Additional Information
Book Details
Abstract
Covering the full spectrum of endoscopic ultrasound, Endosonography, 4th Edition, by Drs. Robert Hawes, Paul Fockens, and Shyam Varadarajulu, is a comprehensive, one-stop resource for mastering both diagnostic and therapeutic EUS procedures. Leading global authorities guide you step by step through both introductory and advanced techniques, covering everything from interpretation and accurate diagnosis to treatment recommendations. High-quality images and an easy-to-navigate format make this updated reference a must-have for both beginning and experienced endosonographers.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| ENDOSONOGRAPHY | i | ||
| ENDOSONOGRAPHY | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Acknowledgments | x | ||
| Contents | xii | ||
| Video Contents | xiv | ||
| I - Basics of EndoscopicUltrasonography | 1 | ||
| 1 - Principles of Ultrasound | 2 | ||
| Basic Ultrasound Physics | 2 | ||
| Wavelength, Frequency, and Velocity | 2 | ||
| Density, Compressibility, and Bulk Modulus | 2 | ||
| Ultrasound Interactions in Tissue | 3 | ||
| Reflection | 3 | ||
| Scattering | 4 | ||
| Absorption | 4 | ||
| Ultrasound Intensity | 4 | ||
| Basics of Ultrasound Instrumentation | 5 | ||
| Transducers | 5 | ||
| Processors | 5 | ||
| Transmit/Receive | 5 | ||
| System Gain and Time Gain Compensation | 5 | ||
| Signal Processor | 5 | ||
| Imaging Principles | 6 | ||
| Resolution | 6 | ||
| Axial Resolution | 6 | ||
| Lateral Resolution | 6 | ||
| Elevation Resolution | 6 | ||
| A-Mode Scanning | 6 | ||
| B-Mode Imaging | 7 | ||
| Doppler | 7 | ||
| Continuous-Wave Doppler | 7 | ||
| Pulsed-Wave Doppler | 8 | ||
| Color Doppler | 8 | ||
| Power Doppler | 8 | ||
| Imaging Artifacts | 8 | ||
| Reverberation | 8 | ||
| Reflection (Mirror Image) | 9 | ||
| Acoustic Shadowing | 9 | ||
| Through Transmission | 10 | ||
| Tangential Scanning | 10 | ||
| Side Lobe Artifacts | 11 | ||
| Endoscopic Ultrasound Elastography | 11 | ||
| Contrast-Enhanced Harmonic Imaging | 12 | ||
| High-Intensity Focused Ultrasound | 14 | ||
| Summary | 14 | ||
| Key References | 14 | ||
| References | 14 | ||
| 2 - Equipment | 15 | ||
| Introduction | 15 | ||
| Radial Scopes | 15 | ||
| Linear Scopes | 16 | ||
| Processors | 17 | ||
| Endoscopic Ultrasound With Elastography | 19 | ||
| Miniprobes | 19 | ||
| Rectal Probes | 21 | ||
| Accessories | 21 | ||
| Fine-Needle Aspiration Needles | 21 | ||
| Fine-Needle Biopsy Needles | 22 | ||
| Endoscopic Ultrasound-Guided Fiducial Placement | 25 | ||
| Confocal Laser Endomicroscopy | 25 | ||
| Radiofrequency Ablation | 26 | ||
| Endoscopic Ultrasound-Guided Lumen-Apposing Stents | 26 | ||
| 3 - Training and Simulators | 29 | ||
| Introduction | 29 | ||
| Training in Endoscopic Ultrasound | 30 | ||
| Current Status of Endoscopic Ultrasound Training | 31 | ||
| Guidelines for Competency Assessment | 31 | ||
| Learning Curves and Competence in Endoscopic Ultrasound | 31 | ||
| Towards Competency-Based Medical Education | 32 | ||
| Credentialing, Recredentialing, and Renewal of Privileges in Endoscopic Ultrasound | 33 | ||
| Endoscopic Ultrasound Training Using Simulators | 36 | ||
| Quality Metrics in Endoscopic Ultrasound | 36 | ||
| Future Directions | 36 | ||
| Conclusions | 37 | ||
| Key References | 38 | ||
| References | 38 | ||
| 4 - Indications, Preparation, and Adverse Effects | 39 | ||
| Indications | 39 | ||
| Diagnostic Imaging | 39 | ||
| Tumor Staging | 39 | ||
