Current indications and yield of endoscopic ultrasound and ancillary techniques in pancreatic cystic neoplasms

Salom, Federico; Prat, Frédéric

doi:10.1007/s12328-018-00930-2

Cited by 7 publications

(5 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Not surprisingly, given the advances in cross-sectional imaging and improvements in image quality, most of the pancreatic cystic lesions are currently diagnosed incidentally during such studies performed for other indication [ 26 ].…”

Section: The Role Of Cross-sectional Imagingmentioning

confidence: 99%

Advances in the Diagnosis of Pancreatic Cystic Lesions

et al. 2022

View full text Add to dashboard Cite

Pancreatic cystic lesions (PCLs) are a heterogenous group of lesions ranging from benign to malignant. There has been an increase in PCLs prevalence in recent years, mostly due to advances in imaging techniques, increased awareness of their existence and population aging. Reliable discrimination between neoplastic and non-neoplastic cystic lesions is paramount to ensuring adequate treatment and follow-up. Although conventional diagnostic techniques such as ultrasound (US), magnetic resonance imaging (MRI) and computer tomography (CT) can easily identify these lesions, assessing the risk of malignancy is limited. Endoscopic ultrasound (EUS) is superior to cross-sectional imaging in identifying potentially malignant lesions due to its high resolution and better imaging characteristics, and the advantage of allowing for cyst fluid sampling via fine-needle aspiration (FNA). More complex testing, such as cytological and histopathological analysis and biochemical and molecular testing of the aspirated fluid, can ensure an accurate diagnosis.

show abstract

Section: The Role Of Cross-sectional Imagingmentioning

confidence: 99%

Advances in the Diagnosis of Pancreatic Cystic Lesions

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Conversely, diagnosis of a > 2 cm IPMN, especially in young/ middle-aged patients, will require a more strict surveillance and an attempt to establish a more precise diagnosis. New advances in cross-sectional imaging have dramatically improved image quality for pancreas evaluation, a fact responsible for the cyst pandemia we are observing [2]. The most important finding to investigate is the presence of communication of the cyst with the main pancreatic duct (MPD), which when present strongly indicate side-branch IPMN [15•].…”

Section: Epidemiological Datamentioning

confidence: 99%

Diagnostic Approach to Incidentally Detected Pancreatic Cystic Lesions

Rimbaș

Rizzatti

Larghi

2022

Curr Treat Options Gastro

View full text Add to dashboard Cite

Purpose of review The objective of this study is to answer few key questions in order to establish the best possible available diagnostic strategy for incidentally discovered pancreatic cystic lesions (PCLs). Recent findings Advances in EUS-guided sampling techniques, cross-sectional and intracystic confocal imaging, molecular biomarkers analysis, determination of cyst fluid glucose, and artificial intelligence, appear to be associated with an improved diagnostic accuracy in distinguishing mucinous from non-mucinous PCLs. Summary The diagnostic process has the aim of recognizing cysts with malignant potential and identifying those with high-risk stigmata and/or worrisome features. Clinicians should avoid performance of unnecessary tests from one side and misdiagnosis from the other, which can easily result in inadvertent surgery of an otherwise benign lesion or malignant progression of a precancerous cyst. Clinical studies to validate recent reported results utilizing novel diagnostic tests are needed, in order to gradually incorporate and combine them into updated guidelines.

show abstract

“…Detailed information about the cyst wall, cyst size, septa, and mural nodules can be collected due to its high spatial resolution and the possibility to visualize structures from different angles during the examination. One of the biggest advances of EUS in comparison with other imaging modalities is the ability to characterize mural nodules and to directly obtain targeted tissue and/or cyst fluid for analysis [48].…”

Section: Diagnostic Endoscopic Management Of Ipmnmentioning

confidence: 99%

“…It can specially contribute in distinguishing mural nodules from mucus clots or debris, thereby enabling targeted tissue acquisition ( Fig. 3) [48]. Compared with conventional EUS, CH-EUS is more accurate in detecting true mural nodules with an excellent interobserver agreement [51].…”

Section: Contrast-enhanced Harmonic Eusmentioning

confidence: 99%

“…Hyperenhancement of mural nodules, septations, or solid components are concerning for malignancy [14]. In general, noninvasive malignant nodules are visualized as isoechoic enhancing solid components with a fast washout and homogenous distribution, while invasive carcinoma presents as a hypoenhancing and heterogeneous lesion [48]. Mucus clots, necrotic debris, and other benign structures are generally non-enhancing due to the lack of vasculature (Fig.…”

Section: Contrast-enhanced Harmonic Eusmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Management and Follow-Up of Intraductal Papillary Mucinous Neoplasia (IPMN)

Hoogenboom¹,

Fockens²,

Wallace³

et al. 2020

Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Intraductal papillary mucinous neoplasms (IPMN) are common and increasingly detected in patients undergoing cross-sectional imaging for reasons unrelated to the pancreas. Individuals diagnosed with an IPMN should be followed over time because of the malignant potential of these cystic lesions. The primary goal of surveillance is to identify the small minority of IPMN that progresses into advanced neoplasia and benefits from resection, while simultaneously avoiding unnecessary pancreatic surgery in the majority of IPMN that remains benign. Cross-sectional imaging and endoscopic ultrasound with or without fluid and tissue acquisition are currently used to evaluate the risk of malignancy in IPMN. This chapter summarizes the diagnostic workup, surveillance, and treatment of IPMN, focusing on endoscopic modalities and adjacent tests.

show abstract

Current indications and yield of endoscopic ultrasound and ancillary techniques in pancreatic cystic neoplasms

Cited by 7 publications

References 84 publications

Advances in the Diagnosis of Pancreatic Cystic Lesions

Advances in the Diagnosis of Pancreatic Cystic Lesions

Diagnostic Approach to Incidentally Detected Pancreatic Cystic Lesions

Endoscopic Management and Follow-Up of Intraductal Papillary Mucinous Neoplasia (IPMN)

Contact Info

Product

Resources

About