Clinical Endoscopy

Review

Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE): Moon Jae Chung, Se Woo Park, Seong-Hun Kim, Chang Min Cho, Jun-Ho Choi, Eun Kwang Choi, Tae Hoon Lee, Eunae Cho, Jun Kyu Lee, Tae Jun Song, Jae Min Lee, Jun Hyuk Son, Jin Suk Park, Chi Hyuk Oh, Dong-Ah Park, Jeong-Sik Byeon, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun, Ho Soon Choi, Chan Guk Park, Joo Young Cho; Clin Endosc 2021;54(2):161-181. Published online March 24, 2021; DOI: https://doi.org/10.5946/ce.2021.069

Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in 8 categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice.

Citations

Citations to this article as recorded by

An optimal curriculum for training in endoscopic ultrasound: a summarized evidence-based literature systematic review
Julieta Montanelli, Ariosto Honorio Hernandez Lara, Ana Karla Uribe Rivera, Juan Manuel Verde, Eike Burmester, Mohammad A. Al-Haddad, Stephan Hollerbach, Peter Vilmann, Monder Abu-Suboh Abadia, Abdenor Badaoui, Paolo Giorgio Arcidiacono, Christoph Schlag,
Surgical Endoscopy.2025; 39(7): 4076. CrossRef
Expanding the horizon of diagnostic endosonograpy: the promise of trans-colorectal endoscopic ultrasound-guided fine-needle aspiration
Hao-Che Chang, Ping-Huei Tseng, Li-Chun Chang
Clinical Endoscopy.2025; 58(6): 859. CrossRef
Role of Endoscopic Ultrasound in the Management of Pancreatic Cancer
Balaji Musunuri, Shiran Shetty
Indian Journal of Surgical Oncology.2024; 15(S2): 269. CrossRef
Endoscopic Ultrasound (EUS) guided biopsy of healthy pig pancreas: Towards the histological diagnosis of chronic pancreatitis.
Julio Iglesias-García, Yessica Domínguez-Novoa, Héctor Lazare-Iglesias, Antonio González-Cantalapiedra, Ihab Abdulkader-Nallib, Óscar Varela-López, José Lariño-Noia, Enrique Domínguez-Muñoz
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef
When ROSE is not possible: Evaluating the diagnostic yield of>4mm tissue specimen with macroscopi c onsite evaluation. 22G EUS-FNB Acquire needle experience
S. Karim, S. Kadir, A. Faryal
Endoscopy.2024; 56(S 02): S153. CrossRef
Optimising EUS-FNB guided tissue acquisition: The significance of TRAP score in solid pancreatic and gastrointestinal lesions for positive diagnostic output
S. Karim, S. Kadir, A. Faryal
Endoscopy.2024; 56(S 02): S380. CrossRef
Endoscopic ultrasound-guided tissue acquisition for personalized treatment in pancreatic adenocarcinoma
Sang Myung Woo
Clinical Endoscopy.2023; 56(2): 183. CrossRef
Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ
Hiroaki Kusunose, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Kazuki Endo, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
Clinical Endoscopy.2023; 56(3): 353. CrossRef
Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
Clinical Endoscopy.2023; 56(5): 658. CrossRef
Endoscopic ultrasound-guided tissue acquisition and gene panel testing for pancreatic cancer
Kentaro SUDO, Emiri KITA, Akiko TSUJIMOTO, Kazuyoshi NAKAMURA, Akiko ODAKA, Makiko ITAMI, Sana YOKOI, Hiroshi ISHII
Suizo.2022; 37(1): 8. CrossRef
Impact of rapid on-site evaluation on diagnostic accuracy of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a single center
Irem Guvendir, Itir Ebru Zemheri, Kamil Ozdil
BMC Gastroenterology.2022;[Epub] CrossRef
Endoscopic Ultrasound Guided Fine Needle Aspiration and Biopsy for Pancreatic Disease
Kwang Hyuck Lee
The Korean Journal of Pancreas and Biliary Tract.2021; 26(4): 241. CrossRef

