Twenty years after the introduction of endoscopic ultrasonography, many papers on
the topic are still being published every year in the medical literature. Along with
established clinical indications, such as gastrointestinal and pancreatic cancer staging
and differential diagnosis of submucosal tumors, new applications have been suggested,
such as mediastinal and liver tumor sampling with fine-needle aspiration.
Improved accuracy and cost-effectiveness have been demonstrated in comparison with
other imaging techniques. Reports of large series of fine-needle aspiration procedures
have described a high level of accuracy for EUS in the diagnosis of lymph nodes and
perivisceral masses. Pancreatic and ampullary tumors still represent a major challenge,
as shown by numerous articles describing differential-diagnostic criteria and cytological
sampling techniques. A few papers have also been published on the topic of portal
hypertension, but it seems questionable whether there is any real advantage for endoscopic
ultrasonography over traditional endoscopy here.
New techniques such as radiofrequency tumor ablation are promising, while others such
as three-dimensional imaging and the use of contrast enhancement have not yet met
with routine clinical application. Finally, some of the papers published during the
last year have studied the technique of endoscopic ultrasonography itself, dealing
with issues of outcome, current clinical availability and use, and the learning curve.
Evidently, endoscopic ultrasonography is still widely underused - not only among general
practitioners and physicians in other specialties, but even by gastroenterologists.
Although endoscopic ultrasonography is already 20 years old, considerable efforts
are still needed, therefore, to ensure that it becomes more widely accepted in clinical
practice.
References
- 1
Chak A.
Endoscopic ultrasonography.
Endoscopy.
2000;
32
146-152
- 2
Giovannini M, Monges G, Seitz J F, et al.
Distant lymph node metastases in esophageal cancer: impact of endoscopic ultrasound-guided
biopsy.
Endoscopy.
1999;
31
536-540
- 3
Wallace M B, Hawes R H, Sahai A V, et al.
Dilation of malignant esophageal stenosis to allow EUS guided fine-needle aspiration:
safety and effect on patient management.
Gastrointest Endosc.
2000;
51
309-313
- 4
Van Dam J, Rice T W, Catalano M F, et al.
High-grade malignant stricture is predictive of esophageal tumor stage: risks of endosonographic
evaluation.
Cancer.
1993;
71
2910-2917
- 5
Catalano M F, Van Dam J, Sivak MV J r.
Malignant esophageal strictures: staging accuracy of endoscopic ultrasonography.
Gastrointest Endosc.
1995;
41
535-539
- 6
Salminen J T, Farkkila M A, Ramo O J, et al.
Endoscopic ultrasonography in the preoperative staging of adenocarcinoma of the distal
oesophagus and oesophagogastric junction.
Scand J Gastroenterol.
1999;
34
1178-1182
- 7
Schlick T, Heintz A, Junginger T.
The examiner's learning effect and its influence on the quality of endoscopic ultrasonography
in carcinoma of the esophagus and gastric cardia.
Surg Endosc.
1999;
13
894-898
- 8
Wallace M B, Hoffman B J, Sahai A S, et al.
Imaging of esophageal tumors with a water-filled condom and a catheter US probe.
Gastrointest Endosc.
2000;
51
597-600
- 9
Aabakken L, Silvestri G A, Hawes R, et al.
Cost-efficacy of endoscopic ultrasonography with fine-needle aspiration vs. mediastinotomy
in patients with lung cancer and suspected mediastinal adenopathy.
Endoscopy.
1999;
31
707-711
- 10
Mishra G, Sahai A V, Penman I D, et al.
Endoscopic ultrasonography with fine-needle aspiration: an accurate and simple diagnostic
modality for sarcoidosis.
Endoscopy.
1999;
31
377-382
- 11
Ohashi S, Segawa K, Okamura S, et al.
The utility of endoscopic ultrasonography and endoscopy in the endoscopic mucosal
resection of early gastric cancer.
Gut.
1999;
45
599-604
- 12
Kojima T, Takahashi H, Parra-Bianco A, et al.
Diagnosis of submucosal tumor of the upper GI tract by endoscopic resection.
Gastrointest Endosc.
1999;
50
516-522
- 13
Palazzo L, Landi B, Cellier C, et al.
Endosonographic features predictive of benign and malignant gastrointestinal stromal
cell tumours.
Gut.
2000;
46
88-92
- 14
Gress F G, Hawes R H, Savides T J, et al.
Role of EUS in the preoperative staging of pancreatic cancer: a large single center
experience.
Gastrointest Endosc.
1999;
50
786-791
- 15
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
- 16
Voss M, Hammel P, Molas G, et al.
Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis
of solid pancreatic masses.
Gut.
2000;
46
244-249
- 17
Gress F, Gottlieb K, Cummings O, et al.
Endoscopic ultrasound characteristics of mucinous cystic neoplasms of the pancreas.
Am J Gastroenterol.
2000;
95
961-965
- 18
Ardengh J C, Rosenbaum P, Ganc A J, et al.
Role of EUS in the preoperative localization of insulinomas compared with spiral CT.
Gastrointest Endosc.
2000;
51
552-555
- 19
Kubo H, Chijiiwa Y, Akahoshi K, et al.
Pre-operative staging of ampullary tumours by endoscopic ultrasound.
Br J Radiol.
1999;
72
443-447
- 20
Cannon M E, Carpenter S L, Elta G H, et al.
EUS compared with CT, magnetic resonance imaging, and angiography and the influence
of biliary stenting on staging accuracy of ampullary neoplasms.
Gastrointest Endosc.
1999;
50
27-33
- 21
Hastier P, Buckley M JM, Francois R, et al.
