The evolving role of EUS-guided tissue acquisition.


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The evolving role of EUS-guided tissue acquisition.

J Dig Dis. 2021 Feb 21;:

Authors: Ang TL, Wang LM

Abstract
The introduction of endoscopic ultrasound guided fine needle aspiration into clinical practice was a pivotal moment for diagnostic gastrointestinal endoscopy. It facilitated ease of tissue acquisition from previously inaccessible sites. The performance characteristics of cytological diagnosis was excellent. However, there remained areas of inadequacies. These included procedural inefficiencies such as the need for rapid on-site cytological evaluation or macroscopic on-site evaluation, the crucial role of histology for diagnosis in specific conditions, the issue of sampling errors and need for repeat procedures, and the shift towards personalized medicine which requires histology, immunohistochemical studies and molecular analysis. The original Trucut biopsy needle had been cumbersome to use, but the recent introduction of newer generation biopsy needles has transformed the landscape, such that there is now a greater focus on tissue acquisition for histological assessment. Concomitant technological advances of endoscopic ultrasound processors enabled higher resolution imaging, and facilitated image enhancement using contrast harmonic endoscopic ultrasound and endoscopic ultrasound elastography. These techniques can be used as an adjunct to guide tissue acquisition in challenging situations. There is ongoing research on the use of artificial intelligence to complement diagnostic endoscopic ultrasound and early data are promising. Artificial intelligence may be especially important to guide clinical decision making if biopsy results are non-diagnostic. This article is protected by copyright. All rights reserved.

PMID: 33611846 [PubMed – as supplied by publisher]

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