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Endosonography E-Book

Endosonography E-Book

Robert H. Hawes | Paul Fockens

(2010)

Additional Information

Book Details

Abstract

Endosonography—by Drs. Robert H. Hawes, Paul Fockens, and Shyam Varadarjulu—is a rich visual guide that covers everything you need to effectively perform EUS, interpret your findings, diagnose accurately, and choose the best treatment course. World-renowned endosonographers help beginners apply endosonography in the staging of cancers, evaluating chronic pancreatitis, and studying bile duct abnormalities and submucosal lesions. Practicing endosonographers can learn cutting-edge techniques for performing therapeutic interventions such as drainage of pancreatic pseudocysts and EUS-guided anti-tumor therapy. This updated 2nd edition features online access to the fully searchable text, videos detailing various methods and procedures, and more at www.expertconsult.com. You’ll have a complete overview of all aspects of EUS, from instrumentation to therapeutic procedures.

  • Gain a detailed visual understanding on how to perform EUS using illustrations and high-quality images.
  • Understand the role of EUS with the aid of algorithms that define its place in specific disease states.
  • Locate information quickly and easily through a consistent chapter structure, with procedures organized by body system.
  • Access the fully searchable text online at www.expertconsult.com, along with 60 procedural video clips, 300 downloadable PowerPoint slides, and 400 downloadable images, and regular updates reflecting the latest findings.
  • Stay abreast of the most recent studies thanks to downloadable tables that summarize new information, updated on a quarterly basis.
  • Master the technique of systematically performing EUS, then download the hundreds of slides and videos available online to teach and train the newer generation of endoscopists.
  • Find coverage relevant to your needs with detailed chapters, illustrations, and videos on how to perform EUS for the beginner; a new section on international EUS and technical tips on how to handle difficult FNAs for the advanced user; a totally revised chapter on cytopathology for the pathologist; and a chapter on EBUS and EUS dedicated to the mediastinum for the pulmonologist.
  • Get a clear overview of everything you need to know to establish an endoscopic practice, from what equipment to buy to providing effective cytopathology service.
  • Tap into the expertise of world-renowned leaders in endosonography, Drs. Robert H. Hawes, Paul Fockens, and Shyam Varadarajulu.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Endosonography iii
Copyright iv
Dedication v
Contributors vii
Preface ix
Acknowledgments xi
Contents xiii
Section I: Basics of EUS 1
Chapter 1: Principles of Ultrasound 2
Introduction 2
Basic Ultrasound Physics 2
Basics of Ultrasound Instrumentation 4
Imaging Principles 6
Doppler 8
Imaging Artifacts 9
Summary 12
References 12
Chapter 2: Equipment 13
Introduction 13
Establishing an eus service 13
Equipment 14
Accessories 18
Choosing Equipment 21
References 21
Chapter 3: Training and Simulators 22
Introduction 22
Guidelines for Training 23
Training Program Requirements 24
Credentialing in EUS 25
Mucosal tumors 25
Subepithelial abnormalities 25
Pancreaticobiliary imaging 25
EUS-Guided Fine-Needle Aspiration 25
Comprehensive EUS competence 26
Recredentialing and renewal of EUS privileges 26
Simulators in EUS 26
Summary 27
References 27
Chapter 4: Indications, Preparation, Risks, and Complications 29
Indications 29
Patient Preparation 30
Risks and Complications 34
References 36
Section II: Mediastinum 39
Chapter 5: How to Perform EUS in the Esophagus and Mediastinum 40
Esophagus 40
Mediastinum 41
Summary 44
Reference 44
Chapter 6: EUS and EBUS in Non-Small Cell Lung Cancer 45
Introduction 45
EUS Fine-Needle Aspiration for the Diagnosis and Staging of Lung Cancer 45
EBUS Transbronchial Needle Aspiration for the Diagnosis and Staging of Lung Cancer 52
Impact of Endosonography on Patient Management 54
Endosonography versus other mediastinal staging methods 54
Complete Echoendoscopic Staging 55
Position of EUS and EBUS in lung cancer staging algorithms 55
Future Perspectives 55
References 56
Chapter 7: EUS in Esophageal Cancer 59
Introduction 59
Importance of staging 59
EUS, Computed Tomography, and Positron Emission Tomography 59
Equipment 61
Technique 62
Esophageal Dilation and Alternatives 63
Finding and Evaluating the Celiac Axis 63
Evaluation of the liver 65
Staging of Malignant Strictures 65
EUS in Superficial Cancer and Barrett's Esophagus 67
EUS-guided fine-needle aspiration biopsy of celiac and peri-intestinal lymph nodes 68
Controversies in EUS staging 68
Role and Limitation of EUS Following Neoadjuvant Therapy 68
Impact of EUS on survival in patients with esophageal cancer 69
Summary 69
References 69
Chapter 8: EUS in the Evaluation of Posterior Mediastinal Lesions 71
Introduction 71
EUS Evaluation of Enlarged Posterior Mediastinal Lymph Nodes 71
