Clin Endosc.  2013 Sep;46(5):552-562.

Technical Advances in Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition for Pancreatic Cancers: How Can We Get the Best Results with EUS-Guided Fine Needle Aspiration?

• Kedia P
• Gaidhane M
• Kahaleh M

Abstract

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is one of the least invasive and most effective modality in diagnosing pancreatic adenocarcinoma in solid pancreatic lesions, with a higher diagnostic accuracy than cystic tumors. EUS-FNA has been shown to detect tumors less than 3 mm, due to high spatial resolution allowing the detection of very small lesions and vascular invasion, particularly in the pancreatic head and neck, which may not be detected on transverse computed tomography. Furthermore, this minimally invasive procedure is often ideal in the endoscopic procurement of tissue in patients with unresectable tumors. While EUS-FNA has been increasingly used as a diagnostic tool, most studies have collectively looked at all primary pancreatic solid lesions, including lymphomas and pancreatic neuroendocrine neoplasms, whereas very few studies have examined the diagnostic utility of EUS-FNA of pancreatic ductal carcinoma only. As with any novel and advanced endoscopic procedure that may incorporate several practices and approaches, endoscopists have adopted diverse techniques to improve the tissue procurement practice and increase diagnostic accuracy. In this article, we present a review of literature to date and discuss currently practiced EUS-FNA technique, including indications, technical details, equipment, patient selection, and diagnostic accuracy.

Keyword

Endosonography; Biopsy, fine-needle; Pancreatic cyst; Lesions; Pancreatic neoplasms

MeSH Terms

Adenocarcinoma
Biopsy, Fine-Needle
Carcinoma, Pancreatic Ductal
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Head
Humans
Lymphoma
Neck
Needles
Pancreatic Cyst
Pancreatic Neoplasms
Patient Selection
Tissue and Organ Procurement

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