• Users Online:953
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Reader Login
Export selected to
Reference Manager
Medlars Format
RefWorks Format
BibTex Format
  Most popular articles (Since September 24, 2013)

  Archives   Most popular articles   Most cited articles
Hide all abstracts  Show selected abstracts  Export selected to
  Viewed PDF Cited
Von Hippel-Lindau syndrome with pancreatic adenocarcinoma (with videos)
Chenchen Zhang, Ning Zhong, Xiao Wang, Qingqing Qi, Zhen Li
July-August 2021, 10(4):311-312
DOI:10.4103/EUS-D-20-00213  PMID:33586693
  80,284 139 -
Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound
Roy Liu, Douglas G Adler
July-September 2014, 3(3):152-160
Gastrointestinal tract duplication cysts are rare congenital gastrointestinal malformation in young patients and adults. They consist of foregut duplication cysts, small bowel duplication cysts, and large bowel duplication cysts. Endoscopic ultrasound (EUS) has been widely used as a modality for the evaluation and diagnosis of duplication cysts. EUS is the diagnostic tool of choice to investigate duplication cysts since it can distinguish between solid and cystic lesions. The question of whether or not to perform EUS-fine needle aspiration (EUS-FNA) on a lesion suspected of being a duplication cyst is controversial as these lesions can become infected with significant consequences, although EUS-FNA is often required to obtain a definitive diagnosis and to rule out more ominous lesions. This manuscript will review the literature on duplication cysts throughout the body and will also focus on the role of EUS and FNA with regards to these lesions.
  28,051 2,553 96
Standard imaging techniques for assessment of portal venous system and its tributaries by linear endoscopic ultrasound: A pictorial essay
CS Rameshbabu, Zeeshn Ahamad Wani, Praveer Rai, Almessabi Abdulqader, Shubham Garg, Malay Sharma
January-March 2013, 2(1):16-34
Linear Endosonography has been used to image the Portal Venous System but no established standard guidelines exist. This article presents techniques to visualize the portal venous system and its tributaries by linear endosonography. Attempt has been made to show most of the first order tributaries and some second order tributaries of splenic vein, superior mesenteric vein and portal vein.
  19,329 2,527 2
Yield of endoscopic ultrasound-guided fine needle aspiration for subcentimetric lymph nodes: A comparison to larger nodes
Narendra S Choudhary, Vijay Bodh, Naveen Kumar, Rajesh Puri, Haimanti Sarin, Mridula Guleria, Tarun Piplani, Sonal Krishan, Rahul Rai, Randhir Sud
May-June 2017, 6(3):168-173
DOI:10.4103/2303-9027.208151  PMID:28621293
Background and Objectives: Subcentimetric (defined as <1 cm at short axis) lymph nodes are considered benign and there is limited literature on the results of fine needle aspiration (FNA) of these nodes. Methods: Endoscopic ultrasound (EUS) guided FNA was done on 189 lymph nodes in 166 patients with pyrexia of unknown origin (n = 113) or malignancy (n = 53). Subcentimetric lymph nodes (Group A) were compared to nodes with short axis diameter ≥1 cm (Group B). Data are shown as number, percentage, and median (25–75 interquartile range). Results: There was no significant difference between Group A and Group B regarding site of lymph nodes (mediastinal in 73.6 and 72.5%, abdominal in 26.3 vs. 27.4%), number of slides (median 14 vs. 15), needle passes (median 2), and needle used (22 G needle in 85.5% vs. 69.9%). Group A had significantly lesser long axis diameter (1.5 [1.2–2] vs. 2.1 [1.6–2.9] cm) and short axis diameter (0.7 [0.6–0.8) vs. 1.4 [1.1–1.6] cm). A diagnosis (pathologic or reactive) could not be made in 2 (2.6%) and 11 (9.7%) lymph nodes in Group A and Group B, respectively (P = 0.078), due to inadequate material. Respective diagnoses in Group A and Group B were reactive lymphadenopathy (51.3% vs. 18.5%, P = 0.000), granulomatous lymphadenopathy (34.2% vs. 53%, P = 0.011), and malignancy (11.8% vs. 18.5%, P = 0.231). The lymph nodes with granulomatous and malignant change were significantly larger and had higher chances of having sharply demarcated borders as compared to reactive nodes. Conclusion: EUS-guided FNA of subcentimetric lymph nodes have comparable results to larger nodes. Almost half of the subcentimetric lymph nodes are pathologic.