| Tissue Acquisition | 40 | ||
| Therapy | 40 | ||
| Contraindications | 40 | ||
| Patient Preparation | 40 | ||
| General Measures | 40 | ||
| Laboratory Studies | 41 | ||
| Medications | 41 | ||
| Daily Medications | 41 | ||
| Antithrombotic Drugs | 41 | ||
| Resuming Antithrombotic Therapy | 43 | ||
| Prophylactic Antibiotics | 43 | ||
| Risks and Adverse Effects | 44 | ||
| Perforation | 44 | ||
| Bleeding | 45 | ||
| Infection | 45 | ||
| Pancreatitis | 45 | ||
| Other Adverse Effects of EUS and EUS FNA | 45 | ||
| Therapeutic Endoscopic Ultrasound | 45 | ||
| Key References | 46 | ||
| References | 46 | ||
| 5 - New Techniques in EUS: Real-Time Elastography, Contrast-Enhanced EUS, and Fusion Imaging | 47 | ||
| Real-Time Endoscopic Ultrasound Elastography | 47 | ||
| Technical Details | 47 | ||
| Clinical Applications | 48 | ||
| Lymph Nodes | 49 | ||
| Pancreatic Masses | 50 | ||
| Other Applications | 51 | ||
| Future Techniques | 51 | ||
| Contrast-Enhanced Endoscopic Ultrasound Elastography | 52 | ||
| Technical Details | 52 | ||
| Clinical Applications | 52 | ||
| Pancreatic Diseases | 53 | ||
| Other Applications | 56 | ||
| Future Techniques | 56 | ||
| Fusion Imaging | 57 | ||
| Key References | 57 | ||
| References | 57 | ||
| II - Mediastinum | 58 | ||
| 6 - How to Perform Endoscopic Ultrasonography in the Esophagus and Mediastinum | 59 | ||
| Esophagus | 59 | ||
| Mediastinum | 60 | ||
| Radial Echoendoscope | 60 | ||
| Linear Array Echoendoscope | 61 | ||
| How to Examine the Adrenal Glands | 63 | ||
| Summary | 64 | ||
| Key Reference | 64 | ||
| 7 - EUS and EBUS in Non–Small Cell Lung Cancer | 65 | ||
| Introduction | 65 | ||
| Endoscopic Ultrasonography-Guided Fine-Needle Aspiration for the Diagnosis and Staging of Lung Cancer | 65 | ||
| Procedure | 65 | ||
| Intrapulmonary Tumors (T) and Endoscopic Ultrasonography | 66 | ||
| Mediastinal Nodal (N) Staging and Endoscopic Ultrasonography | 66 | ||
| Diagnostic Reach of Endoscopic Ultrasonography | 67 | ||
| Endoscopic Ultrasonography Versus Endoscopic Ultrasonography–Fine-Needle Aspiration | 69 | ||
| Accuracy of Mediastinal Staging (N) by Endoscopic Ultrasonography | 69 | ||
| Distant Metastases (M1) and Endoscopic Ultrasonography | 70 | ||
| Endoscopic Ultrasound Using the Endobronchial Ultrasound Scope | 72 | ||
| Endobronchial Ultrasound Procedure | 72 | ||
| Diagnosing Intrapulmonary Tumors (T) by Endobronchial Ultrasound | 72 | ||
| Nodal Staging (N) by Endobronchial Ultrasound | 73 | ||
| Endobronchial Ultrasound Versus Endoscopic Ultrasonography Versus Surgical Staging | 75 | ||
| Training and Competency | 76 | ||
| Future Perspectives | 76 | ||
| Key References | 78 | ||
| References | 78 | ||
| 8 - Endoscopic Ultrasound in Esophageal and Gastric Cancer | 79 | ||
| Esophageal Cancer | 79 | ||
| Background | 79 | ||
| Esophageal Cancer Staging | 79 | ||
| Management Pathways in Esophageal Cancer | 79 | ||
| Staging of Newly Diagnosed Esophageal Cancer | 81 | ||
| Endoscopic Ultrasound Examination Technique | 82 | ||
| Scope Selection | 82 | ||
| Patient Preparation | 82 | ||
| Obstructing Tumors | 82 | ||
| TNM Staging | 82 | ||
| Role of Fine-Needle Aspiration in Staging | 85 | ||
| Early Esophageal Cancer | 87 | ||
| High-Frequency Probes | 88 | ||
| Endoscopic Evaluation | 88 | ||
| Restaging After Neoadjuvant Therapy | 88 | ||
| Influence of Endoscopic Ultrasound on Patient Management | 89 | ||
| Cost-Effectiveness of Endoscopic Ultrasound in Esophageal Cancer | 89 | ||
