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World J Clin Oncol. Feb 10, 2011; 2(2): 108-114
Published online Feb 10, 2011. doi: 10.5306/wjco.v2.i2.108
Interventional endoscopic ultrasonography for pancreatic cancer
Kazuo Hara, Kenji Yamao, Nobumasa Mizuno, Susumu Hijioka, Akira Sawaki, Masahiro Tajika, Hiroki Kawai, Shinya Kondo, Yasuhiro Shimizu, Yasumasa Niwa
Kazuo Hara, Kenji Yamao, Nobumasa Mizuno, Susumu Hijioka, Akira Sawaki, Masahiro Tajika, Hiroki Kawai, Shinya Kondo, Yasumasa Niwa, Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
Yasuhiro Shimizu, Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
Author contributions: Hara K planned of the work, revised the papers, selected figures and drafted the manuscript; Mizuno N, Hijioka S, Sawaki A, Tajika M, Kawai H and Kondo S performed interventional EUS and drafted the manuscript; Shimizu Y drafted the manuscript, analysed and interpreted of data and revised it critically for intellectual content; Niwa Y and Yamao K planned of the work, revised conduction of the work, drafted and revised it critically for intellectual content.
Correspondence to: Kazuo Hara, MD, Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan. khara@aichi-cc.jp
Telephone: +81-52-7626111 Fax: +81-52-7635233
Received: August 10, 2010
Revised: September 27, 2010
Accepted: October 4, 2010
Published online: February 10, 2011
Abstract

Endoscopic ultrasonography (EUS) represents the combination of endoscopy and intraluminal ultrasonography. This allows use of a high-frequency transducer (5-20 MHz) that, due to the short distance to the target lesion, provides ultrasonographic images of higher resolution than those obtained from other imaging modalities, including multiple-detector-row-computed tomography, magnetic resonance imaging, and positron emission tomography. EUS is now a widely accepted modality for diagnosing pancreatic diseases. However, the most important limitation of EUS has been the lack of specificity in differentiating between benign and malignant changes. In 1992, EUS-guided fine needle aspiration (FNA) of lesions in the pancreas head was introduced into clinical practice, using a curved linear-array echoendoscope. Since then, EUS has evolved from EUS imaging to EUS-FNA and wider applications. Interventional EUS for pancreatic cancer includes EUS-FNA, EUS-guided fine needle injection, EUS-guided biliary drainage and anastomosis, EUS-guided celiac neurolysis, radiofrequency ablation, brachytherapy, and delivery of a growing number of anti-tumor agents. This review focuses on interventional EUS, including EUS-FNA and therapeutic EUS for pancreatic cancer.

Keywords: Endoscopic ultrasonography-biliary drainage; Endoscopic ultrasonography-choledochoduodenostomy; Endoscopic ultrasonography-fine needle aspiration; Endoscopic ultrasonography-guided biliary drainage; Interventional endoscopic ultrasonography