Endoscopy 2001; 33(6): 537-540
DOI: 10.1055/s-2001-14973
Editorial

© Georg Thieme Verlag Stuttgart · New York

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

G. Caletti, P. Fusaroli
  • Dipartimento di Medicina Interna e Gastroenterologia, Policlinico S. Orsola, Bologna, Italy
Further Information

Publication History

Publication Date:
31 December 2001 (online)

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.

References

  • 1 Mortensen M B, Pless T, Durup J, et al. Clinical impact of EUS guided fine needle aspiration biopsy in patients with upper GI tract malignancies. A prospective study.  Endoscopy. 2001;  33 478-483
  • 2 Wiersema M J, Hawes R H, Tao L C, et al. Endoscopic ultrasonography as an adjunct to fine needle aspiration cytology of the upper and lower gastrointestinal tract.  Gastrointest Endosc. 1992;  38 35-39
  • 3 Chang K J, Nguyen P, Erickson R A, et al. The clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma.  Gastrointest Endosc. 1997;  45 387-393
  • 4 Erickson R A, Garza A A. Impact of endoscopic ultrasound on the management and outcome of pancreatic carcinoma.  Am J Gastroenterol. 2000;  95 2248-2254
  • 5 Bhutani M S, Hawes R H, Hoffman B J. A comparison of the accuracy of echo features during endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration for diagnosis of malignant lymph node invasion.  Gastrointest Endosc. 1997;  45 474-479
  • 6 Bhutani M S, Hawes R H, Baron P L, et al. Endoscopic ultrasound guided fine needle aspiration of malignant pancreatic lesions.  Endoscopy. 1997;  29 854-858
  • 7 Wiersema M J, Vilmann P, Giovannini M, et al. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment.  Gastroenterology. 1997;  112 1087-1095
  • 8 Williams D B, Sahai A V, Aabakken L, et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience.  Gut. 1999;  44 720-726
  • 9 Gress F G, Savides T J, Sandler A, et al. Endoscopic ultrasonography, fine-needle aspiration biopsy guided by endoscopic ultrasonography, and computed tomography in the preoperative staging of non-small-cell lung cancer: a comparison study.  Ann Intern Med. 1997;  127 604-612
  • 10 Erickson R A, Sayage-Rabie L, Beissner S. Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies.  Gastrointest Endosc. 2000;  51 184-190
  • 11 Fritscher-Ravens A, Topalidis T, Bobrowski C, et al. Endoscopic ultrasound-guided fine-needle aspiration in focal pancreatic lesions: a prospective intraindividual comparison of two needle assemblies.  Endoscopy. 2001;  33 484-490
  • 12 Caletti G, Fusaroli P, Bocus P. Endoscopic ultrasonography in large gastric folds.  Endoscopy. 1998;  30 (Suppl. 1) A72-A75
  • 13 Wegener M, Adamek R. Puncture of submucosal and extrinsic tumors: is there a clinical need? Puncture techniques and their accuracy.  Gastrointest Endosc Clin N Am. 1995;  5 615-623
  • 14 Caletti G C, Brocchi E, Ferrari A, et al. Guillotine needle biopsy as a supplement to endosonography in the diagnosis of gastric submucosal tumors.  Endoscopy. 1991;  23 251-254
  • 15 Giovannini M, Pesenti C, Rolland A L, et al. Endoscopic ultrasound guided drainage of pancreatic pseudo-cysts or pancreatic abscesses using a therapeutic echoendoscope.  .  Endoscopy. 2001;  33 473-477
  • 16 Fockens P, Johnson T G, van Dullemen H M, et al. Endosonographic imaging of pancreatic pseudocysts before endoscopic transmural drainage.  Gastrointest Endosc. 1997;  46 412-416
  • 17 Giovannini M, Bernardini D, Seitz J -F. Cystogastrostomy entirely performed under endosonography guidance for pancreatic pseudocysts: results in six patients.  Gastrointest Endosc. 1998;  48 200-203
  • 18 Seifert H, Dietrich C, Schmitt T, et al. Endoscopic ultrasound-guided one-step transmural drainage of cystic abdominal lesions with a large-channel echo endoscope.  Endoscopy. 2000;  32 255-259
  • 19 Wiersema M J, Wiersema L M. Endosonography-guided celiac plexus neurolysis.  Gastrointest Endosc. 1996;  44 656-662
  • 20 Gress F, Schmitt C, Sherman S, et al. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain.  Am J Gastroenterol. 1999;  94 900-905
  • 21 Gress F, Schmitt C, Sherman S, et al. Endoscopic ultrasound-guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience.  Am J Gastroenterol. 2001;  96 409-416
  • 22 Hoffman B J, Knapple W L, Bhutani M S, et al. Treatment of achalasia by injection of botulinum toxin under endoscopic ultrasound guidance.  Gastrointest Endosc. 1997;  45 77-79
  • 23 Lahoti S, Catalano M F, Alcocer E, et al. Obliteration of esophageal varices using EUS-guided sclerotherapy with color Doppler.  Gastrointest Endosc. 2000;  51 331-333
  • 24 Chang K J, Nguyen P T, Thompson J A, et al. Phase I clinical trial of allogeneic mixed lymphocyte culture (cytoimplant) delivered by endoscopic ultrasound-guided fine-needle injection in patients with advanced pancreatic carcinoma.  Cancer. 2000;  88 1325-1335
  • 25 Goldberg S N, Mallery S, Gazelle G S, Brugge W R. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model.  Gastrointest Endosc. 1999;  50 392-401
  • 26 Doniec M, Loehnert M, Kovacs G, et al. Rectal EUS-guided HDR brachytherapy in patients with anal and perianal malignancies.  Gastrointest Endosc. 2000;  51 AB106
  • 27 Bedford R, Hecht J, Lahoti S, et al. Tolerability and efficacy of direct injection of pancreatic adenocarcinomas with Onyx-015 under endoscopic ultrasound (EUS) guidance.  Gastrointest Endosc. 2000;  51 AB97
  • 28 Sahai A V, Hoffman B J, Hawes R H. Endoscopic ultrasound-guided hepaticogastrostomy to palliate obstructive jaundice: preliminary results in pigs (abstract).  Gastrointest Endosc. 1998;  47 AB37

G. Caletti,M.D. 

Dipartimento di Medicina Interna e Gastroenterologia
Policlinico S. Orsola

Via Massarenti 9
40138 Bologna
Italy


Fax: Fax:+ 39-051-6364358

Email: E-mail:caletti@med.unibo.it