| Impact of Endoscopic Ultrasound on Survival | 89 | ||
| Learning Curve and Procedural Volume | 89 | ||
| Gastric Cancer | 89 | ||
| Background | 89 | ||
| Role of Endoscopic Ultrasound | 90 | ||
| Gastric Cancer Work-Up (Fig. 8.6) | 90 | ||
| Gastric Cancer Staging | 90 | ||
| T Staging | 91 | ||
| N Staging | 92 | ||
| M Staging | 92 | ||
| Management Pathways in Gastric Cancer | 92 | ||
| Accuracy of Endoscopic Ultrasound for Staging Gastric Cancer | 92 | ||
| M Staging | 93 | ||
| Limitations of Endoscopic Ultrasound in Staging | 95 | ||
| Comparison of Endoscopic Ultrasound With Other Imaging Modalities | 95 | ||
| Patient Selection for Staging Laparoscopy | 96 | ||
| Predictor of Survival After Neoadjuvant Chemotherapy | 96 | ||
| Gastric Cancer: Examination Checklist | 96 | ||
| Primary Gastric Non-Hodgkin Lymphoma | 96 | ||
| Diffuse Large B-Cell Lymphoma | 96 | ||
| Mucosa-Associated Lymphoid Tissue Lymphoma | 96 | ||
| Role of Endoscopic Ultrasound in MALT Lymphoma | 97 | ||
| Staging | 97 | ||
| Accuracy of Endoscopic Ultrasound in Staging MALT Lymphoma | 97 | ||
| Role of Endoscopic Ultrasound in Predicting Response to Therapy and in Follow-Up | 97 | ||
| Limitations of Staging Endoscopic Ultrasound | 98 | ||
| Evaluation of Thickened Gastric Folds | 98 | ||
| Linitis Plastica | 98 | ||
| Ménétrier Disease | 98 | ||
| Large Gastric Folds | 98 | ||
| Endoscopic Ultrasound–Based Work-Up | 99 | ||
| References | 99 | ||
| 9 - Endoscopic Ultrasonography in the Evaluation of Posterior Mediastinal Lesions | 100 | ||
| Endoscopic Ultrasonography Evaluation of Enlarged Posterior Mediastinal Lymph Nodes | 100 | ||
| Endoscopic Ultrasonography Appearance of Benign Posterior Mediastinal Lymph Nodes | 100 | ||
| Endoscopic Ultrasonography Appearance of Malignant Posterior Mediastinal Lymph Nodes | 100 | ||
| Transesophageal Endoscopic Ultrasonography Fine-Needle Aspiration of Mediastinal Lymph Nodes | 101 | ||
| Technique for Endoscopic Ultrasonography Fine-Needle Aspiration of Posterior Mediastinal Lesions | 101 | ||
| Endobronchial Ultrasound | 102 | ||
| Accuracy of Endoscopic Ultrasonography Fine-Needle Aspiration for Diagnosing Posterior Mediastinal Lesions | 102 | ||
| Risks of Endoscopic Ultrasonography Fine-Needle Aspiration of Posterior Mediastinal Lesions | 103 | ||
| Endoscopic Ultrasonography Fine-Needle Aspiration Compared With Other Modalities for Evaluation and Biopsy of Posterior Mediasti... | 103 | ||
| Differential Diagnosis of Enlarged Posterior Mediastinal Lymph Nodes | 103 | ||
| Malignant Posterior Mediastinal Lymph Nodes | 103 | ||
| Metastatic Disease From Thoracic Tumors | 103 | ||
| Lung Cancer | 103 | ||
| Mesothelioma | 104 | ||
| Metastatic Disease From Extrathoracic Malignancy | 104 | ||
| Lymphoma | 104 | ||
| Benign Posterior Mediastinal Lymph Nodes | 104 | ||
| Reactive Lymph Nodes | 104 | ||
| Granulomatous Lymph Nodes | 104 | ||
| Sarcoid | 104 | ||
| Histoplasmosis | 105 | ||
| Tuberculosis | 105 | ||
| Other Infections | 105 | ||
| Impact of Endoscopic Ultrasonography Fine-Needle Aspiration of Mediastinal Lymph Nodes on Subsequent Thoracic Surgery Rates | 105 | ||
| Mediastinal Masses | 106 | ||
| Malignant Posterior Mediastinal Masses | 106 | ||
| Neurogenic Tumors | 106 | ||
| Leiomyoma and Gastrointestinal Stromal Tumors | 106 | ||
| Mesothelioma | 106 | ||
| Benign Posterior Mediastinal Masses | 107 | ||
| Mediastinal Cysts | 107 | ||
| Drainage of Mediastinal Pseudocysts and Abscesses | 107 | ||
