Gheorghiu MI, Seicean A, Pojoga C, Hagiu C, Seicean R, Sparchez Z. Contrast-enhanced guided endoscopic ultrasound procedures. World J Gastroenterol 2024; 30(17): 2311-2320 [PMID: 38813054 DOI: 10.3748/wjg.v30.i17.2311]
Corresponding Author of This Article
Andrada Seicean, MD, PhD, Professor, Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, No. 19-21 Str Croitorilor, Cluj-Napoca 400162, Cluj, Romania. andradaseicean@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Marcel Ioan Gheorghiu, Andrada Seicean, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Zeno Sparchez
Marcel Ioan Gheorghiu, Andrada Seicean, Cristina Pojoga, Claudia Hagiu, Zeno Sparchez, Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400162, Cluj, Romania
Cristina Pojoga, Department of Clinical Psychology and Psychotherapy, International Institute for Advanced Study of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca 400375, Cluj, Romania
Radu Seicean, The First Surgical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca 400006, Cluj, Romania
Author contributions: Gheorghiu MI and Sparchez Z contributed to the manuscript writing and study design; Gheorghiu MI, Seicean A, Pojoga C, Hagiu C, Seicean R, and Sparchez Z reviewed the literature, revised the draft, and validated the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrada Seicean, MD, PhD, Professor, Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, No. 19-21 Str Croitorilor, Cluj-Napoca 400162, Cluj, Romania. andradaseicean@gmail.com
Received: January 28, 2024 Revised: March 10, 2024 Accepted: April 15, 2024 Published online: May 7, 2024
Abstract
Contrast-enhanced endoscopic ultrasound (CH-EUS) can overcome the limitations of endoscopic ultrasound-guided acquisition by identifying microvessels inside inhomogeneous tumours and improving the characterization of these tumours. Despite the initial enthusiasm that oriented needle sampling under CH-EUS guidance could provide better diagnostic yield in pancreatic solid lesions, further studies did not confirm the supplementary values in cases of tissue acquisition guided by CH-EUS. This review details the knowledge based on the available data on contrast-guided procedures. The indications for CH-EUS tissue acquisition include isoechoic EUS lesions with poor visible delineation where CH-EUS can differentiate the lesion vascularisation from the surrounding parenchyma and also the mural nodules within biliopancreatic cystic lesions, which occur in select cases. Additionally, the roles of CH-EUS-guided therapy in patients whose pancreatic fluid collections or bile ducts that have an echogenic content have indications for drainage, and patients who have nonvisualized vessels that need to be highlighted via Doppler EUS are presented. Another indication is represented if there is a need for an immediate assessment of the post-radiofrequency ablation of pancreatic neuroendocrine tumours, in which case CH-EUS can be used to reveal the incomplete tumour destruction.
Core Tip: Contrast-enhanced endoscopic ultrasound may be better at identifying the targeted area in lesions by avoiding necrosis and vessels and improving the delineation of lesion margins. Guided fine-needle aspiration or fine-needle biopsy is simple and safe, but its benefit is limited to isoenhanced lesions or those with important surrounding fibrosis. These guided endoscopic ultrasound techniques can also be useful for guiding drainage in patients who have very echogenic content of pancreatic fluid collections or bile ducts.