14,459 View
351 Download
7 Web of Science
12 Crossref

Original Article

Clinical Value of Contrast-Enhanced Harmonic Endoscopic Ultrasonography in the Differential Diagnosis of Pancreatic and Gallbladder Masses: Galam Leem, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Si Young Song, Jae Bock Chung, Seung Woo Park; Clin Endosc 2018;51(1):80-88. Published online September 20, 2017; DOI: https://doi.org/10.5946/ce.2017.044

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Recent studies have revealed that contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) is beneficial in the differential diagnosis of malignant neoplasms of the pancreas and gallbladder from benign masses, in terms of the evaluation of microvasculature and real-time perfusion. In this study, we aimed to prove the clinical value of CEH-EUS in the differential diagnosis of pancreatic and gallbladder masses by direct comparison with that of conventional EUS.
Methods
We reviewed the sonographic images and medical information of 471 patients who underwent conventional EUS and CEH-EUS for the diagnosis of pancreatic and gallbladder masses at a single medical center (Severance Hospital, Seoul, Korea) between March 2010 and March 2016.
Results
The enhancement pattern of CEH-EUS of the pancreatic solid masses showed higher sensitivity and specificity in differentiating pancreatic adenocarcinoma and neuroendocrine tumors (82.0% and 87.9% for pancreatic adenocarcinoma and 81.1% and 90.9% for neuroendocrine tumors, respectively), and the area under the receiver operating characteristic curves was higher than that of conventional EUS. The enhancement texture of CEH-EUS of the gallbladder masses showed a higher sensitivity in differentiating malignant masses than that of conventional EUS; however, the difference between the areas under the receiver operating characteristic curves was not statistically significant.
Conclusions
CEH-EUS can complement conventional EUS in the diagnosis of pancreatic and gallbladder masses, in terms of the limitations of the latter.