| Pleural Effusions | 108 | ||
| Summary | 108 | ||
| References | 108 | ||
| III - Stomach | 109 | ||
| 10 - How to Perform Endoscopic Ultrasonography in the Stomach | 110 | ||
| Summary | 111 | ||
| 11 - Subepithelial Lesions | 112 | ||
| Comparison of Accuracy Between Endoscopic Ultrasonography and Other Imaging Modalities | 112 | ||
| Extramural Lesions | 113 | ||
| Evaluation of Subepithelial Lesions | 114 | ||
| Gastrointestinal Stromal Tumor | 114 | ||
| Aberrant Pancreas | 116 | ||
| Lipoma | 118 | ||
| Carcinoid Tumor | 118 | ||
| Granular Cell Tumor | 120 | ||
| Cysts—Including Duplication Cyst | 120 | ||
| Varices | 122 | ||
| Inflammatory Fibroid Polyps | 122 | ||
| Glomus Tumor | 123 | ||
| Rare Lesions | 123 | ||
| Tissue Sampling for Histologic Assessment of Subepithelial Lesions | 123 | ||
| Management of Subepithelial Lesions | 126 | ||
| Summary | 127 | ||
| Key References | 127 | ||
| References | 127 | ||
| IV - Pancreas and Biliary Tree | 128 | ||
| 12 - How to Perform Endoscopic Ultrasonography in the Pancreas, Bile Duct, and Liver | 129 | ||
| Pancreas | 129 | ||
| Evaluation of the Body and Tail of the Pancreas | 129 | ||
| Radial Echoendoscopes | 129 | ||
| Linear Echoendoscopes | 131 | ||
| Evaluation of the Head and Uncinate Regions of the Pancreas | 132 | ||
| Head of the Pancreas | 132 | ||
| Papilla | 133 | ||
| Uncinate | 135 | ||
| Bile Duct | 137 | ||
| Liver | 138 | ||
| 13 - Endoscopic Ultrasound in Inflammatory Diseases of the Pancreas | 140 | ||
| Introduction | 140 | ||
| Endoscopic Ultrasound in the Nondiseased Pancreas | 140 | ||
| Chronic Pancreatitis | 140 | ||
| Brief Overview | 140 | ||
| Role of Endoscopic Ultrasound | 141 | ||
| Endoscopic Ultrasound Imaging Characteristics | 141 | ||
| Endoscopic Ultrasound Criteria for Chronic Pancreatitis | 141 | ||
| Comparison of Conventional and Rosemont Classification | 144 | ||
| Correlation of Endoscopic Ultrasound Findings and Surgical Histopathology | 144 | ||
| Interobserver Variability | 146 | ||
| Endoscopic Ultrasound Sampling | 146 | ||
| Image-Enhancing Techniques in Endoscopic Ultrasound | 147 | ||
| Endoscopic Ultrasound Elastography | 147 | ||
| Advanced Endoscopic Ultrasound Techniques | 151 | ||
| Endoscopic Ultrasound-Guided Celiac Plexus Block | 151 | ||
| Acute Pancreatitis | 151 | ||
| Brief Overview | 151 | ||
| Role of Endoscopic Ultrasound | 151 | ||
| Acute Biliary Pancreatitis | 151 | ||
| Acute Idiopathic Pancreatitis | 151 | ||
| Recurrent Acute Pancreatitis | 156 | ||
| Endoscopic Ultrasound Imaging Characteristics | 156 | ||
| Advanced Endoscopic Ultrasound Techniques | 159 | ||
| Autoimmune Pancreatitis | 159 | ||
| Brief Overview | 159 | ||
| Role of Endoscopic Ultrasound | 161 | ||
| Endoscopic Ultrasound Imaging Characteristics | 161 | ||
| Endoscopic Ultrasound Sampling | 163 | ||
| Fine-Needle Aspiration | 163 | ||
| Tru-Cut Biopsy | 168 | ||
| Other Endoscopic Ultrasound Fine-Needle Biopsy Techniques | 168 | ||
| Image-Enhancing Techniques in Endoscopic Ultrasound | 169 | ||
| Endoscopic Ultrasound Elastography | 169 | ||
| Contrast-Enhanced Endoscopic Ultrasound | 169 | ||
| Benign Pancreatic Masses | 169 | ||
| Brief Overview | 169 | ||
| Endoscopic Ultrasound Sampling | 169 | ||
| Endoscopic Ultrasound Fine-Needle Aspiration | 169 | ||
| Endoscopic Ultrasound-Guided Core Biopsy | 169 | ||
| Image-Enhancing Techniques in Endoscopic Ultrasound | 170 | ||
| Endoscopic Ultrasound Elastography | 170 | ||
