pages, 1052 KiB  
Review
Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement
by Masahiro Itonaga, Reiko Ashida and Masayuki Kitano
Diagnostics 2020, 10(11), 888; https://doi.org/10.3390/diagnostics10110888 - 30 Oct 2020
Cited by 9 | Viewed by 2818
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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15 pages, 1011 KiB  
Review
A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis
by Wisam Sbeit, Anas Kadah, Mahmud Mahamid, Rinaldo Pellicano, Amir Mari and Tawfik Khoury
Diagnostics 2020, 10(8), 512; https://doi.org/10.3390/diagnostics10080512 - 23 Jul 2020
Cited by 10 | Viewed by 2931
Abstract
Liver diseases are amongst the most common diseases worldwide and manifest as a parenchymatic and/or biliary injury due to several causes as well as focal liver lesions, ranging from benign to malignant ones. The diagnosis of liver diseases is based mainly on biochemical [...] Read more.
Liver diseases are amongst the most common diseases worldwide and manifest as a parenchymatic and/or biliary injury due to several causes as well as focal liver lesions, ranging from benign to malignant ones. The diagnosis of liver diseases is based mainly on biochemical and advanced imaging studies and, when required, on liver biopsy. Endoscopic ultrasound (EUS), which combines endoscopy and ultrasonography, is one of the main examination techniques used in gastroenterology as it is applied to evaluate abnormalities in the lumen of the upper and lower gastrointestinal tract and to define pancreatic and hepato-biliary features, often in chronic patients. Given its high spatial resolution and its proximity to the liver, EUS is gaining popularity in the diagnostic work up of liver diseases. This is a comprehensive overview of the current literature on the diagnostic indications for EUS use in patients with liver diseases. We performed a MEDLINE\PubMed and Embase search, and all articles that were relevant, after reviewing abstracts, were assessed and the full text was analyzed to extract data regarding technical success, diagnostic yield, bioptic characteristics, and complications rate. EUS-guided imaging and biopsy techniques in liver diseases have shown consistent favorable promising results among the reports through the literature, with an excellent diagnostic yield and safety profile, especially in the context of focal lesions and portal hypertension. The application of EUS in the diagnosis of liver diseases is a promising technique and should be considered as a first-line therapeutic option in selected cases. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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16 pages, 2508 KiB  
Review
Current Status of Needles in the Optimization of Endoscopic Ultrasound-Guided Procedures
by Akashi Fujita, Shomei Ryozawa, Yuki Tanisaka, Tomoya Ogawa, Masahiro Suzuki, Tatsuya Noguchi, Hiromune Katsuda and Masafumi Mizuide
Diagnostics 2020, 10(7), 463; https://doi.org/10.3390/diagnostics10070463 - 8 Jul 2020
Cited by 7 | Viewed by 4908
Abstract
Endoscopic ultrasound (EUS) is among the most important tools for the evaluation of gastrointestinal tumors and affected areas around the gastrointestinal tract. It enables the acquisition of material from abnormal lesions via the gastrointestinal wall for tissue confirmation via endoscopic ultrasound-guided fine-needle aspiration [...] Read more.
Endoscopic ultrasound (EUS) is among the most important tools for the evaluation of gastrointestinal tumors and affected areas around the gastrointestinal tract. It enables the acquisition of material from abnormal lesions via the gastrointestinal wall for tissue confirmation via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-FNA has played a vital role in oncological care and has become the standard method for tissue sampling. The choice of needle type is an important factor determining tissue acquisition and has been evaluated by many researchers. New needles are introduced into the market almost every year, and opinions vary regarding proper needle selection. While there are diverse opinions but no definitive recommendations about the use of one particular device, fine-needle biopsy needles may provide detailed information on a tissue’s architecture based on greater sample yields. This permits additional analyses, including genetic sequencing and phenotyping, thereby enabling the provision of more personalized treatment plans. Furthermore, other EUS-guided procedures have been developed, including interventional EUS and through-the-needle devices. Given the continued attempts to improve the diagnostic ability and therapeutic techniques, we review in detail the available types of puncture needles to provide guidance on the selection of the appropriate needle types. Full article
(This article belongs to the Special Issue The Advanced Role of Diagnostic Endoscopic Ultrasonography)
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