Citations

Citations to this article as recorded by

Role of endoscopic ultrasonography in differential diagnosis of gallbladder wall thickening: a multi-center retrospective study
Min Woo Lee, Seong-Hun Kim, Woo Hyun Paik, Se Woo Park, Dong Wook Oh, Dong Kee Jang, Hyung Ku Chon, Sung Ill Jang, Jin Ho Choi, In Rae Cho, Ji Kon Ryu, Jae Hee Cho, Sang Hyub Lee
HPB.2026; 28(3): 324. CrossRef
Efficacy of Contrast‐Enhanced Endoscopic Ultrasound in the Diagnosis of Gallbladder Tumor: A Retrospective Multicenter Cohort Study
Kensaku Yoshida, Akinori Maruta, Shinya Uemura, Keisuke Iwata, Shogo Shimizu, Tsuyoshi Mukai, Takuji Iwashita, Masahito Shimizu
Journal of Hepato-Biliary-Pancreatic Sciences.2026;[Epub] CrossRef
Recent Advances in Endoscopic Ultrasound for Gallbladder Disease Diagnosis
Kosuke Takahashi, Eisuke Ozawa, Akane Shimakura, Tomotaka Mori, Hisamitsu Miyaaki, Kazuhiko Nakao
Diagnostics.2024; 14(4): 374. CrossRef
Clinical value of endoscopic ultrasound sound speed in differential diagnosis of pancreatic solid lesion and prognosis of pancreatic cancer
Jianing Qiu, Kangrong Li, Xiuyan Long, Xiaoyu Yu, Pan Gong, Yu Long, Xiaoyan Wang, Li Tian
Cancer Medicine.2024;[Epub] CrossRef
Endoscopic ultrasound diagnosis system based on deep learning in images capture and segmentation training of solid pancreatic masses
Anliu Tang, Pan Gong, Ning Fang, Mingmei Ye, Shan Hu, Jinzhu Liu, Wujun Wang, Kui Gao, Xiaoyan Wang, Li Tian
Medical Physics.2023; 50(7): 4197. CrossRef
Novel Technique of Endoscopic Ultrasonography for the Differential Diagnosis of Gallbladder Lesions and Intraductal Papillary Mucinous Neoplasms: A Single-Center Prospective Study
Yasunobu Yamashita, Reiko Ashida, Takaaki Tamura, Toshio Shimokawa, Hirofumi Yamazaki, Yuki Kawaji, Takashi Tamura, Keiichi Hatamaru, Masahiro Itonaga, Masayuki Kitano
Diagnostics.2023; 13(13): 2132. CrossRef
The Latest Advancements in Diagnostic Role of Endosonography of Pancreatic Lesions
Jagoda Oliwia Rogowska, Łukasz Durko, Ewa Malecka-Wojciesko
Journal of Clinical Medicine.2023; 12(14): 4630. CrossRef
The role of contrast-enhanced endoscopic ultrasound for biliary diseases
Senju Hashimoto, Eizaburo Ohno, Satoshi Yamamoto, Kazunori Nakaoka, Yoshiki Hirooka
Journal of Medical Ultrasonics.2023;[Epub] CrossRef
Contrast-enhanced harmonic endoscopic ultrasonography for predicting the efficacy of first-line gemcitabine and nab-paclitaxel chemotherapy in pancreatic cancer
Tomoya Emori, Reiko Ashida, Takashi Tamura, Yuki Kawaji, Keiichi Hatamaru, Masahiro Itonaga, Yasunobu Yamashita, Toshio Shimokawa, Nobuyuki Higashino, Akira Ikoma, Tetsuo Sonomura, Manabu Kawai, Masayuki Kitano
Pancreatology.2022; 22(4): 525. CrossRef
Differential diagnoses of gallbladder tumors using CT‐based deep learning
Hiroaki Fujita, Taiichi Wakiya, Keinosuke Ishido, Norihisa Kimura, Hayato Nagase, Taishu Kanda, Masashi Matsuzaka, Yoshihiro Sasaki, Kenichi Hakamada
Annals of Gastroenterological Surgery.2022; 6(6): 823. CrossRef
Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer
Yasutaka Ishii, Masahiro Serikawa, Tomofumi Tsuboi, Ryota Kawamura, Ken Tsushima, Shinya Nakamura, Tetsuro Hirano, Ayami Fukiage, Takeshi Mori, Juri Ikemoto, Yusuke Kiyoshita, Sho Saeki, Yosuke Tamura, Sayaka Miyamoto, Kazuaki Chayama
Diagnostics.2021; 11(2): 238. CrossRef
The Asian Federation of Societies for Ultrasound in Medicine and Biology (AFSUMB) Guidelines for Contrast-Enhanced Endoscopic Ultrasound
Masayuki Kitano, Yasunobu Yamashita, Ken Kamata, Tiing Leong Ang, Hiroo Imazu, Eizaburo Ohno, Yoshiki Hirooka, Pietro Fusaroli, Dong-Wan Seo, Bertrand Napoléon, Anthony Yuen Bun Teoh, Tae Hyeon Kim, Christoph F. Dietrich, Hsiu-Po Wang, Masatoshi Kudo
Ultrasound in Medicine & Biology.2021; 47(6): 1433. CrossRef
A simple method for diagnosing gallbladder malignant tumors with subserosa invasion by endoscopic ultrasonography