| Contrast-Enhanced Endoscopic Ultrasound | 170 | ||
| Key References | 170 | ||
| References | 170 | ||
| 14 - Endoscopic Ultrasound and Pancreatic Tumors | 171 | ||
| Examination Checklist for Evaluation of a Suspected Pancreatic Tumor | 171 | ||
| Tumor | 171 | ||
| Vascular Invasion | 171 | ||
| Lymph Nodes | 171 | ||
| Liver | 171 | ||
| Ascites | 171 | ||
| Endoscopic Ultrasound-Guided Tissue Acquisition | 171 | ||
| Staging | 172 | ||
| Pancreatic Ductal Adenocarcinoma | 172 | ||
| Background | 172 | ||
| Detection of Pancreatic Ductal Adenocarcinoma | 172 | ||
| Endoscopic Ultrasound Versus Computed Tomography | 172 | ||
| Endoscopic Ultrasound Versus Magnetic Resonance Imaging | 172 | ||
| Contrast-Enhanced Endoscopic Ultrasound | 172 | ||
| Endoscopic Ultrasound Elastography | 172 | ||
| Assessment of Resectability and Cancer Staging | 172 | ||
| Staging | 173 | ||
| Endoscopic Ultrasound-Guided Fine-Needle Aspiration | 176 | ||
| Fine-Needle Aspiration Techniques/Accessories for Tissue Acquisition | 176 | ||
| Specimen Interpretation and Processing | 176 | ||
| Challenges in Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Mass Lesions | 177 | ||
| Adverse Events of Fine-Needle Aspiration | 177 | ||
| Fine-Needle Biopsy | 177 | ||
| Pancreatic Neuroendocrine Tumor | 179 | ||
| Background | 179 | ||
| Diagnosis | 180 | ||
| Imaging Modalities in Pancreatic Neuroendocrine Tumor | 180 | ||
| Endoscopic Ultrasound Versus Other Imaging Modalities | 181 | ||
| Endoscopic Ultrasound-Guided Tissue Acquisition | 181 | ||
| Endoscopic Ultrasound-Guided Ablation Therapy | 181 | ||
| Metastatic Lesions to the Pancreas | 182 | ||
| Pancreatic Lymphoma | 183 | ||
| Personalized Cancer Therapy | 183 | ||
| Key References | 184 | ||
| References | 184 | ||
| 15 - Endoscopic Ultrasonography in the Evaluation of Pancreatic Cysts | 185 | ||
| Introduction | 185 | ||
| Types of Pancreatic Cysts | 185 | ||
| Diagnostic Approach | 185 | ||
| Clinical History and Imaging | 185 | ||
| Endoscopic Ultrasound | 186 | ||
| Confocal Laser Endomicroscopy | 188 | ||
| Endoscopic Ultrasound-Guided Fine-Needle Aspiration | 189 | ||
| Analysis of Cyst Fluid | 190 | ||
| Appearance of the Aspirate and the String Test | 190 | ||
| Cytology | 191 | ||
| Protein Markers | 191 | ||
| Carcinoembryonic Antigen | 191 | ||
| Cyst Fluid Amylase | 191 | ||
| Other Markers | 191 | ||
| Molecular Markers | 191 | ||
| When to Perform Endoscopic Ultrasound-Guided Fine-Needle Aspiration and What to Send It for | 191 | ||
| Type of Pancreatic Cysts | 192 | ||
| Pseudocysts | 192 | ||
| Serous Cystadenoma | 193 | ||
| Mucinous Cystic Neoplasm | 194 | ||
| Intraductal Papillary Mucinous Neoplasia | 195 | ||
| Solid Pseudopapillary Neoplasm | 197 | ||
| Cystic Neuroendocrine Tumors | 197 | ||
| Cystic Ductal Adenocarcinoma | 198 | ||
| Future Developments | 198 | ||
| Analysis of Molecular Markers in Pancreatic Juice | 198 | ||
| Cyst Ablation | 199 | ||
| Key References | 200 | ||
| References | 200 | ||
| 16 - Endoscopic Ultrasound in Bile Duct, Gallbladder, and Ampullary Lesions | 201 | ||
| Endoscopic Ultrasound and Biliary Stones | 201 | ||
| Bile Duct Stones | 201 | ||
| Endoscopic Ultrasound Technique for Detecting Choledocholithiasis | 201 | ||
| The Use of Endoscopic Ultrasound, Magnetic Resonance Cholangiopancreatography, and Endoscopic Retrograde Cholangiopancreatograph... | 202 | ||
| Summary | 206 | ||
| Gallstones | 206 | ||
| Summary | 207 | ||
| Endoscopic Ultrasound in Bile Duct Strictures | 208 | ||