Differential diagnosis of enlarged posterior mediastinal lymph nodes 74
Malignant posterior mediastinal lymph nodes 74
Benign Posterior Mediastinal Lymph Nodes 74
Impact of EUS Fine-Needle Aspiration of Mediastinal Lymph Nodes on Subsequent Thoracic Surgery Rates 75
Mediastinal Masses 76
Summary 77
References 78
Section III: Stomach 81
Chapter 9: How to Perform EUS in the Stomach 82
Summary 83
Chapter 10: Submucosal Lesions 84
Introduction 84
Comparison of accuracy between EUS and other imaging modalities 84
Extramural Lesions 85
Evaluation of submucosal lesions 86
Gastointestinal stromal tumor 86
Aberrant Pancreas 87
Lipoma 88
Carcinoid Tumor 89
Granular Cell Tumor 89
Cysts including duplication cyst 90
Varices 91
Inflammatory Fibroid Polyps 91
Rare lesions 92
Tissue Sampling for Histologic Assessment of Subepithelial Lesions 93
Management of Subepithelial Lesions 94
Summary 94
References 95
Chapter 11: EUS in the Evaluation of Gastric Tumors 97
Introduction 97
Gastric Cancer 97
Primary Gastric Non-Hodgkin Lymphoma 104
Evaluation of Thickened Gastric Folds at EUS 109
References 111
Section IV: Pancreas and Biliary Tree 115
Chapter 12: How to Perform EUS in the Pancreas, Bile Duct, and Liver 116
Pancreas 116
Bile Duct 123
Liver 124
Chapter 13: EUS in Inflammatory Diseases of the Pancreas 127
Introduction 127
The Noninflamed Pancreas on EUS 128
Chronic Pancreatitis Diagnosis and Staging 128
Acute Pancreatitis 140
Enhanced EUS in pancreatitis 142
Summary 143
Acknowledgments 144
References 144
Chapter 14: EUS in Pancreatic Tumors 148
Introduction 149
Detection of Pancreatic Tumors 149
Staging of Pancreatic Tumors 151
Vascular Invasion by Pancreatic Tumors 153
Resectability of pancreatic tumors 155
EUS Fine-Needle Aspiration of Pancreatic Cancer 155
Pancreatic neuroendocrine tumors 159
Pancreatic Metastases 159
References 162
Chapter 15: EUS in the Evaluation of Pancreatic Cysts 166
Introduction 166
EUS and other imaging modalities 166
Congenital or \"simple\" cysts 167
Pseudocysts 167
Serous cystadenoma 168
Mucinous Cystadenoma and Adenocarcinoma 169
Intraductal papillary mucinous neoplasia 170
Solid cystic pseudopapillary neoplasm 171
Cystic endocrine tumors 171
Other Cystic Lesions 171
Endosonographic appearances of cystic lesions 172
EUS-guided fine-needle aspiration 172
EUS-guided core biopsies and brush cytology 173
Complications of EUS fine-needle aspiration of cystic lesions 173
Cytology and Cyst Fluid Analysis 173
Diagnostic approach 174
Future Developments 175
References 176
Chapter 16: EUS in Bile Duct, Gallbladder, and Ampullary Lesions 178
Bile Duct Stones 178
Bile Duct Tumors 184
Gallbladder Disease (Excluding Stones) 188
Ampullary Tumors 191
References 195
Secton V: Anorectum 201
Chapter 17: How to Perform Anorectal EUS 202
The perianal area 202
The Rectum 202
Reference 204
Chapter 18: EUS in Rectal Cancer 205
Introduction 205
EUS technique 205
Equipment 206
Staging 207
Learning Curve 208
Recurrent rectal cancer 208
Follow-Up After Resection 209
References 209
Chapter 19: Evaluation of the Anal Sphincter by Anal EUS 211
Introduction 211
Equipment and examination technique 211
Anal sphincter anatomy 212
Normal Endosonographic Findings 213
Anal sphincter function 214
Anorectal Physiologic Testing 215
Sonographic Findings in Anal Incontinence 215
Sonographic Findings in Other Anal Disorders 219
References 221
Section VI: EUS-Guided Fine-Needle Aspiration 223
Chapter 20: How to Perform EUS-Guided Fine-Needle Aspiration and Biopsy 224
Introduction 224
Steps for EUS Fine-Needle Aspiration 224
EUS-guided biopsy 230
Special Issues 231
Summary 232
References 232
Chapter 21: A Cytology Primer for Endosonographers 234
Introduction 234
Technical Aspects of EUS that Improve Diagnostic Yield 234
Factors Associated with Improved Cytologic Preparation 238
EUS Fine-Needle Aspiration of Specific Sites 240
Summary 249
References 249
Section VII: Interventional EUS 253
Chapter 22: EUS-Guided Drainage of Pancreatic Pseudocysts 254
Introduction 254
Current Treatment Approaches and Limitations 254
Clinical Outcomes of Eus-Guided Drainage 260
Technical Limitations 261
Summary 262
References 263
Chapter 23: EUS-Guided Drainage of the Biliary and Pancreatic Ductal Systems 264
Introduction 264
General Role 264
Patient Preparation 264
Equipment and Technical Considerations 265
EUS-Guided Access and Therapy of the Biliary Ductal System (Videos 23.1 and 23.2) 265
EUS-Guided Access and Therapy of the Pancreatic Ductal System (Video 23.3) 270
Technical Challenges and Tips 272
Physician Experience and Training 273
Summary 273
References 273
Chapter 24: EUS-Guided Ablation Therapy and Celiac Plexus Interventions 275
Introduction 275
Instrumentation 275
Radiofrequency Ablation and Brachytherapy 275
Fine-Needle Injection Therapy 277
EUS-Guided Fiducial Placements 278
EUS-Guided Pancreatic Cyst Ablation 279
Celiac Plexus Interventions 280
Summary 281
References 282
Chapter 25: EUS-Guided Drainage of Pelvic Abscesses 283
Introduction 283
Current treatment options 283
Why EUS-Guided Drainage? 284
Summary 286
References 286
Appendix: Videos 287
Index 289