Hiroyuki Maguchi1. 1. Center for Gastroenterology, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, 006-8555, Sapporo, Japan.
Abstract
BACKGROUND: Over 20 years have passed since the development of endoscopic ultrasonography (EUS), and this technique is now widely used for the diagnosis of digestive and pancreaticobiliary diseases. EUS plays a number of roles in the clinical diagnosis of pancreatic tumors including detection of small tumors, differential diagnosis of tumors, and evaluation of tumor extent. METHODS: We evaluated the ability of EUS to detect pancreatic carcinoma in comparison with ultrasonography (US) and computed tomography (CT). RESULTS: The overall tumor detection rates were: US, 69%; CT, 79%; and EUS, 97%. With a tumor size smaller than 2 cm (TS1), the detection rate by EUS was as high as 100%, in contrast to 60% and 50% for US and CT, respectively, except for carcinoma in situ. However, EUS has some pitfalls. The EUS imaging technique is not always easy, EUS has limited penetration, and EUS alone cannot accurately differentiate malignancy from inflammation. CONCLUSIONS: The following points are the future themes of EUS. (1) It will be necessary to foster a large number of operators and to establish a standard EUS scanning technique. (2) Development of a new instrument with high resolution and deep penetration is anticipated. (3) Development of a new medium that can be infused into a vein and that allows diagnosis from B-mode images is much anticipated.
BACKGROUND: Over 20 years have passed since the development of endoscopic ultrasonography (EUS), and this technique is now widely used for the diagnosis of digestive and pancreaticobiliary diseases. EUS plays a number of roles in the clinical diagnosis of pancreatic tumors including detection of small tumors, differential diagnosis of tumors, and evaluation of tumor extent. METHODS: We evaluated the ability of EUS to detect pancreatic carcinoma in comparison with ultrasonography (US) and computed tomography (CT). RESULTS: The overall tumor detection rates were: US, 69%; CT, 79%; and EUS, 97%. With a tumor size smaller than 2 cm (TS1), the detection rate by EUS was as high as 100%, in contrast to 60% and 50% for US and CT, respectively, except for carcinoma in situ. However, EUS has some pitfalls. The EUS imaging technique is not always easy, EUS has limited penetration, and EUS alone cannot accurately differentiate malignancy from inflammation. CONCLUSIONS: The following points are the future themes of EUS. (1) It will be necessary to foster a large number of operators and to establish a standard EUS scanning technique. (2) Development of a new instrument with high resolution and deep penetration is anticipated. (3) Development of a new medium that can be infused into a vein and that allows diagnosis from B-mode images is much anticipated.
Authors: Jong-Shin Woo; Kwang Ro Joo; Yong Sik Woo; Jae Young Jang; Young Woon Chang; Joung Lee; Rin Chang Journal: Korean J Intern Med Date: 2006-12 Impact factor: 2.884
Authors: Babu P Mohan; Antonio Facciorusso; Shahab R Khan; Deepak Madhu; Lena L Kassab; Suresh Ponnada; Saurabh Chandan; Stefano F Crino; Gursimran S Kochhar; Douglas G Adler; Michael B Wallace Journal: Endosc Ultrasound Date: 2022 May-Jun Impact factor: 5.275