Endoscopic UltrasoundPub Date : 2024-09-01Epub Date: 2024-11-08DOI: 10.1097/eus.0000000000000086
Courtney N Walker, Michael B Andrews, Douglas G Adler
{"title":"Safety of the contrast enhancement agent sulfur hexafluoride in ultrasound: Analysis of the Federal Drug Administration Adverse Event Reporting System database.","authors":"Courtney N Walker, Michael B Andrews, Douglas G Adler","doi":"10.1097/eus.0000000000000086","DOIUrl":"10.1097/eus.0000000000000086","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sulfur hexafluoride is an inert gas that creates microbubbles to enhance diagnostic accuracy in a variety of ultrasound (US) studies and is widely used in EUS. We analyzed the reported adverse events (AEs) of the US contrast agent, sulfur hexafluoride, extensively used during EUS procedures using a US national database.</p><p><strong>Methods: </strong>From December 2008 to January 2024, AEs reported in the Federal Drug Administration Adverse Event Reporting System database for sulfur hexafluoride were examined.</p><p><strong>Results: </strong>There were 1069 individual reports analyzed. Reports were excluded if they contained drugs other than sulfur hexafluoride. Echocardiogram (70.9%) was the common diagnostic study in which sulfur hexafluoride was administered. The most common AE reported was anaphylactic reaction (<i>n</i> = 179, 16.7%), followed by hypotension (<i>n</i> = 162, 15.2%), cardiac arrest (<i>n</i> = 161, 15.1%), and dyspnea (<i>n</i> = 159, 14.9%). The most common gastrointestinal AE was nausea (<i>n</i> = 135, 12.6%). Severity of AEs ranged from nonserious to death. Death associated with sulfur hexafluoride use was reported in 58 patients (5.4% of AE reports).</p><p><strong>Conclusions: </strong>Anaphylactic reaction was the most common AE reported with sulfur hexafluoride use, and severe AEs including death may be more common than prior large, retrospective, observational studies to date have suggested.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"13 5","pages":"306-311"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endoscopic UltrasoundPub Date : 2024-09-01Epub Date: 2024-11-08DOI: 10.1097/eus.0000000000000085
Shanshan Liu, Chaoqun Han, Qi He, Guochen Shang, Yu Jin, Jun Liu, Zhen Ding, Rong Lin
{"title":"The comparison of clinicopathological characteristics of two distinct manifestations of gastric signet ring cell carcinoma under EUS.","authors":"Shanshan Liu, Chaoqun Han, Qi He, Guochen Shang, Yu Jin, Jun Liu, Zhen Ding, Rong Lin","doi":"10.1097/eus.0000000000000085","DOIUrl":"10.1097/eus.0000000000000085","url":null,"abstract":"<p><strong>Background and objectives: </strong>There are two different endoscopic ultrasonographic manifestations of gastric signet ring cell carcinoma (GSRCC). No studies have been reported on the differences in the clinical profiles of patients based on EUS examination. We aim to study the variations in clinicopathological characteristics between two distinct endoscopic ultrasonographic manifestations of GSRCC.</p><p><strong>Methods: </strong>A total of 302 patients with GSRCC confirmed by pathological examination who underwent EUS were enrolled in the study. Based on the endoscopic ultrasonographic features, patients were categorized into two groups: type 1, where the entire layer structure disappeared, and type 2, where the layer structure was still present and appeared lymphomatoid. Clinicopathologic features were collected retrospectively and analyzed.</p><p><strong>Results: </strong>Compared with type 2 patients, type 1 patients tended to develop GSRCC at an older age (<i>P</i> = 0.033) and had higher serum levels of tumor markers and were more likely to experience anemia (<i>P</i> < 0.001) and weight loss (<i>P</i> < 0.001) during the disease progression. Significant increases in the tumor size (<i>P</i> < 0.001), thickness of the affected gastric wall (<i>P</i> < 0.001), and depth of tumor invasion (<i>P</i> < 0.001) were observed in type 1 patients. Furthermore, type 1 patients had higher prevalence of affected blood vessels (<i>P</i> < 0.001), nerves (<i>P</i> < 0.001), lymph nodes (<i>P</i> < 0.001), and peritoneal metastasis (<i>P</i> < 0.001). However, no difference was found in the duration of disease between the two groups, and all deficient mismatch repairs were observed in type 1 patients.</p><p><strong>Conclusions: </strong>The two distinct endoscopic ultrasonographic manifestations of GSRCC exhibited different clinicopathological characteristics, suggesting that they may represent different subtypes of the disease that require special attention in management strategies.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"13 5","pages":"293-299"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endoscopic UltrasoundPub Date : 2024-09-01Epub Date: 2024-11-08DOI: 10.1097/eus.0000000000000089
