Endoscopy International Open最新文献

{"title":"Benefits of macroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling.","authors":"Junya Sato, Hirotoshi Ishiwatari, Kazuma Ishikawa, Hiroki Sakamoto, Takuya Doi, Masahiro Yamamura, Kazunori Takada, Yoichi Yamamoto, Masao Yoshida, Sayo Ito, Noboru Kawata, Kenichiro Imai, Kinichi Hotta, Hiroyuki Ono","doi":"10.1055/a-2593-4172","DOIUrl":"10.1055/a-2593-4172","url":null,"abstract":"<p><strong>Background and study aims: </strong>Matched therapy based on comprehensive genomic profiling is a potential treatment option for patients with inoperable pancreatic cancer; however, the optimal method for obtaining tissue samples suitable for comprehensive genomic profiling using endoscopic ultrasound-guided tissue acquisition remains unclear. This study aimed to determine the optimal endoscopic ultrasound-guided tissue acquisition method to obtain samples for comprehensive genomic profiling.</p><p><strong>Patients and methods: </strong>This retrospective study included 86 consecutive patients with pancreatic cancer who underwent comprehensive genomic profiling using FoundationOne CDx (Foundation Medicine Inc.) and endoscopic ultrasound-guided tissue acquisition between June 2019 and January 2023. Macroscopic visible core length was measured using on-site macroscopic evaluation in all patients. Foundation Medicine Inc. reported analysis results categorized as passed (successful FoundationOne CDx), qualified, or failed. We investigated factors predicting successful FoundationOne CDx treatment.</p><p><strong>Results: </strong>Needles sized 22, 20, and 19 gauge were used in 63, one, and 23 patients, respectively. The stylet slow-pull and suction techniques were performed in 43 and 41 patients, respectively. Median total macroscopic visible core length in the formalin-fixed paraffin-embedded blocks subjected to FoundationOne CDx was 41 mm. The success rate for FoundationOne CDx was 66%. Multiple linear regression analysis revealed that macroscopic visible core length independently affected successful FoundationOne CDx ( <i>P</i> = 0.0019).</p><p><strong>Conclusions: </strong>In tissue specimens obtained using endoscopic ultrasound-guided tissue acquisition, macroscopic visible core length can be associated with an appropriate sample for FoundationOne CDx.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25934172"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of endoscopic ultrasound-guided radiofrequency ablation for pancreatic metastases of renal cell carcinoma.","authors":"Morgane Stouvenot, Stephane Koch, Alexandre Frontzcak, Christelle D'Engremont, Aurélien Boinette, Alexandre Doussot, Tristan Maurina, Lucine Vuitton","doi":"10.1055/a-2566-7350","DOIUrl":"https://doi.org/10.1055/a-2566-7350","url":null,"abstract":"<p><strong>Background and study aims: </strong>Pancreatic metastases from renal cell carcinoma (RCC) are usually managed surgically but with significant morbidity. As an alternative, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has shown promising results in treatment of pancreatic neuroendocrine tumors. The aim of our study was to assess technical success, effectiveness, and safety of EUS-RFA in patients with pancreatic metastases of RCC.</p><p><strong>Patients and methods: </strong>This retrospective, observational study included consecutive patients referred for EUS-RFA of pancreatic RCC metastases. EUS-RFA was performed through 18G or 19G dedicated RFA needles. Effectiveness of EUS-RFA treatment was defined by necrosis with no contrast enhancement or lesion disappearance, determined by contrast-enhanced computed tomography (CT) scan, at 2 to 5 months post procedure, 1 year, and at the end of follow-up. Safety was assessed per and post procedure.</p><p><strong>Results: </strong>Between January 2015 and January 2021, eight patients with 11 lesions were treated and median time from RCC diagnosis to pancreatic metastases RFA was 8.5 years (1-15). Mean lesion size was 13.9 mm (± 3.9). Technical success assessed by immediate post procedure contrast-enhanced CT or Doppler was 100%. At the first CT scan follow-up, complete response was 45.4% and partial response was 27.3%. At 1 year, complete response was 45.4% and partial response was 27.3%. Three patients had multiple EUS-RFAs. Adverse events occurred in 3 patients (mild acute pancreatitis, abdominal pain, and pancreatic fistula with retro-gastric pseudocyst).</p><p><strong>Conclusions: </strong>Our study demonstrated the feasibility and safety of EUS-RFA for patients with pancreatic metastases of RCC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25667350"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicolegal aspects of digestive endoscopy: Results of a Chilean national survey.","authors":"Oscar Corsi, María Jesús Fuenzalida, José Ignacio Vargas, Verónica Silva, Maximiliano Figueroa, Juan Andrés Prato, Andrea Künsemüller, Alberto Espino","doi":"10.1055/a-2570-6490","DOIUrl":"https://doi.org/10.1055/a-2570-6490","url":null,"abstract":"<p><strong>Background and study aims: </strong>Medical professional liability (MPL) is a significant concern for gastrointestinal physicians, yet there are limited data available from Latin America. We aimed to assess frequency of complaints and lawsuits related to digestive endoscopy among gastrointestinal endoscopists in Chile and to identify associated factors.</p><p><strong>Methods: </strong>An online survey collected sociodemographic data, information about endoscopy unit characteristics, and MPL-related experiences. Invitations were sent to 525 gastrointestinal endoscopists in Chile between August and September 2022. Associations between categorical variables were analyzed using the Chi-square test.