  19,946 262 2
When to puncture, when not to puncture: Submucosal tumors
Wajeeh Salah, Douglas O Faigel
April-June 2014, 3(2):98-108
DOI:10.4103/2303-9027.131038  PMID:24955339
Subepithelial masses of the gastrointestinal (GI) tract are a frequent source of referral for endosonographic evaluation. Subepithelial tumors most often appear as protuberances in the GI tract with normal overlying mucosa. When there is a need to obtain a sample of the mass for diagnosis, endoscopic ultrasound (EUS) - guided fine-needle aspiration (FNA) is superior to other studies and should be the first choice to investigate any subepithelial lesion. When the decision is made to perform EUS-guided FNA several technical factors must be considered. The type and size of the needle chosen can affect diagnostic accuracy, adequacy of sample size and number of passes needed. The use of a stylet or suction and a fanning or standard technique during EUS-guided FNA are other factors that must be considered. Another method proposed to improve the efficacy of EUS-guided FNA is having an on-site cytopathologist or cytotechnician. Large or well-differentiated tumors may be more difficult to diagnose by standard EUS-FNA and the use of a biopsy needle can be used to acquire a histopathology sample. This can allow preservation of tissue architecture and cellularity of the lesion and may lead to a more definitive diagnosis. Alternatives to FNA such as taking bite-on-bite samples and endoscopic submucosal resection (ESMR) have been studied. Comparison of these two techniques found that ESMR has a significantly higher diagnostic yield. Most complications associated with EUS-FNA such as perforation, infection and pancreatitis are rare and the severity and incidence of these adverse events is not known. Controversy exists as to the optimal method in which to perform EUS-FNA and larger prospective trials are needed.
  14,381 1,910 16
Basic technique in endoscopic ultrasound-guided fine needle aspiration for solid lesions: What needle is the best?
Jesse Lachter
January-March 2014, 3(1):46-53
DOI:10.4103/2303-9027.124313  PMID:24949410
Basic technique for endoscopic ultrasound (EUS) of solid lesions has developed during 30 years of EUS, as endoscopes and accessory equipment, particularly needles, have been developed. Systematic high-quality examinations require understanding and planning. Needles used for EUS-guided fine needle aspiration (FNA) have gone through many improvements; some 18 characteristics of any needle are presented and these come under consideration whenever choosing the best needle for each procedure. The bright future of EUS and FNA for solid lesions currently still leaves much room for continued developments.
  14,408 1,195 3
Portal venous system and its tributaries: A radial endosonographic assessment
Malay Sharma, C.S Ramesh Babu, Shubham Garg, Praveer Rai
July-September 2012, 1(2):96-107
DOI:10.7178/eus.02.008  PMID:24949345
The use of Color Doppler in endosonography has enabled detailed real-time assessment of the abdominal vasculature. Standard stations are used during the routine evaluation on endosonography. However, the imaging techniques do not describe the vascular imaging of the portal venous system and its tributaries, in detail. This article demonstrates the normal findings on the portal venous system and its tributaries using radial endosonography.
  12,383 1,354 -
An unusual case: Pseudoachalasia caused by metastatic ovarian cancer
Jialiang Huang, Liming Xu, Guilian Cheng, Wei Wu, Wen Tang, Longjiang Xu, Duanmin Hu
November-December 2021, 10(6):479-480
DOI:10.4103/EUS-D-20-00217  PMID:33885000
  13,452 139 -
Endoscopic ultrasound of peritoneal spaces
Malay Sharma, Jayan Gopinath Madambath, Piyush Somani, Amit Pathak, Chittapuram Srinivasan Rameshbabu, Raghav Bansal, Kovil Ramasamy, Amol Patil
March-April 2017, 6(2):90-102
DOI:10.4103/2303-9027.204816  PMID:28440234
The peritoneal cavity is subdivided into supracolic and infracolic compartments by transverse colon and its mesocolon. The supracolic compartment contains the liver, spleen, stomach, and lesser omentum. The infracolic compartment contains the coils of small bowel surrounded by ascending, transverse, and descending colon and the paracolic gutters. The imaging of different compartments is possible by various methods such as ultrasound (US) and computerized tomography. The treating physicians should be familiar with the relevant radiological anatomy of different compartments and spaces as accurate localization of fluid collection/lymph node in peritoneal cavity greatly aids in selection of a treatment strategy. The role of endoscopic US (EUS) is emerging for detail evaluation of all parts of peritoneal cavity as it provides an easy access for fine-needle aspiration from different compartments of peritoneal cavity. In this review, we describe the techniques of evaluation of different parts of supracolic compartments of peritoneum by EUS.