A prospective study of pancreatic disease in patients with alcoholic cirrhosis: comparative
diagnostic value of ERCP and EUS and long-term significance of isolated parenchymal
abnormalities.
Gastrointest Endosc.
1999;
49
705-709
- 22
Sahai A V, Mishra G, Penman I D, et al.
EUS to detect evidence of pancreatic disease in patients with persistent or nonspecific
dyspepsia.
Gastrointest Endosc.
2000;
52
153-159
- 23
Tamada K, Wada S, Ohashi A, et al.
Intraductal US in assessing the effects of radiation therapy and prediction of patency
of metallic stents in extrahepatic bile duct carcinoma.
Gastrointest Endosc.
2000;
51
405-411
- 24
Chak A, Isenberg G, Kobayashi K, et al.
Prospective evaluation of an over-the-wire catheter US probe.
Gastrointest Endosc.
2000;
51
202-205
- 25
Menzel J, Poremba C, Dietl K H, Domschke W.
Preoperative diagnosis of bile duct strictures: comparison of intraductal ultrasonography
with conventional endosonography.
Scand J Gastroenterol.
2000;
35
77-82
- 26
Polkowski M, Palucki J, Regula J, et al.
Helical computed tomographic cholangiography versus endosonography for suspected bile
duct stones: a prospective blinded study in non-jaundiced patients.
Gut.
1999;
45
744-749
- 27
Liu C L, Lo C M, Chan J KF, et al.
EUS for detection of occult cholelithiasis in patients with idiopathic pancreatitis.
Gastrointest Endosc.
2000;
51
28-32
- 28
Lachter J, Rubin A, Shiller M, et al.
Linear EUS for bile duct stones.
Gastrointest Endosc.
2000;
51
51-54
- 29
Sugiyama M, Atomi Y, Yamato T.
Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions:
analysis in surgical and follow up series.
Gut.
2000;
46
250-254
- 30
Fujita N, Noda Y, Kobayashi G, et al.
Diagnosis of the depth of invasion of gallbladder carcinoma by EUS.
Gastrointest Endosc.
1999;
50
659-663
- 31
McClave S A, Jones W F, Woolfolk G M, et al.
Mistakes on EUS staging of colorectal carcinoma: error in interpretation or deception
from innate pathologic features?.
Gastrointest Endosc.
2000;
51
682-689
- 32
Norton S A, Thomas M G.
Staging of rectosigmoid neoplasia with colonoscopic endoluminal ultrasonography.
Br J Surg.
1999;
86
942-946
- 33
Lohnert M S, Doniec J M, Henne-Bruns D.
Effectiveness of endoluminal sonography in the identification of occult local rectal
cancer recurrence.
Dis Colon Rectum.
2000;
43
483-491
- 34
Spinelli P, Schiavo M, Meroni E, et al.
Results of EUS in detecting perirectal lymph node metastases of rectal cancer: the
pathologist makes the difference.
Gastrointest Endosc.
1999;
49
754-758
- 35
Magdeburg B, Fried M, Meyenberger C.
Endoscopic ultrasonography in the diagnosis, staging, and follow-up of anal carcinomas.
Endoscopy.
1999;
31
359-364
- 36
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
- 37
Sahai A V, Schembre D, Stevens P D, et al.
A multicenter U.S. experience with EUS-guided fine-needle aspiration using the Olympus
GF-UM30P echoendoscope: safety and effectiveness.
Gastrointest Endosc.
1999;
50
792-796
- 38
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
- 39
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
- 40
Lee Y T, Chan F KL, Ng E KW, et al.
EUS-guided injection of cyanoacrylate for bleeding gastric varices.
Gastrointest Endosc.
2000;
52
168-174
- 41
Nguyen P, Feng J C, Chang K J.
Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (FNA) of liver lesions.
Gastrointest Endosc.
1999;
50
357-361
- 42
Erickson R A, Tretjak Z.
Clinical utility of endoscopic ultrasound and endoscopic ultrasound-guided fine needle
aspiration in retroperitoneal neoplasms.
Am J Gastroenterol.
2000;
95
1188-1194
- 43
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
- 44
Chak A, Isenberg G, Mallery S, et al.
Prospective comparative evaluation of video US endoscope.
Gastrointest Endosc.
1999;
49
695-699
- 45
Nomura N, Goto H, Niwa Y, et al.
Usefulness of contrast-enhanced EUS in the diagnosis of upper GI tract disease.
Gastrointest Endosc.
1999;
50
555-560
- 46
Tamada K, Tomiyama T, Ohashi A, et al.
Preoperative assessment of extrahepatic bile duct carcinoma using three-dimensional
intraductal US.
Gastrointest Endosc.
1999;
50
548-554
- 47
Allescher H D, Rösch T, Willkomm G, et al.
Performance, patient acceptance, appropriateness of indications and potential influence
on outcome of EUS: a prospective study in 397 consecutive patients.
Gastrointest Endosc.
1999;
50
737-745
- 48
Nickl N.
Endosonography at a crossroads: the outcomes obligation.
Gastrointest Endosc.
1999;
50
875-878
- 49
Kim L S, Koch J.
Do we practice what we preach? Clinical decision making and utilization of endoscopic
ultrasound for staging esophageal cancer.
Am J Gastroenterol.
1999;
94
1847-1852
G. Caletti,M.D.
Dipartimento di Medicina Interna e Gastroenterologia
Policlinico S. Orsola
Via Massarenti 9
40138 Bologna
Italy
Fax: Fax:+ 39-51-6364358
eMail: E-mail:caletti@med.unibo.it
