A randomized comparison of EUS-guided FNA versus CT or US-guided FNA for the evaluation of pancreatic mass lesions

Horwhat, John D.; Paulson, Erik K.; McGrath, Kevin; Branch, M. Stanley; Baillie, John; Tyler, Douglas S.; Pappas, Theodore N.; Enns, Robert; Robuck, Gail; Stiffler, Helen; Jowell, Paul S.

doi:10.1016/j.gie.2005.09.028

Cited by 186 publications

(110 citation statements)

References 40 publications

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“…135 A recent prospective randomized study comparing CT or ultrasound-guided FNA with EUS-FNA showed that EUS-FNA is the preferred modality, especially for tumors smaller than 3 cm that have not been identified by previous ultrasound or CT examinations. 136 The main advantage of EUS-FNA is the possibility to target, small, intrapancreatic masses not visualized on CT. 53,124 EUS can also target small tumors such as neuroendocrine tumors and metastatic lesions to the pancreas, which are difficult to access via percutaneous guidance. 137 The indications of EUS-FNA for pancreatic cancer lesions are more controversial, but they currently include 50 : patients with distant metastasis and advanced locoregional disease before the initiation of chemoradiotherapy; diagnosis in resectable patients to exclude other rare pathology (lymphoma, small cell carcinoma, metastasis, etc) or to alter the planned surgery to perform organ-preserving surgery (neuroendocrine tumors, papillary cancers, etc); patient preference and desire to know the complete diagnosis before any planned invasive surgical treatment.…”

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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“…Currently, the procedure with the highest sensitivity for cancer is cytologic evaluation of fine-needle aspirates taken during endoscopic ultrasound (Figure 3f). In one randomized study in patients with suspected pancreatic cancer, rates for the detection of cancer in fineneedle aspirates were higher for specimens taken by endoscopic ultrasound (84%) than for specimens taken percutaneously under ultrasound or CT control (62%) (Horwhat et al, 2006). Similar results have been obtained for confirmation of bile duct cancer although the yield was significantly higher in distal cancer (81%) than in proximal cancer (59%) (Mohamadnejad et al, 2011).…”

Section: Tissue Samplingmentioning

confidence: 64%

Diagnostic and Therapeutic Endoscopy in the Biliary Tract and Pancreas

Roberts‐Thomson¹,

Nguyen²

2011

Therapeutic Gastrointestinal Endoscopy

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“…� ��ndomized com��ison be��een ��-�� nd CT-o� ��-guided �� o� m��ign�n� ��nc�e��ic �umo�s ��so �eve��ed sensi�ivi�ies o� ��4% �nd 62%, �es�ec�ive�y. T�us, ��-�� s su�e�io� �o CT-, ��-�� s su�e�io� �o CT-��-�� s su�e�io� �o CT-� o� ��-guided ��, es�eci��y �o� sm�� m�sses di�ficu�� o de�ec� �i�� CT o� �� [23] 23] ] �� sing �� o� sc��nnom�s, i� is di�ficu�� o find � s��e i� is di�ficu�� o find � s��e i� is di�ficu�� o find � s��e di�ficu�� o find � s��e a sa�e sa�e �ou�e ��om ��e skin �o ��e �esion, es�eci��y in medi�s�in��, ��e skin �o ��e �esion, es�eci��y in medi�s�in��, skin �o ��e �esion, es�eci��y in medi�s�in��, the ��esion�� es�ecia�� in me��iastina�� esion�� es�ecia�� in me��iastina�� es�ecia�� in me��iastina�� es�ecia�� in me��iastina�� erirecta�� or retro�eritonea�� masses [21] …”

Section: Discussionmentioning

confidence: 99%

Three cases of retroperitoneal schwannoma diagnosed by EUS-FNA

Kudo

Kawakami²,

Kuwatani³

et al. 2011

WJG

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Schwannomas are peripheral nerve tumors that are typically solitary and benign. Their diagnosis is largely based on surgically resected specimens. Recently, a number of case reports have indicated that retroperito� neal schwannomas could be diagnosed with endoscopic endoscopic ultrasound�guided fine�needle aspiration �E�S�FNA�.�guided fine�needle aspiration �E�S�FNA�. �needle aspiration �E�S�FNA�. needle aspiration �E�S�FNA�. We report the diagnosis of three cases of schwannoma using E�S�FNA. Subjects were two males and one fe� two males and one fe� wo males and one fe� male, ages 22, 40, and 46 years, respectively, all of whom were symptom�free. Imaging findings showed well�circumscribed round tumors. However, as the s. However, as the . However, as the tumors could not be diagnosed using these findings alone, E�S�FNA was performed. Hematoxylin�eosin staining of the resulting tissue fragments revealed bland spindle cells with nuclear palisading. There was no disparity in nuclear sizes. Immunostaining revealed nuclear sizes. Immunostaining revealed nuclear sizes. Immunostaining revealed S�100 protein positivity and all cases were diagnosed as schwannomas. Ki�67 indexes were ��1��, 2��, es were ��1��, 2��, were ��1��, 2��, and ��, respectively. No case showed any signs of ma� lignancy. As most schwannomas are benign tumors and ost schwannomas are benign tumors and schwannomas are benign tumors and benign tumors and benign tumors and s and and seldom become malignant, we observed these patients without therapy. All tumors demonstrated no enlarge� no enlarge� enlarge� ment and no change in characteristics. Schwannomas and no change in characteristics. Schwannomas no change in characteristics. Schwannomas are almost always benign and can be observed follow� ing diagnosis by E�S�FNA. Key words: Schwannoma; Endoscopic ultrasonography; ndoscopic ultrasonography; ultrasonography; ltrasonography; nography; Fine�needle aspiration; Retroperitoneal tumor; S100 ine�needle aspiration; Retroperitoneal tumor; S100 �needle aspiration; Retroperitoneal tumor; S100 needle aspiration; Retroperitoneal tumor; S100 ; Retroperitoneal tumor; S100 proteins; Ki�67 index

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A randomized comparison of EUS-guided FNA versus CT or US-guided FNA for the evaluation of pancreatic mass lesions

Cited by 186 publications

References 40 publications

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Diagnostic and Therapeutic Endoscopy in the Biliary Tract and Pancreas

Three cases of retroperitoneal schwannoma diagnosed by EUS-FNA

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