Endoscopic ultrasound -guided

Vander Noot MR III, Eloubeidi MA, Chen VK et al (2004) Diagnosis of gastrointestinal tract lesions by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer 102 157-163... 

Yan BM, Van Dam J (2008) Endoscopic ultrasound-guided intratumoural therapy for pancreatic cancer. Can J Gastroenterol 22(4) 405-410... 

Vilmann P, Krasnik M, Larsen SS, et al. Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy a combined approach in the evaluation of mediastinal lesions. Endoscopy 2005 37(9) 833-839. 

Larsen SS, Krasnik M, Vilmann P, et al. Endoscopic ultrasound guided biopsy of mediastinal lesions has a major impact on patient management. Thorax 2002 57(2) 98-103. 

Linghu, E., Matthes, K., Mino-Kenudson, M., Brugge, W.R. Feasibility of endoscopic ultrasound-guided OncoGel (ReGel/paclitaxel) injection into the pancreas in pigs. Endoscopy 37(11), 1140-1142 (2005). doi 10.1055/s-870224... 

The diagnosis of carcinoid and submucosal tumors by endoscopy or barium contrast studies is not easy since these tumors are usually covered with a normal mucosal layer. To determine the main portion of the wall stratification in the gastrointestinal wall in which the tumors lie is the most important part of diagnostic imaging of submucosal tumors. For this purpose, endoscopic ultrasound (BUS), including the use of an EUS-guided fine-needle aspiration biopsy (FNA), is the best choice (Arantes et al. 2004 Vandernoot et... 

Ultrasound-guided FNBs (Ledermann etal. 2001) have been performed mostly in suspected primary or metastatic neoplastic gastrointestinal lesions, also in those patients with HIV infection (Bhaduri et al. 1999) in which gastrointestinal manifestations (such as opportunistic infections or lymphoproliferative or neoplastic disease) occurs in about 50% of the patients, and endoscopic diagnosis is not possible due to the submucosal nature of the disease (Fig. 24.6). 

Fig. 24.7. Ultrasound-guided fine-needle biopsy with a cutting needle in a case of endoscopically negative biopsies. The needle tip is clearly visible in hypoechoic gastric wall (arrow). Final diagnosis gastric adenocarcinoma...

Arantes V, Logrono R, Faruqi S et al (2004) Endoscopic sono-graphically guided fine-needle aspiration yield in submucosal tumors of the gastrointestinal tract. J Ultrasound Med... 

The indications to the procedure were impossibility to perform endoscopy in 8 cases, non-diagnostic endoscopic biopsies in 20 cases (Fig. 24.7), and endo-scopically inaccessible lesion in 6 cases (Fig. 24.8). No complications occurred and the procedure was well tolerated in all patients however, an alternative approach to diagnosis of gastrointestinal diseases may be needed in some cases. In particular when the lesion is clearly visible at ultrasound, US-guided FNB could be considered a simple, rapid, relatively non-invasive and accurate procedure. 

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