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Review
. 2014 Jun 28;20(24):7808-18.
doi: 10.3748/wjg.v20.i24.7808.

Applications of endoscopic ultrasound in pancreatic cancer

Leticia Perondi Luz  1 , Mohammad Ali Al-Haddad  1 , Michael Sai Lai Sey  1 , John M DeWitt  1
Affiliations
Review

Applications of endoscopic ultrasound in pancreatic cancer

Leticia Perondi Luz et al. World J Gastroenterol. .

Abstract

Since the introduction of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA), EUS has assumed a growing role in the diagnosis and management of pancreatic ductal adenocarcinoma (PDAC). The objective of this review is to discuss the various applications of EUS and EUS-FNA in PDAC. Initially, its use for detection, diagnosis and staging will be described. EUS and EUS-FNA are highly accurate modalities for detection and diagnosis of PDAC, this high accuracy, however, is decreased in specific situations particularly in the presence of chronic pancreatitis. Novel techniques such as contrast-enhanced EUS, elastography and analysis of DNA markers such as k-ras mutation analysis in FNA samples are in progress and might improve the accuracy of EUS in the detection of PDAC in this setting and will be addressed. EUS and EUS-FNA have recently evolved from a diagnostic to a therapeutic technique in the management of PDAC. Significant developments in therapeutic EUS have occurred including advances in celiac plexus interventions with direct injection of ganglia and improved pain control, EUS-guided fiducial and brachytherapy seed placement, fine-needle injection of intra-tumoral agents and advances in EUS-guided biliary drainage. The future role of EUS and EUS in management of PDAC is still emerging.

Keywords: Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endoscopic ultrasound guided fine-needle aspiration; Endosonography; Pancreatic ductal carcinoma; Pancreatic neoplasm.

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Figures

Figure 1
Figure 1
Endoscopic ultrasound guided fine-needle aspiration of pancreatic mass in a patient with painless jaundice.
Figure 2
Figure 2
Endoscopic ultrasound guided deployment (A) and view (B) of fiducials in a pancreatic head mass.
Figure 3
Figure 3
Celiac ganglia identified during endoscopic ultrasound (A) and injected during neurolysis under endoscopic ultrasound guidance (B).
See this image and copyright information in PMC

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