  12,267 878 3
Imaging of peritoneal ligaments by endoscopic ultrasound (with videos)
Malay Sharma, Praveer Rai, Chittapuram Srinivasan Rameshbabu, Baiju Senadhipan
January-March 2015, 4(1):15-27
DOI:10.4103/2303-9027.151317  PMID:25789280
Double layered peritoneal folds or ligaments act as conduits for the passage of blood vessels in intraperitoneal organs and also provide a pathway for the spread of disease. It is difficult to identify these normal peritoneal folds at imaging. Computed tomography is the most common imaging modality used to detect diseases of the peritoneum. The ultrasound (US) has been also used for evaluation of diseases involving ligaments. Endoscopic ultrasound (EUS) is being increasingly used both for diagnostic and interventional purposes in abdomen. In this article, we have described the normal EUS anatomy of the peritoneal ligaments.
  11,909 1,199 8
Role of endoscopic ultrasound in treatment of pancreatic cancer
Xiaozhong Guo, Zhongmin Cui, Zhigang Hu
October-December 2013, 2(4):181-189
DOI:10.4103/2303-9027.121238  PMID:24949393
Endoscopic ultrasound (EUS) can help diagnose diseases with high accuracy because it overcomes the limitations of gastrointestinal gas and abdominal fat. The emergence of curved linear-array echoendoscopy has significantly promoted the applications of the technique to new levels. The advancement has appeared from EUS imaging to EUS-guided fine needle aspiration, drainage and injection. Computed tomography and magnetic resonance imaging present certain limitations for diagnosing pancreatic tumors due to the specificity of the location of such growths. In addition, traditional chemotherapy does not show ideal results because pancreatic cancer (PC) exhibits hypovascular characteristics. Interventional EUS can overcome these limitations and has potential to become the mainstream method of PC local treatment in the future. This paper reviews the use of interventional EUS in the treatment of PC based on previous studies.
  7,742 2,954 11
Endoscopic ultrasound-guided fine needle aspiration: How to obtain a core biopsy?
Lorenzo Fuccio, Alberto Larghi
April-June 2014, 3(2):71-81
DOI:10.4103/2303-9027.123011  PMID:24955336
Endoscopic ultrasound (EUS)-guided fine needle aspiration has emerged as the procedure of choice to obtain samples to reach a definitive diagnosis of lesions of the gastrointestinal tract and of adjacent organs. The obtainment of a tissue core biopsy presents several advantages that can substantially contribute to the widespread diffusion of EUS utilization in the community and in countries where cytology expertise may be difficult to be achieved. This article will review the EUS-guided fine needle biopsy techniques developed so far, the clinical results, their limitations as well as their future perspective.
  9,216 1,445 13
Techniques of imaging of nodal stations of gastric cancer by endoscopic ultrasound
Malay Sharma, Praveer Rai, Chittapuram Srinivasan Rameshbabu
July-September 2014, 3(3):179-190
Nodal staging is of crucial importance in the management of gastric cancer (GC). The available modalities of nodal imaging in GC do not provide a high sensitivity and specificity of lymph node status. Comparative study of endoscopic ultrasonography (EUS) and multislice spiral computed tomography in GC has shown greater accuracy of EUS for N staging. EUS is not used routinely in patients with GC as it is not available at all centers, and its accuracy is operator dependent. Standard techniques of identification of nodal station (as suggested by Japanese Research Society for the Study of Gastric Cancer) by EUS have not been described so far. Identification of each nodal station by EUS requires adequate knowledge of anatomy as well as understanding the proper technique to perform EUS. This review presents a method to identify the regional nodal stations of GC by linear EUS and hence will help in appropriate N staging of GC.
