• Title/Summary/Keyword: Endoscopic ultrasound

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Clinical Application of $^{18}F-FDG$ PET in Esophageal Cancer (식도암에서의 $^{18}F-FDG$ PET의 임상 이용)

  • Choi, Joon-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.32-38
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    • 2008
  • This review focuses on the clinical use of $^{18}F-FDG$ PET in esophageal cancer. For initial staging of esophageal cancer, $^{18}F-FDG$ PET is better than chest CT and is complementary to endoscopic ultrasound. Due to its good results for detecting distant metastasis, $^{18}F-FDG$ PET evades unnecessary curative surgery. Also, PET findings are associated with prognosis in esophageal cancer. $^{18}F-FDG$ PET seems to be useful for detecting recurrence and restaging in esophageal cancer. For therapy response assessment, $^{18}F-FDG$ PET is effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in esophageal cancer, which is better than chest CT and endoscopic ultrasound. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations.

The roles of endoscopic ultrasound in the diagnosis of pancreatobiliary cancer (췌·담도암 진단에 있어서 내시경초음파의 역할)

  • Kim, Kook Hyun
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.77-84
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    • 2016
  • Pancreatic cancer, the 4th leading cause of cancer-related death in the United States, has a very poor prognosis. Cholangiocarcinoma originates from either intrahepatic or extrahepatic bile duct, and its incidence is gradually increasing worldwide. Endoscopic retrograde cholangiopancreatography with brush cytology has a high false-negative rate for the diagnosis of biliary malignancy. Recently, endoscopic ultrasonography (EUS) has emerged as the potential modality to detect pancreatic cancer. EUS-guided fine needle aspiration for cytologic analysis made it possible to overcome the obstacle in differentiating between benign and malignant lesions in the pancreatobiliary lesion, and it has been well established as a safe and effective procedure. Herein, the clinical application of EUS in the diagnosis of pancreatobiliary cancer was reviewed.

Current and Future Technologies for a Gastrointestinal Endoscopy (소화기 내시경의 기술 현황과 전망)

  • Chee, Young-Joon;Woo, Jih-Wan
    • Journal of Biomedical Engineering Research
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    • v.31 no.5
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    • pp.335-343
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    • 2010
  • This article presents a review of technologies for an endoscope. The classification according to the clinical applications and the imaging modalities are summarized. The major parts are focused on describing the gastrointestinal endoscope's structures and mechanisms. The details of the image enhanced endoscopic techniques, such as NBI (narrow band imaging), OCT (optical coherence tomography), and EUS (endoscopic ultrasound), are also explained. Finally, the trend of NOTES (natural orifice transluminal endoscopic surgery) which is new fusion technology in the field of endoscopic diagnosis and surgery is introduced.

Prospective Assessment of the Performance of a New Fine Needle Biopsy Device for EUS-Guided Sampling of Solid Lesions

  • El Hajj, Ihab I.;Wu, Howard;Reuss, Sarah;Randolph, Melissa;Harris, Akeem;Gromski, Mark A.;Al-Haddad, Mohammad
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.576-583
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    • 2018
  • Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissue acquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguided sampling of solid lesions and compare it with the historical FNA technique. Methods: $Acquire^{(R)}$ 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtained using $Expect^{(R)}$ 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independently evaluated by two cytopathologists blinded to the formal cytopathological diagnosis. Results: Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantly lower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNA groups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNB group. Two patients developed post-FNB abdominal pain. Conclusions: The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to those obtained by FNA, but with fewer passes.

Diagnosis of Metastatic Undifferentiated Sarcoma by Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA) (내시경초음파 세침흡인술을 통한 전이성 미분화육종의 진단)

  • Si Young Kim;Hee Seung Lee;Moon Jae Chung;Jeong Youp Park;Seungmin Bang;Seung Woo Park;Si Young Song
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.120-124
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    • 2017
  • A-49-year-old male patient with no specific medical history was admitted to the clinic because of persistent epigastric pain radiating to back for 4 months. He had multiple parenchymal tumors in body and tail of pancreas, para-spinal muscle, and mediastinum on abdomen CT image. Cytologic examination of the pancreas which was done by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) showed adenocarcinoma, whereas histological examination of the para-spinal mass showed undifferentiated sarcoma. Histologic examination of the pancreatic mass was made through endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for accurate diagnosis, and the histologic examination of both the pancreas and posterior mediastinal mass showed the same undifferentiated sarcoma. Therefore, we reviewed the cytopathic tissue obtained from the pancreas for the first time, and it was confirmed to be similar to histologic findings in the mediastinal mass.

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Clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling of pancreatic cancer

  • Nozomi Okuno;Kazuo Hara;Nobumasa Mizuno;Shin Haba;Takamichi Kuwahara;Yasuhiro Kuraishi;Daiki Fumihara;Takafumi Yanaidani
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.221-228
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    • 2023
  • Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting. Methods: CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively. Results: The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375). Conclusions: To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.