Endoscopic Ultrasonography (EUS) and EUS-Fine-Needle Procedures: Fascinating Technique but Little Clinical Impact?

For quite some time endoscopic ultrasonography (EUS) has been more than a mere imaging technique. With linear-scanning echoendoscopes it is possible to introduce needles and many other tools into virtually every part of the upper and lower gastrointestinal tract and the surrounding structures (fine-needle procedures, [FNPs]). This can be done in order to aspirate tissue material for cytological examination (fine-needle aspiration, [FNA]) or to deliver drugs and apply many other therapeutic tools (guide-wires and stents, cytoimplants, radiofrequency treatment, contrast media, brachytherapy, modified adenoviruses, etc.).

All these FNPs are exciting and, above all, the ability to perform tissue diagnosis has been welcomed as the “Copernican revolution” in EUS. However, the contribution of these procedures in terms of patient management has not yet been thoroughly investigated for them all.

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