| Endoscopic Ultrasound-Fine-Needle Aspiration Considerations in Biliary Strictures and Tumors | 208 | ||
| The Performance of Intraductal Ultrasonography in Biliary Strictures | 210 | ||
| Cholangioscopy in Biliary Strictures | 212 | ||
| Multimodality Approach to Bile Duct Strictures | 213 | ||
| Staging of Cholangiocarcinoma | 214 | ||
| Endoscopic Ultrasound in Gallbladder Disease (Excluding Stones) | 215 | ||
| Gallbladder Polyps | 215 | ||
| Gallbladder Tumors | 216 | ||
| Summary | 216 | ||
| Other Gallbladder Disorders Presenting With Wall Thickening | 217 | ||
| Summary | 218 | ||
| Ampullary Tumors | 218 | ||
| Role of Intraductal Ultrasonography in Ampullary Tumors | 223 | ||
| Multimodality Approach in the Management of Ampullary Tumors | 224 | ||
| Summary | 224 | ||
| References | 224 | ||
| V - Anorectum | 225 | ||
| 17 - How to Perform Anorectal Endoscopic Ultrasonography | 226 | ||
| The Perianal Area | 226 | ||
| The Rectum | 226 | ||
| Key Reference | 228 | ||
| 18 - Endoscopic Ultrasonography in Rectal Cancer | 229 | ||
| Relevant Anorectal Anatomy and the American Joint Committee on Cancer 2010 Staging System for Rectal Cancer | 229 | ||
| Anorectal Anatomy | 229 | ||
| Rectal Cancer Tumor-Node-Metastasis Staging | 230 | ||
| Rectal Endoscopic Ultrasonography in the Setting of De Novo Rectal Cancer | 231 | ||
| T-Staging Considerations | 231 | ||
| N-Staging Considerations | 232 | ||
| Magnetic Resonance Imaging Assessment Versus Endoscopic Ultrasonography | 233 | ||
| Computed Tomography and Positron Emission Tomography-Computed Tomography Evaluation Versus Endoscopic Ultrasonography | 233 | ||
| Endoscopic Ultrasonography Evaluation Following Neoadjuvant Therapy | 234 | ||
| Endoscopic Ultrasonography for Recurrent Rectal Cancer Following Radical and Local Surgery | 234 | ||
| Endoscopic Ultrasonography for Rectal Wall Metastases | 234 | ||
| Innovative Interventions and Adverse Event Profile for Lower Gastrointestinal Endoscopic Ultrasonography | 234 | ||
| Translational Medicine | 236 | ||
| Conclusion | 236 | ||
| Key References | 236 | ||
| References | 236 | ||
| 19 - Evaluation of the Anal Sphincter by Anal Endosonography | 237 | ||
| Introduction | 237 | ||
| Equipment and Examination Technique | 237 | ||
| Anal Sphincter Anatomy | 238 | ||
| Normal Endosonographic Findings | 239 | ||
| Anal Sphincter Function | 240 | ||
| Anorectal Physiologic Testing | 241 | ||
| Manometry | 241 | ||
| Pudendal Nerve Latency | 241 | ||
| Electromyography | 241 | ||
| Sonographic Findings in Anal Incontinence | 242 | ||
| Obstetric Injury | 242 | ||
| Idiopathic Internal Anal Sphincter Degeneration and External Anal Sphincter Atrophy | 245 | ||
| Iatrogenic Sphincter Injury and Anal Trauma | 245 | ||
| Sonographic Findings in Other Anal Disorders | 246 | ||
| Recent Developments | 247 | ||
| Key References | 248 | ||
| References | 248 | ||
| VI - Endoscopic Ultrasonography-Guided Tissue Acquisition | 249 | ||
| 20 - How to Perform Endoscopic Ultrasonography-Guided Fine-Needle Aspiration | 250 | ||
| Introduction | 250 | ||
| Indications and Contraindications | 250 | ||
| Steps for Endoscopic Ultrasonography-Fine-Needle Aspiration | 251 | ||
| Verify the Indication | 251 | ||
| Localize the Lesion and Position the Echoendoscope | 251 | ||
| Choose the Correct Needle | 252 | ||
| Insert the Endoscopic Ultrasonography-Fine-Needle Aspiration Needle Into the Echoendoscope | 252 | ||
| Position the Lesion in the Needle Path | 252 | ||
