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      • Record: found
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      A quarter century of EUS-FNA: Progress, milestones, and future directions

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          Abstract

          Tissue acquisition using EUS has considerably evolved since the first EUS-FNA was reported 25 years ago. Its introduction was an important breakthrough in the endoscopic field. EUS-FNA has now become a part of the diagnostic and staging algorithm for the evaluation of benign and malignant diseases of the gastrointestinal tract and of the organs in its proximity, including lung diseases. This review aims to present the history of EUS-FNA development and to provide a perspective on the recent developments in procedural techniques and needle technologies that have significantly extended the role of EUS and its clinical applications. There is a bright future ahead for EUS-FNA in the years to come as extensive research is conducted in this field and various technologies are continuously implemented into clinical practice.

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          Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with nonmalignant diseases.

          W Jeffrey Allard, Jeri Matera, M. Craig Miller … (2004)
          The purpose of this study was to determine the accuracy, precision, and linearity of the CellSearch system and evaluate the number of circulating tumor cells (CTCs) per 7.5 mL of blood in healthy subjects, patients with nonmalignant diseases, and patients with a variety of metastatic carcinomas. The CellSearch system was used to enumerate CTCs in 7.5 mL of blood. Blood samples spiked with cells from tumor cell lines were used to establish analytical accuracy, reproducibility, and linearity. Prevalence of CTCs was determined in blood from 199 patients with nonmalignant diseases, 964 patients with metastatic carcinomas, and 145 healthy donors. Enumeration of spiked tumor cells was linear over the range of 5 to 1,142 cells, with an average recovery of >/=85% at each spike level. Only 1 of the 344 (0.3%) healthy and nonmalignant disease subjects had >/=2 CTCs per 7.5 mL of blood. In 2,183 blood samples from 964 metastatic carcinoma patients, CTCs ranged from 0 to 23,618 CTCs per 7.5 mL (mean, 60 +/- 693 CTCs per 7.5 mL), and 36% (781 of 2,183) of the specimens had >/=2 CTCs. Detection of >/=2 CTCs occurred at the following rates: 57% (107 of 188) of prostate cancers, 37% (489 of 1,316) of breast cancers, 37% (20 of 53) of ovarian cancers, 30% (99 of 333) of colorectal cancers, 20% (34 of 168) of lung cancers, and 26% (32 of 125) of other cancers. The CellSearch system can be standardized across multiple laboratories and may be used to determine the clinical utility of CTCs. CTCs are extremely rare in healthy subjects and patients with nonmalignant diseases but present in various metastatic carcinomas with a wide range of frequencies.
          Article 0 comments Cited 823 times – based on 0 reviews     Review now
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            Elastography: a quantitative method for imaging the elasticity of biological tissues.

            J Ophir (1991)
            We describe a new method for quantitative imaging of strain and elastic modulus distributions in soft tissues. The method is based on external tissue compression, with subsequent computation of the strain profile along the transducer axis, which is derived from cross-correlation analysis of pre- and post-compression A-line pairs. The strain profile can then be converted to an elastic modulus profile by measuring the stresses applied by the compressing device and applying certain corrections for the nonuniform stress field. We report initial results of several phantom and excised animal tissue experiments which demonstrate the ability of this technique to quantitatively image strain and elastic modulus distributions with good resolution, sensitivity and with diminished speckle. We discuss several potential clinical uses of this technique.
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              Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo.

              Markus F. Neurath, Steven Thomas, M. Enders … (2004)
              A confocal laser endoscopy system has recently been developed that may allow subsurface imaging of living cells in colonic tissue in vivo. The aim of the present study was to assess its potential for prediction of histology during screening colonoscopy for colorectal cancer. Twenty-seven patients underwent colonoscopy with the confocal endoscope using acriflavine hydrochloride or fluorescein sodium with blue laser illumination. Furthermore, 42 patients underwent colonoscopy with this system using fluorescein sodium. Standardized locations and circumscript lesions were examined by confocal imaging before taking biopsy specimens. Confocal images were graded according to cellular and vascular changes and correlated with conventional histology in a prospective and blinded fashion. Acriflavine hydrochloride and fluorescein sodium both yielded high-quality images. Whereas acriflavine hydrochloride strongly labeled the superficial epithelial cells, fluorescein sodium offered deeper imaging into the lamina propria. Fluorescein sodium was thus used for the prospective component of the study in which 13,020 confocal images from 390 different locations were compared with histologic data from 1038 biopsy specimens. Subsurface analysis during confocal laser endoscopy allowed detailed analysis of cellular structures. The presence of neoplastic changes could be predicted with high accuracy (sensitivity, 97.4%; specificity, 99.4%; accuracy, 99.2%). Confocal laser endoscopy is a novel diagnostic tool to analyze living cells during colonoscopy, thereby enabling virtual histology of neoplastic changes with high accuracy. These newly discovered diagnostic possibilities may be of crucial importance in clinical practice and lead to an optimized rapid diagnosis of neoplastic changes during ongoing colonoscopy.
              Article 0 comments Cited 134 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Endosc Ultrasound
                Journal ID (iso-abbrev): Endosc Ultrasound
                Journal ID (publisher-id): EUS
                Title: Endoscopic Ultrasound
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 2303-9027
                ISSN (Electronic): 2226-7190
                Publication date (Print): May-Jun 2018
                Publication date (Electronic): 25 June 2018
                Volume: 7
                Issue: 3
                Pages: 141-160
                Affiliations
                [1 ]Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania
                [2 ]Department of Gastroenterology, Hepatology, and Nutrition, University of Texas – MD Anderson Cancer Center, Houston, Texas, USA
                [3 ]Gastrounit, Division of Surgery, Copenhagen University Hospital Herlev, Copenhagen, Denmark
                Author notes
                Address for correspondence Dr. Manoop S. Bhutani, Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Unit 1466, 1515 Holcombe Blvd., Houston, Texas 77030, USA. E-mail: manoop.bhutani@ 123456mdanderson.org
                Article
                Publisher ID: EUS-7-141
                DOI: 10.4103/eus.eus_19_18
                PMC ID: 6032705
                PubMed ID: 29941723
                SO-VID: dd63dcfa-a9a5-490b-bd90-d6c9ce826cd0
                Copyright © Copyright: © 2018 Spring Media Publishing Co. Ltd
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 21 February 2018
                Date accepted : 21 March 2018
                Categories
                Subject: Review Article

                Keywords: eus,eus-fna,tissue acquisition
                Data availability:
                Keywords: eus, eus-fna, tissue acquisition

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