  9,308 1,336 2
Techniques of imaging of the aorta and its first order branches by endoscopic ultrasound (with videos)
Malay Sharma, Praveer Rai, Varun Mehta, CS Rameshbabu
April-June 2015, 4(2):98-108
DOI:10.4103/2303-9027.156722  PMID:26020043
Endoscopic ultrasonography (EUS) is a useful modality for imaging of the blood vessels of the mediastinum and abdomen. The aorta acts as an important home base during EUS imaging. The aorta and its branches are accessible by standard angiographic methods, but endosonography also provides a unique opportunity to evaluate the aorta and its branches. This article describes the techniques of imaging of different part of the aorta by EUS.
  8,870 1,386 4
Endoscopic ultrasound forum summary from the asian pacific digestive week 2012
Pradermchai Kongkam, Benedict M Devereaux, Ryan Ponnudurai, Thawee Ratanachu-ek, Anand V Sahai, Takuji Gotoda, Suthep Udomsawaengsup, Jacques Van Dam, Nonthalee Pausawasdi, Somchai Limsrichemrern, Dong-Wan Seo, Shomei Ryozawa, Yoshiki Hirooka, Yongyut Sirivatanauksorn, Siyu Sun, Sundeep Punamiya, Takao Itoi, Bancha Ovartlanporn, Ichiro Yasuda, Tiing Leong Ang, Hsiu-Po Wang, Khek Yu Ho, Heng Boon Yim, Kenjiro Yasuda, Christopher J.L Khor
January-March 2013, 2(1):43-60
  9,319 587 4
Endobronchial ultrasound: First choice for the mediastinum
Felix J. F. Herth
October-December 2013, 2(4):179-180
DOI:10.4103/2303-9027.121235  PMID:24949392
  4,409 4,725 3
The role of EUS and EUS-guided FNA in the management of subepithelial lesions of the esophagus: A large, single-center experience
Birol Baysal, Omar A Masri, Mohamad A Eloubeidi, Hakan Senturk
September-October 2017, 6(5):308-316
DOI:10.4103/2303-9027.155772  PMID:26365993
Background: Referral for endosonographic evaluation of subepithelial lesions seen in the gastrointestinal (GI) tract is fairly common. Although rarely studied separately in details, esophageal lesions have some unique differences from other GI sites and might deserve some special considerations regarding follow-up and management. Materials and Methods: All cases referred for endoscopic ultrasound (EUS) evaluation of subepithelial esophageal lesions at Bezmialem University Hospital, a tertiary center in Istanbul, Turkey were retrospectively reviewed. Data were collected for patient and lesion characteristics as well as for pathology results and follow-up if available. Lesions were subcategorized according to their size, location, and final diagnosis. Results: A total of 164 EUS examinations were identified. In 22.5% of cases, the lesion could not be identified by EUS. Of the remaining cases, 57.6% had a lesion larger than 1 cm in size. Extramural compression was the diagnosis in 12% and leiomyoma in around 60%. Thirteen patients had follow-up examinations with only two showing an increase in size after 12 months. Sixty-five EUS-guided fine needle aspirations (EUS-guided FNAs) were performed, with around 50% having nondiagnostic samples and 94% of the remaining samples confirming the presumptive diagnosis. Conclusions: The majority of subepithelial lesions in the esophagus are benign with extremely low malignancy potential. EUS examinations performed for lesions smaller than 2 cm as well as FNAs taken from lesions smaller than 3 cm might have minimal impact on their ultimate management and outcome. More than one FNA pass should be attempted in order to improve the yield.
  8,089 772 10
Endoscopic ultrasound features of chronic pancreatitis: A pictorial review
Surinder Singh Rana, Peter Vilmann
January-March 2015, 4(1):10-14
DOI:10.4103/2303-9027.151314  PMID:25789279
As endoscopic ultrasound (EUS) is the most sensitive imaging modality for diagnosing pancreatic disorders, it can demonstrate subtle alterations in the pancreatic parenchymal and ductal structure even before traditional imaging and functional testing demonstrate any abnormality. In spite of this fact and abundant literature, the exact role of EUS in the diagnosis of chronic pancreatitis (CP) is still not established. The EUS features to diagnose CP have evolved over a period from a pure qualitative approach to more advanced and complicated scoring systems incorporating multiple parenchymal and ductal EUS features. The rosemont criteria have attempted to define precisely each EUS criterion and thus have good inter-observer agreement. However, initial studies have failed to demonstrate any significant improvement in the inter-observer variability and further validation studies are needed to define the exact role of these criteria. The measurement of strain ratio using quantitative EUS elastography and thus allowing quantification of pancreatic fibrosis seems to be a promising new technique.