Mitsuru Sugimoto, Hiroki Irie, Mika Takasumi, Minami Hashimoto, Yuka Oka, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Jun Nakamura, Tsunetaka Kato, Ryoichiro Kobashi, Yuko Hashimoto, Shigeru Marubashi, Takuto Hikichi, Hiromasa Ohi
BMC Cancer.2021;[Epub] CrossRef
Correlation Between Enhancement Patterns on Transabdominal Ultrasound and Survival for Pancreatic Ductal Adenocarcinoma
Tongtong Zhou, Li Tan, Yang Gui, Jing Zhang, Xueqi Chen, Menghua Dai, Mengsu Xiao, Qing Zhang, Xiaoyan Chang, Qun Xu, Chunmei Bai, Yuejuan Cheng, Qiang Xu, Xue Wang, Hua Meng, Wanying Jia, Ke Lv, Yuxin Jiang
Cancer Management and Research.2021; Volume 13: 6823. CrossRef
The Role of Endoscopic Ultrasound in the Diagnosis of Gallbladder Lesions
Senju Hashimoto, Kazunori Nakaoka, Naoto Kawabe, Teiji Kuzuya, Kohei Funasaka, Mitsuo Nagasaka, Yoshihito Nakagawa, Ryoji Miyahara, Tomoyuki Shibata, Yoshiki Hirooka
Diagnostics.2021; 11(10): 1789. CrossRef
Utility of Contrast-Enhanced Harmonic Endoscopic Ultrasonography for Early Diagnosis of Small Pancreatic Cancer
Yasunobu Yamashita, Kensuke Tanioka, Yuki Kawaji, Takashi Tamura, Junya Nuta, Keiichi Hatamaru, Masahiro Itonaga, Takeichi Yoshida, Yoshiyuki Ida, Takao Maekita, Mikitaka Iguchi, Masaki Terada, Tetsuo Sonomura, Seiko Hirono, Ken-Ichi Okada, Manabu Kawai,
Diagnostics.2020; 10(1): 23. CrossRef
The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid
Jae Young Lee, Yasunori Minami, Byung Ihn Choi, Won Jae Lee, Yi-Hong Chou, Woo Kyoung Jeong, Mi-Suk Park, Nobuki Kudo, Min Woo Lee, Ken Kamata, Hiroko Iijima, So Yeon Kim, Kazushi Numata, Katsutoshi Sugimoto, Hitoshi Maruyama, Yasukiyo Sumino, Chikara Oga
Ultrasonography.2020; 39(3): 191. CrossRef
Les nouvelles techniques diagnostiques des tumeurs neuroendocrines pancréatiques
R. Coriat
Oncologie.2020;[Epub] CrossRef
RETRACTED ARTICLE: Meta-analysis of contrast-enhanced ultrasound and contrast-enhanced harmonic endoscopic ultrasound for the diagnosis of gallbladder malignancy
Xue Liang, Xiang Jing
BMC Medical Informatics and Decision Making.2020;[Epub] CrossRef
Impact of endoscopic ultrasonography on diagnosis of pancreatic cancer
Masayuki Kitano, Takeichi Yoshida, Masahiro Itonaga, Takashi Tamura, Keiichi Hatamaru, Yasunobu Yamashita
Journal of Gastroenterology.2019; 54(1): 19. CrossRef
Value of contrast‐enhanced harmonic endoscopic ultrasonography with enhancement pattern for diagnosis of pancreatic cancer: A meta‐analysis
Yasunobu Yamashita, Toshio Shimokawa, Bertrand Napoléon, Pietro Fusaroli, Rodica Gincul, Masatoshi Kudo, Masayuki Kitano
Digestive Endoscopy.2019; 31(2): 125. CrossRef
Cavernous Hemangioma of the Gallbladder Masquerading as a Carcinoma
Naotake Funamizu, Yukio Nakabayashi
Case Reports in Gastroenterology.2019; 13(1): 219. CrossRef
Can Contrast-Enhanced Harmonic Endoscopic Ultrasonography Differentiate Malignancy from Benign Disease?
Tae Hoon Lee
Clinical Endoscopy.2018; 51(1): 5. CrossRef
Indication and Usefulness of Bile Juice Cytology for Diagnosis of Gallbladder Cancer
Hiroshi Itsuki, Masahiro Serikawa, Tamito Sasaki, Yasutaka Ishii, Ken Tsushima, Yoshinari Furukawa, Yoshiaki Murakami, Koji Arihiro, Kazuaki Chayama
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef
Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies
Lingaku Lee, Tetsuhide Ito, Robert T. Jensen
Expert Review of Anticancer Therapy.2018; 18(9): 837. CrossRef
Accuracy of EUS and CEH EUS for the diagnosis of pancreatic tumours
B. Bunganič, M. Laclav, T. Dvořáková, O. Bradáč, E. Traboulsi, Š. Suchánek, P. Frič, M. Zavoral
Scandinavian Journal of Gastroenterology.2018; 53(10-11): 1411. CrossRef
Large cell neuroendocrine carcinoma and adenocarcinoma of gallbladder with concomitant hepatitis C infection
Sarthak Soin, Bibek Singh Pannu, Phyo Thazin Myint, Amandeep Singh Dhillon
BMJ Case Reports.2018; 2018: bcr-2018-225141. CrossRef