Muyun Liu, Wei An, Jie Gao, Xingang Shi
{"title":"Intraductal papillary mucinous neoplasm originating from a heterotopic pancreas within the stomach.","authors":"Muyun Liu, Wei An, Jie Gao, Xingang Shi","doi":"10.1097/eus.0000000000000089","DOIUrl":"10.1097/eus.0000000000000089","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"13 5","pages":"317-319"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multicenter, randomized controlled trial of EUS-guided fine-needle biopsy using a fork-tip needle with macroscopic or rapid on-site evaluation for pancreatic lesions (H<sub>2</sub>O trial).","authors":"Takeshi Ogura, Susumu Hijioka, Kazuo Hara, Nobu Nishioka, Atsushi Okuda, Saori Ueno, Hiroki Nishikawa, Masanori Yamada, Yoshikuni Nagashio, Yuya Hisada, Yumi Murashima, Kotaro Takeshita, Shin Haba, Takamichi Kuwahara, Nozomi Okuno","doi":"10.1097/eus.0000000000000087","DOIUrl":"10.1097/eus.0000000000000087","url":null,"abstract":"<p><strong>Background and objectives: </strong>According to previous reports, EUS-fine-needle biopsy (FNB) with or without rapid on-site evaluation (ROSE) showed the nonsuperiority of EUS-FNB + ROSE over EUS-FNB. However, previous studies included various kinds of FNB needle. This might be a critical limitation due to heterogeneity. Therefore, the aim of the present multicenter, randomized controlled trial was to compare the diagnostic accuracy of the fork-tip needle with or without ROSE for pancreatic lesions.</p><p><strong>Methods: </strong>In the ROSE group, if an adequate sample was obtained to diagnose by on-site evaluation, EUS-FNB was stopped. If cytological results were insufficient or indeterminate, EUS-FNB was repeated. In the macroscopic on-site evaluation (MOSE) group, if a 4-mm length of visible core tissue was obtained, EUS-FNB was finished. If visible core tissue was not obtained or was less than 4 mm in length, a second puncture was attempted.</p><p><strong>Results: </strong>One hundred seventy-one patients were randomized, 85 to the ROSE group and 86 to the MOSE group. In the MOSE group, diagnostic sensitivity and accuracy were 94.4% and 91.8%, respectively, for visible core tissue and 80.6% and 70.0%, respectively, for red tissue. Finally, overall diagnostic sensitivity and accuracy were 97.1% and 95.3%, respectively, in the ROSE group and 95.8% and 95.3%, respectively, in the MOSE group. Although there were no significant differences regarding adverse events between groups, the mean number of punctures was significantly lower in the MOSE group than in the ROSE group (1.47 <i>vs</i>. 1.20, <i>P</i> = 0.0171).</p><p><strong>Conclusions: </strong>EUS-FNB using a fork-tip needle for pancreatic lesions has high diagnostic yield even without ROSE.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"13 5","pages":"300-305"},"PeriodicalIF":4.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Huiyun Zhu, Yiqi Du, Kaixuan Wang, Zhaoshen Li, Zhendong Jin
{"title":"Consensus guidelines on the diagnosis and treatment of pancreatic pseudocyst and walled-off necrosis from a Chinese multiple disciplinary team expert panel","authors":"Huiyun Zhu, Yiqi Du, Kaixuan Wang, Zhaoshen Li, Zhendong Jin","doi":"10.1097/eus.0000000000000080","DOIUrl":"https://doi.org/10.1097/eus.0000000000000080","url":null,"abstract":"<h3>Objective </h3>\u0000<p>To prepare a set of practice guidelines to standardize the entire process, from diagnosis to treatment and follow-up, for pancreatic pseudocysts and walled-off necrosis.</p>\u0000<h3>Methods </h3>\u0000<p>Thirty-six experts in the fields of digestive endoscopy, pancreatic surgery, interventional radiology, and others presented their opinions via discussions in online conferences by referring to the patient, intervention, comparison, and outcomes principles and then reviewed the evidence and statements using the Delphi method to reach a consensus. The consensus of >80% was finally achieved for the items.