An evidence-based consensus statement on the role and application of endosonography in clinical practice

F. Maluf-Filho; C. M. Dotti; B. Halwan; A. F. Queiros; C. Kupski; D. M. Chaves; F. S. Nakao; A. Kumar

doi:10.1055/s-0029-1215192

Endoscopy, Table of Contents

Endoscopy 2009; 41(11): 979-987
DOI: 10.1055/s-0029-1215192

Review

An evidence-based consensus statement on the role and application of endosonography in clinical practice

F. Maluf-Filho¹ , C. M. Dotti³ , B. Halwan² , A. F. Queiros⁴ , C. Kupski⁵ , D. M. Chaves⁶ , F. S. Nakao⁷ , A. Kumar⁸

¹Department of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, Brazil
²Division of Digestive Diseases, SUNY Downstate Medical Center, Brooklyn, New York, USA
³Endoscopy, Ingecad, Campo Grande, Brazil
⁴Department of Gastroenterology, São Paulo University Medical School, São Paulo, Brazil
⁵Department of Gastroenterology, Catholic University of Rio Grande do Sul, Rio Grande, Brazil
⁶Department of Endoscopy, Centro de Medicina Diagnóstica Fleury, São Paulo, São Paulo, Brazil
⁷Federal University of School of São Paulo Medicina, São Paulo
⁸Stony Brook University, Northport, New York, USA

Abstract

Background: Endoscopic ultrasonography (EUS) has evolved over the past 20 years with the emergence of novel diagnostic and therapeutic indications. Our goal was to identify the best evidence supporting the use of EUS.

Materials and methods: A six-step approach was employed to develop recommendations using accepted methodology. Twenty-two experienced endosonographers identified topics and reviewed studies using MeSH (medical subject headings) terminology and free text in PubMed. Medline and society abstracts were reviewed if necessary. The quality of evidence, the strength of recommendations, and level of consensus were graded and voted on.

Results: Consensus was reached for several clinical scenarios for which the impact of EUS findings was supported by a high level of evidence. These included diagnosis and staging of esophageal cancer, differential diagnosis of subepithelial lesions, thickened gastric folds, assessment of peritoneal involvement in patients with gastric cancer, mucosa-associated lymphoid tissue lymphoma, diagnosis of common bile duct/gallbladder stones, diagnosis of chronic pancreatitis, differential diagnosis of a solid mass in patients with chronic pancreatitis, differential diagnosis of pancreatic cyst, rectal cancer staging, and diagnosis and staging of non-small-cell lung cancer. The recommendations were adopted by the Brazilian Society of Gastrointestinal Endoscopy. Several indications continue to emerge and require additional validation.

Full Text

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F. Maluf-FilhoMD

Gastrointestinal Endoscopy Division
São Paulo University

Brazil

Fax: 55113884-7599

Email: fauze.maluf@terra.com.br