  7,110 1,650 16
A multicenter evaluation of a new EUS core biopsy needle: Experience in 200 patients
Douglas G Adler, V. Raman Muthusamy, Dean S Ehrlich, Gulshan Parasher, Nirav C Thosani, Ann Chen, Jonathan M Buscaglia, Anoop Appannagari, Eduardo Quintero, Harry Aslanian, Linda Jo Taylor, Ali Siddiqui
March-April 2019, 8(2):99-104
DOI:10.4103/eus.eus_53_17  PMID:29623911
Background and Objectives: We present a multicenter study of a new endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle (Acquire, Boston Scientific, Natick, MA). The aim of the study was to analyze the needle's clinical performance when sampling solid lesions and to assess the safety of this device. Methods: We performed a multicenter retrospective study of patients undergoing EUS-FNB during July 1–November 15, 2016. Results: Two hundred patients (121 males and 79 females) underwent EUS-FNB of solid lesions with the Acquire needle. Lesions included solid pancreatic masses (n = 109), adenopathy (n = 45), submucosal lesions (n = 34), cholangiocarcinoma (n = 8), liver lesions (n = 6), and other (n = 8). Mean lesion size was 30.6 mm (range: 3–100 mm). The mean number of passes per target lesion was 3 (range: 1–7). Rapid onsite cytologic evaluation (ROSE) by a cytologist was performed in all cases. Tissue obtained by EUS-FNB was adequate for evaluation and diagnosis by ROSE in 197/200 cases (98.5%). Data regarding the presence or absence of a core of tissue obtained after EUS-FNB were available in 145/200 procedures. In 131/145 (90%) of cases, a core of tissue was obtained. Thirteen out of 200 patients (6.5%) underwent some form of repeat EUS-based tissue acquisition after EUS-FNB with the Acquire needle. There were no adverse events. Conclusion: Overall, this study showed a high rate of tissue adequacy and production of a tissue core with this device with no adverse events seen in 200 patients. Comparative studies of different FNB needles are warranted in the future to help identify which needle type and size is ideal in different clinical settings.
  8,155 570 36
Imaging of the pancreatic duct by linear endoscopic ultrasound
Malay Sharma, Praveer Rai, Chittapuram Srinivasan Rameshbabu, Shalini Arya
July-September 2015, 4(3):198-207
DOI:10.4103/2303-9027.162997  PMID:26374577
The current gold standard investigation for anatomic exploration of the pancreatic duct (PD) is endoscopic retrograde cholangiopancreatography. Magnetic resonance cholangiopancreatography is a noninvasive method for exploration of the PD. A comprehensive evaluation of the course of PD and its branches has not been described by endoscopic ultrasound (EUS). In this article, we describe the techniques of imaging of PD using linear EUS.
  7,092 1,624 2
Esophageal duplication cyst in an adult masquerading as submucosal tumor
Vinita Chaudhary, Surinder Singh Rana, Vishal Sharma, Amit Raj Sharma, Ritambhra Nada, Rajesh Gupta, Usha Dutta, Kartar Singh, Deepak Kumar Bhasin
July-September 2013, 2(3):165-167
Gastrointestinal duplications usually manifest in children and may involve the esophagus in 20% cases. Esophageal duplication cysts are a rare cause of dysphagia in adults. We report the case of a 35-year-old male who presented to us with progressive dysphagia of 6 months duration. Contrast enhanced computed tomography showed a soft-tissue lesion in right lateral wall of distal thoracic esophagus. On endoscopic ultrasound, a heterogeneously echotextured lesion with anechoic component present at intramural location in the lower esophagus was noted. The patient underwent surgical excision of the lesion and histopathology confirmed the diagnosis of esophageal duplication cyst.
