EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV – EUS-guided Interventions: General aspects and EUS-guided sampling (Long Version)

Abstract

The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-guided sampling. Endoscopic ultrasound combines the most advanced high-resolution ultrasound imaging of lesions within the wall and in the vicinity of the gastrointestinal tract and safe and effective fine needle based tissue acquisition from these lesions. The guideline addresses the indications, contraindications, techniques, adverse events, training and clinical impact of EUS-guided sampling. Advantages and drawbacks are weighed in comparison with image-guided percutaneous biopsy. Based on the most current evidence, clinical practice recommendations are given for crucial preconditions and steps of EUS-guided sampling as well as for safe performance. Additionally, the guideline deals with the principles and reliability of cytopathological reporting in endoscopic ultrasound-guided sampling (long version).

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“…Practitioners need to be competent in the intravenous administration of contrast agents, be familiar with contraindications and be able to manage any possible adverse effects within the medical and legal framework of their country [4,38]. We refer to the educational activities of the collaborating societies of this paper, the World Federation of Ultrasound in Medicine and Biology (WFUMB) [9,23,[93][94][95][96][97][98][99][100][101][102], the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) [1,3,4,11,37,38,49,50,74,79,[103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119] and the CEUS LI-RADS Working Group for Liver Imaging Reporting and Data System (LI-RADS®) [34][35][36][120]…”

The EFSUMB website, a great source for ultrasound information and education

“…The guidelines consist of six main parts that are published in Ultraschall in der Medizin / European Journal of Ultrasound [22][23][24][25][26][27][28][29][30], an introduction [19] and Editorial [18] and comment papers [31][32][33]. In addition, EFSUMB has made recommendations for the performance and reporting of US examinations in portal hypertension [34,35].…”

“…The atlas is work in process including also videos and figures for the INVUS guidelines [19,[22][23][24][25][26][27][28][29][30].…”

Ultrasound contrast agents

“…Extravascular applications with SonoVue ® , mentioned in the European Federation of Societies for US in Medicine and Biology guideline,[37] include injection of contrast for assessment of hysterosalpingo-contrast-sonography, ascites to evaluate hepatic hydrothorax, bile ducts via percutaneous transhepatic cholangiography and drainage,[3839] endoscopic retrograde cholangiography or surgically placed T-tube, sialography, perianal fistula, abscesses,[40] pseudocysts, gastroesophageal reflux, Zenker's diverticulum,[41] enema, and nephrostomy tubes. [12637]…”