</p>\u0000<h3>Results </h3>\u0000<p>The experts discussed and reached a consensus on 29 statements including 10 categories: (1) definition and classification, (2) imaging and endoscopic diagnosis, (3) therapeutic implications, (4) surgical therapy, (5) percutaneous catheter drainage, (6) endoscopic retrograde cholangiopancreatography, (7) EUS-guided drainage, (8) stent selection for EUS-guided drainage, (9) complication related to stents for cyst drainage, and (10) drug treatment and follow-up.</p>\u0000<h3>Conclusion </h3>\u0000<p>This consensus based on the clinical experience of experts in various fields and international evidence-based medicine further standardizes the multidisciplinary diagnosis and treatment processes for pancreatic pseudocysts and walled-off necrosis.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"51 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Computed tomography–based radial endobronchial ultrasound image simulation of peripheral pulmonary lesions using deep learning","authors":"Chunxi Zhang, Yongzheng Zhou, Chuanqi Sun, Jilei Zhang, Junxiang Chen, Xiaoxuan Zheng, Ying Li, Xiaoyao Liu, Weiping Liu, Jiayuan Sun","doi":"10.1097/eus.0000000000000079","DOIUrl":"https://doi.org/10.1097/eus.0000000000000079","url":null,"abstract":"<h3>Background and Objectives </h3>\u0000<p>Radial endobronchial ultrasound (R-EBUS) plays an important role during transbronchial sampling of peripheral pulmonary lesions (PPLs). However, existing navigational bronchoscopy systems provide no guidance for R-EBUS. To guide intraoperative R-EBUS probe manipulation, we aimed to simulate R-EBUS images of PPLs from preoperative computed tomography (CT) data using deep learning.</p>\u0000<h3>Materials and Methods </h3>\u0000<p>Preoperative CT and intraoperative ultrasound data of PPLs in 250 patients who underwent R-EBUS–guided transbronchial lung biopsy were retrospectively collected. Two-dimensional CT sections perpendicular to the biopsy path were transformed into ultrasonic reflection and transmission images using an ultrasound propagation model to obtain the initial simulated R-EBUS images. A cycle generative adversarial network was trained to improve the realism of initial simulated images. Objective and subjective indicators were used to evaluate the similarity between real and simulated images.</p>\u0000<h3>Results </h3>\u0000<p>Wasserstein distances showed that utilizing the cycle generative adversarial network significantly improved the similarity between real and simulated R-EBUS images. There was no statistically significant difference in the long axis, short axis, and area between real and simulated lesions (all <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">P</em> > 0.05). Based on the experts’ evaluation, a median similarity score of ≥4 on a 5-point scale was obtained for lesion size, shape, margin, internal echoes, and overall similarity.</p>\u0000<h3>Conclusions </h3>\u0000<p>Simulated R-EBUS images of PPLs generated by our method can closely mimic the corresponding real images, demonstrating the potential of our method to provide guidance for intraoperative R-EBUS probe manipulation.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"31 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathleen Möller, Alina Batali, Christian Jenssen, Barbara Braden, Michael Hocke, Wei On, Simon M. Everett, Yi Dong, Nan Ge, Siyu Sun, Michael Gerber, Siegbert Faiss, David Srivastava, Riccardo de Robertis, Mirko D´Onofrio, Benjamin Misselwitz, Christoph F. Dietrich
{"title":"Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine contrast-enhanced ultrasound guidelines: Multiparametric imaging and EUS-guided sampling in rare pancreatic tumors. Benign mesenchymal pancreatic tumors","authors":"Kathleen Möller, Alina Batali, Christian Jenssen, Barbara Braden, Michael Hocke, Wei On, Simon M. Everett, Yi Dong, Nan Ge, Siyu Sun, Michael Gerber, Siegbert Faiss, David Srivastava, Riccardo de Robertis, Mirko D´Onofrio, Benjamin Misselwitz, Christoph F. Dietrich","doi":"10.1097/eus.0000000000000070","DOIUrl":"https://doi.org/10.1097/eus.0000000000000070","url":null,"abstract":"<p>The focus of the review is on primary benign mesenchymal pancreatic tumors and their imaging appearance. These tumors are extremely rare. Usually, they are not diagnosed until postoperative histology is available, and so even benign tumors have undergone extensive pancreatic resection. The very limited data on abdominal and EUS findings including contrast-enhanced techniques of these pancreatic lesions are summarized here. Case reports will be presented for some of these rare tumors with application of modern ultrasound and endosonographic techniques.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}