| Puncture the Lesion and Move the Needle Within the Lesion | 255 | ||
| Withdraw the Needle and Process the Aspirate | 256 | ||
| Prepare the Needle for Subsequent Passes | 256 | ||
| Evolving Trends in Endoscopic Ultrasonography-Fine-Needle Aspiration | 256 | ||
| Use of the Stylet | 256 | ||
| Use of Suction | 256 | ||
| Sampling Techniques | 257 | ||
| Fine-Needle Aspiration Particularities According to Site | 257 | ||
| Esophagus | 257 | ||
| Stomach | 258 | ||
| Duodenal Bulb | 258 | ||
| Duodenal Sweep (D2) | 258 | ||
| Special Issues | 258 | ||
| Sampling of Multiple Lesions | 258 | ||
| Endoscopic Ultrasonography-Fine-Needle Aspiration of Cystic Lesions | 259 | ||
| Mobile Lesions | 259 | ||
| Indurated Lesions | 259 | ||
| Tumor Seeding | 259 | ||
| Conclusion | 259 | ||
| Key References | 260 | ||
| References | 260 | ||
| 21 - Techniques for Endoscopic Ultrasound-Guided Fine-Needle Biopsy | 261 | ||
| Introduction | 261 | ||
| Endoscopic Ultrasound-Guided Tru-Cut Biopsy | 261 | ||
| Endoscopic Ultrasound-Guided Fine-Needle Biopsy Using a Standard 22-Gauge Needle | 262 | ||
| Background | 262 | ||
| Design and Technique | 262 | ||
| Results | 262 | ||
| Endoscopic Ultrasound Fine-Needle Biopsy Using a Standard 19-Gauge Needle | 263 | ||
| Background | 263 | ||
| Endoscopic Ultrasound-Guided Fine-Needle Biopsy Technique | 263 | ||
| Results | 263 | ||
| Endoscopic Ultrasound-Guided Fine-Needle Biopsy Using ProCore Needles | 264 | ||
| Introduction | 264 | ||
| Design and Technique | 264 | ||
| Results | 266 | ||
| Endoscopic Ultrasound-Guided Fine-Needle Biopsy Using the Sharkcore and the Acquire Needles | 267 | ||
| Design and Technique | 267 | ||
| Results | 267 | ||
| Conclusions and Future Perspective | 270 | ||
| Key References | 271 | ||
| References | 271 | ||
| 22 - Cytology Primer for Endosonographers | 272 | ||
| Technical Aspects of Endoscopic Ultrasonography That Improve Diagnostic Yield | 272 | ||
| Preliminary Planning | 272 | ||
| Fine-Needle Aspirates | 273 | ||
| Choice of Needles | 274 | ||
| Needle Core Biopsy Versus Fine-Needle Aspiration | 274 | ||
| To Apply or Not to Apply Suction | 275 | ||
| Number of Passes | 275 | ||
| Immediate Cytologic Evaluation | 275 | ||
| Factors Associated With Improved Cytologic Preparation | 276 | ||
| Cytology Smears and Cell Block | 276 | ||
| Air-Dried or Alcohol-Fixed Smears | 277 | ||
| Transport Media and Liquid-Based Preparations | 277 | ||
| Cytology Interpretation | 277 | ||
| Adequacy | 277 | ||
| Diagnostic Evaluation of the Slide | 277 | ||
| Endoscopic Ultrasonography Fine-Needle Aspiration of Specific Sites | 279 | ||
| Pancreas | 279 | ||
| Global Approach to Diagnosis | 279 | ||
| Pancreatic Adenocarcinoma and Chronic Pancreatitis | 279 | ||
| Pancreatic Neuroendocrine Tumors | 283 | ||
| Major Differential Diagnosis | 283 | ||
| Cystic Pancreatic Lesions | 283 | ||
| Causes of False Diagnosis | 285 | ||
| Lymph Nodes | 286 | ||
| Sample Collection | 286 | ||
| Algorithmic Approach to Interpretation of Lymph Node Aspirates | 286 | ||
| How to Confirm Lymph Nodes | 287 | ||
| Differential Diagnosis | 287 | ||
| Monomorphous Lymphoid Population | 287 | ||
| Nonhematopoietic Cells in Background of Lymphoid Cells | 288 | ||
| Nonhematopoietic Cells Without the Background of Lymphoid Cells | 288 | ||
| Spleen | 288 | ||
| Gastrointestinal Tract | 288 | ||
| Detection of Foregut Cysts | 289 | ||
| Gastrointestinal Stromal Tumors | 289 | ||
| Hepatobiliary Tree | 289 | ||