  8,132 560 2
Endosonography-assisted diagnosis and therapy of gastrointestinal submucosal tumors
Jintao Guo, Zhijun Liu, Siyu Sun, Sheng Wang, Nan Ge, Xiang Liu, Guoxin Wang, Wen Liu
July-September 2013, 2(3):125-133
Submucosal tumors (SMTs) are usually discovered fortuitously during routine endoscopy, including various non-neoplastic and neoplastic conditions. Endoscopic ultrasound (EUS) is considered to be the best imaging procedure to characterize SMTs and to determine the need for further treatment. In this review, the following issues will be addressed: The role of EUS in diagnosis for SMTs, tissue diagnosis for SMTs and the influence of EUS on endoscopic resection techniques for SMTs.
  7,557 1,106 19
Fluid collection after partial pancreatectomy: EUS drainage and long-term follow-up
Fabrice Caillol, Sebastien Godat, Olivier Turrini, Christophe Zemmour, Erwan Bories, Christian Pesenti, Jean Phillippe Ratone, Jacques Ewald, Jean Robert Delpero, Marc Giovannini
March-April 2019, 8(2):91-98
DOI:10.4103/eus.eus_112_17  PMID:29600794
Background and Objectives: Postoperative fluid collection due to pancreatic leak is the most frequent complication after pancreatic surgery. EUS-guided drainage of post-pancreatic surgery fluid collection is the gold standard procedure; however, data on outcomes of this procedure are limited. The primary endpoint of our study was relapse over longterm followup, and the secondary endpoint was the efficiency and safety of EUS-guided drainage of post-pancreatic surgery fluid collection. Patients and Methods: This retrospective study was conducted at a single center from December 2008 to April 2016. Global morbidity was defined as the occurrence of an event involving additional endoscopic procedures, hospitalization, or interventional radiologic or surgical procedures. EUS-guided drainage was considered a clinical failure if surgery was required to treat a relapse after stent removal. Results: Fortyone patients were included. The technical success rate was 100%. Drainage was considered a clinical success in 93% (39/41) of cases. Additionally, 19 (46%) complications were identified as global morbidity. The duration between surgery and EUS-guided drainage was not a significantly related factor for morbidity rate (P = 0.8); however, bleeding due to arterial injuries (splenic artery and gastroduodenal artery) from salvage drainage procedures occurred within 25 days following the initial surgery. There was no difference in survival between patients with and without complications. No relapse was reported during the followup (median: 44.75 months; range: 29.24 to 65.74 months). Conclusion: EUSguided drainage for post-pancreatic surgery fluid collection was efficient with no relapse during longterm followup. Morbidity rate was independent of the duration between the initial surgery and EUS-guided drainage; however, bleeding risk was likely more important in cases of early drainage.
  7,745 457 9
Role of endoscopic ultrasound for pancreatic cystic lesions: Past, present, and future!
Manoop S Bhutani
October-December 2015, 4(4):273-275
DOI:10.4103/2303-9027.170400  PMID:26643692
  2,994 5,170 11
How good is fine needle aspiration? What results should you expect?
Pierre Eisendrath, Mostafa Ibrahim
January-March 2014, 3(1):3-11
DOI:10.4103/2303-9027.127122  PMID:24949404
Tissue acquisition plays a key role before treatment decision in most of oncological pathologies but also in several benign diseases. By offering tissue sampling, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become an essential tool in the diagnostic processes. One of the reasons for the success of the technique is related to its excellent diagnostic performance. The diagnostic accuracy of EUS-FNA is above 80% for most of the usual indications. These performances are however dependent on some factors related to both the disease and patient's medical history but also related to medical staff expertise. Endoscopist needs to know how to reach a lesion but also how to efficiently acquire good tissue samples. This review aims to report general recommendations available in the literature for high quality EUS-FNA. Sample processing and sample interpretation also influence diagnostic accuracy of FNA. This paper includes a discussion on sample processing and benefits of the on-site pathology examination. It also provides the results reported in the literature of sample adequacy and diagnostic performance of EUS-FNA for most common indications: Pancreatic diseases, sub-mucosal lesion, mucosal thickenings, lymph nodes, cystic lesion and free fluids.
  7,074 1,073 12