9,544 View
223 Download
32 Web of Science
27 Crossref

Focused Review Series: Past, present and future of gastrointestinal stents

Past, Present, and Future of Gastrointestinal Stents: New Endoscopic Ultrasonography-Guided Metal Stents and Future Developments: Hee Seung Lee, Moon Jae Chung; Clin Endosc 2016;49(2):131-138. Published online March 22, 2016; DOI: https://doi.org/10.5946/ce.2016.044

Abstract PDF PubReader ePub

Innovations in stent technology and technological advances in endoscopic ultrasonography have led to rapid expansion of their use in the field of gastrointestinal diseases. In particular, endoscopic ultrasonography-guided metal stent insertion has been used for the management of pancreatic fluid collection, bile duct drainage, gallbladder decompression, and gastric bypass. Endoscopic ultrasonography-guided drainage of intra-abdominal fluid collections using a plastic or metal stent is well established. Because of the various limitations—such as stent migration, injury and bleeding in the lumen—recently developed, fully covered self-expanding metal stents or lumen-apposing metal stents have been introduced for those fluids management. This article reviews the recent literature on newly developed endoscopic ultrasonography-guided metal stents and the efficacy thereof.

Citations

Citations to this article as recorded by

Extrapancreatic Advanced Endoscopic Interventions
Haresh Vijay Naringrekar, Haroon Shahid, Cyril Varghese, Alex Schlachterman, Sandeep P. Deshmukh, Christopher G. Roth
RadioGraphics.2022; 42(2): 379. CrossRef
Endoscopic Ultrasonography-guided Gastrojejunostomy for Patients with Gastric Outlet Obstruction and Pyloric Metal Stent Dysfunction
Byung Sun Kim, Sung Yeol Yang, Won Dong Lee, Jae Sun Song, Min A Yang, Gum Mo Jung, Jin Woong Cho, Ji Woong Kim
The Korean Journal of Gastroenterology.2022; 79(6): 260. CrossRef
Endoscopic transluminal interventions in the treatment of acute necrotizing pancreatitis
A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
Khirurgiya. Zhurnal im. N.I. Pirogova.2021; (9): 85. CrossRef
Innovation of EUS-guided transmural gallbladder drainage using a novel self-expanding metal stent
Gunn Huh, Jin Ho Choi, Sang Hyub Lee, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim, Seok Jeong, Don Haeng Lee, Gyeong Hwan Kim, Sung Gwon Kang
Scientific Reports.2020;[Epub] CrossRef
Design of Continuum Robot With Variable Stiffness for Gastrointestinal Stenting Using Conformability Factor
Joonmyeong Choi, Se Hyeok Ahn, Chunwoo Kim, Jung-Hoon Park, Ho-Young Song, Kyu-Jin Cho
IEEE Transactions on Medical Robotics and Bionics.2020; 2(4): 529. CrossRef
Advanced Endoscopic Procedures: An Update for Radiologists
Preethi Guniganti, Andrea S. Kierans
American Journal of Roentgenology.2019; 213(2): 332. CrossRef
A novel lumen-apposing metal stent with an anti-reflux valve for endoscopic ultrasound-guided drainage of pseudocysts and walled-off necrosis: A pilot study
In Rae Cho, Moon Jae Chung, Jung Hyun Jo, Hee Seung Lee, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Haydar Celik
PLOS ONE.2019; 14(9): e0221812. CrossRef
Lumen-Apposing Metal Stents
Matthew W. Stier, Irving Waxman
Gastrointestinal Endoscopy Clinics of North America.2018; 28(2): 207. CrossRef
A Newly Designed, Fully Covered, Metal Stent with Wide Flanges for EUS-Guided Drainage and Access
Tae Yoon Lee, Young Koog Cheon, Chan Sup Shim
The Korean Journal of Pancreas and Biliary Tract.2018; 23(4): 159. CrossRef
Lumen apposing metal stents: A review of current uses and outcomes
Jeffrey S. Bank, Douglas G. Adler
International Journal of Gastrointestinal Intervention.2017; 6(1): 9. CrossRef

14,812 View
182 Download
7 Web of Science
10 Crossref

First
Prev
Page of 1
Next
Last

Search