| Liver | 289 | ||
| Adrenal Glands | 289 | ||
| Summary | 290 | ||
| Key References | 290 | ||
| References | 290 | ||
| 23 - Endoscopic Ultrasound-Guided Drainage of Pancreatic Fluid Collections | 291 | ||
| Definitions | 291 | ||
| Indications for Intervention | 291 | ||
| Types of Interventions | 291 | ||
| Walled-Off Necrosis | 292 | ||
| Percutaneous Drainage | 292 | ||
| Endoscopic-Ultrasonography-Guided Drainage | 293 | ||
| Preprocedure Checklist | 293 | ||
| Cautions Prior to Endoscopic Ultrasonography-Guided Pancreatic Fluid Collection Drainage | 293 | ||
| Procedure Techniques | 294 | ||
| Endoscopic Necrosectomy | 297 | ||
| Adverse Events | 297 | ||
| Follow-Up | 298 | ||
| Disconnected Pancreatic Duct Syndrome | 299 | ||
| Summary | 299 | ||
| Key References | 301 | ||
| References | 301 | ||
| 24 - Endoscopic Ultrasonography-Guided Drainage of the Biliary-Pancreatic Ductal Systems and Gallbladder | 302 | ||
| Introduction | 302 | ||
| Endoscopic Ultrasonography-Guided Biliary Drainage | 302 | ||
| Nomenclature | 302 | ||
| Indications of Endoscopic Ultrasonography-Guided Biliary Drainage | 303 | ||
| Outcomes of the Endoscopic Ultrasonography-Guided Biliary Drainage Procedures | 303 | ||
| Endoscopic Ultrasonography-Rendezvous Endoscopic Retrograde Cholangiopancreatography (Biliary) | 303 | ||
| Endoscopic Ultrasonography-Guided Antegrade Stenting | 304 | ||
| Endoscopic Ultrasonography-Guided Choledochoduo | 304 | ||
| Comparison of Endoscopic Ultrasonography-Guided Biliary Drainage With Percutaneous Transhepatic Biliary Drainage | 306 | ||
| Pros and Cons of Each Procedure | 306 | ||
| Algorithm for Drainage and Choice of Procedure | 307 | ||
| Endoscopic Ultrasonography-Guided Pancreatic Duct Drainage | 307 | ||
| Indications for Endoscopic Ultrasonography-Guided Pancreatic Duct Drainage | 307 | ||
| Nomenclature | 308 | ||
| Outcomes of Endoscopic Ultrasonography-Guided Pancreatic Duct Drainage Procedures | 308 | ||
| Algorithm for Endoscopic Ultrasonography-Guided Pancreatic Duct Drainage Procedures | 309 | ||
| Endoscopic Ultrasonography-Guided Gallbladder Drainage | 309 | ||
| Indications for Endoscopic Ultrasonography-Guided Transmural Gallbladder Drainage | 309 | ||
| Outcomes of Endoscopic Ultrasonography-Guided Transmural Gallbladder Drainage | 309 | ||
| Comparison Between Endoscopic Ultrasonography-Guided Transmural Gallbladder Drainage and Percutaneous Cholecystostomy | 309 | ||
| Techniques Used in Endoscopic Ultrasonography-Guided Drainage Procedures | 310 | ||
| Procedural Considerations and Equipment | 310 | ||
| Patient Preparation | 310 | ||
| Echoendoscope | 310 | ||
| Needles and Guidewires | 310 | ||
| Tract Dilation | 310 | ||
| Stents | 310 | ||
| Technique of Endoscopic Ultrasonography-Rendezvous (Biliary) | 311 | ||
| Considerations | 311 | ||
| Site of Needle Puncture | 311 | ||
| The Procedure (Fig. 24.6 and Video 24.1) | 311 | ||
| Troubleshooting | 312 | ||
| Technique of Endoscopic Ultrasonography-Guided Antegrade Biliary | 312 | ||
| Considerations | 312 | ||
| The Procedure (Fig. 24.7 and Video 24.2) | 312 | ||
| Index | 341 | ||
| A | 341 | ||
| B | 342 | ||
| C | 343 | ||
| D | 344 | ||
| E | 344 | ||
| F | 347 | ||
| G | 348 | ||
| H | 348 | ||
| I | 348 | ||
| J | 349 | ||
| K | 349 | ||
| L | 349 | ||
| M | 349 | ||
| N | 350 | ||
| O | 351 | ||
| P | 351 | ||
| R | 353 | ||
| S | 354 | ||
| T | 355 | ||
| U | 356 | ||
| V | 356 | ||
| W | 356 | ||
| X | 356 | ||
| Z | 356 | ||
| IBC | ES2 |