</p><p><strong>Results: </strong>In total, 140 endoscopists participated (response rate: 26.7%). Mean age was 48.8 years; 68.6% were gastroenterologists, 70.7% were male, and 95% had MPL insurance. Written complaints were reported by 55% of participants, with an average of 1.5 complaints per year. The most common causes were procedure costs, adverse events (AEs), and sedation issues. Colonoscopy was the procedure most frequently associated with complaints (63.2%). Complaints related to AEs included perforation (48.7%), hemorrhage (23.7%), pancreatitis (21.1%), and death (13.2%). Factors associated with complaints included years of endoscopic practice ( <i>P</i> = 0.047), therapeutic procedures ( <i>P</i> < 0.001), and patient satisfaction assessments ( <i>P</i> = 0.048). Of respondents, 14.5% reported at least one lawsuit. Factors associated with lawsuits included age ( <i>P</i> = 0.0047), male gender ( <i>P</i> = 0.0033), Chilean nationality ( <i>P</i> = 0.0257), therapeutic procedures ( <i>P</i> = 0.004), and patient satisfaction assessments ( <i>P</i> = 0.002).</p><p><strong>Conclusions: </strong>Gastrointestinal endoscopists are frequently exposed to complaints and lawsuits. Key factors include procedure costs, AEs, sedation practices, years of experience, type of endoscopic procedure, and communication. Proactive strategies to address these factors could mitigate medico-legal risks and improve patient outcomes.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25706490"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective case-control study of the impact of dialysis on bowel preparation scores.","authors":"Sébastien Kindt, Michele Vanhooren, Pieter Jan Poortmans, Karlien François","doi":"10.1055/a-2565-8022","DOIUrl":"https://doi.org/10.1055/a-2565-8022","url":null,"abstract":"<p><strong>Background and study aims: </strong>Inadequate bowel preparation (BP) negatively affects diagnostic performance of colonoscopy. Most trials assessing adequacy of bowel preparation regimens have excluded patients affected by chronic kidney disease (CKD), especially patients on dialysis. This study aimed to assess the impact of dialysis on BP quality and adenoma detection rate (ADR) and identify factors related to quality of BP.</p><p><strong>Patients and methods: </strong>We retrospectively compared patient-specific, preparation-specific (preparation solution, preparation regimen (split-dose vs. 1-day preparation, outpatient preparation), and colonoscopy-specific data (indication, Boston Bowel Preparation Score [BBPS], sedation type, presence of adenoma or cancer) between 79 patients on dialysis and 158 matched controls. Adequate BP was defined as a BBPS score ≧2 in every colonic segment. Significant contributors to BP were assessed by logistic regression.</p><p><strong>Results: </strong>Despite matching, dialysis patients were significantly older (69.0 ± 11.9 vs 64.2 ± 14.6, <i>P</i> = 0.008) and less frequently women (30% vs 52%, <i>P</i> = 0.002). There was no significant difference in BP or ADR between patients on dialysis and controls (85% vs 89%, <i>P</i> = 0.39 and 35% vs 35%, <i>P</i> = 1.00, respectively). Older age ( <i>P</i> = 0.03), lower body mass index ( <i>P</i> = 0.03), type of BP regimen ( <i>P</i> <0.001), outpatient preparation ( <i>P</i> = 0.03), and residency in residential care ( <i>P</i> = 0.05) were significantly associated with BP adequacy. According to the logistic regression model, split-dose regimen was the main predictor of adequate BP ( <i>P</i> <0.001, odds ratio 3.1 [1.65-5.81]).</p><p><strong>Conclusions: </strong>Safe and adequate BP is achievable in dialysis patients. Bowel preparation regimen rather than treatment with dialysis influences BP quality. Split-dose preparation remains the most important determinant of adequate BP for colonoscopy, irrespective of regimen.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25658022"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental footprint of a colonoscopy procedure: Life cycle assessment.","authors":"Paulina Lämmer, Dorien Oomkens, Tim Stobernack, Marjolijn Duijvestein","doi":"10.1055/a-2570-6599","DOIUrl":"https://doi.org/10.1055/a-2570-6599","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastroenterology is a specialty that has evolved rapidly over time, especially in terms of advancements in endoscopic procedures. However, these advancements also present challenges, given the substantial resource demands associated with endoscopy procedures. Numerous actions could be taken to develop a resilient healthcare system that consumes as few resources as possible, but recommendations are needed to prioritize which processes could be improved. We aimed to evaluate the environmental footprint of a colonoscopy procedure, and to identify the main contributing impact process categories.</p><p><strong>Methods: </strong>A single-center observational study was conducted at a Dutch university hospital. No clinical patient data were collected, but the colonoscopy procedure was studied. Data were collected during 13 colonoscopies. Life cycle assessment (LCA) was used to calculate environmental impact.</p><p><strong>Results: </strong>Damage to human health from one colonoscopy was 11.3·10 ^-5 disability-adjusted life-years, equivalent to 1 hour. A single colonoscopy resulted in emission of 56.4 kg of CO ₂ -equivalent (CO ₂ eq), equal to driving a car for 255 km or 55 days of emissions for an average European household. Transportation of patients and staff (76.5%) and disposables (13.5%) were the greatest contributors to damage to human health.</p><p><strong>Conclusions: </strong>Among the 13 colonoscopies studied, the environmental impact was mainly attributable to transportation of patients and staff, and disposables. Therefore, raising awareness about the impact of transportation by car, and reducing resource consumption, particularly of disposable products, should be prioritized. Implementing alternatives to colonoscopy, such as intestinal ultrasound, could reduce the environmental footprint of the healthcare system.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25706599"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful endoscopic submucosal dissection of a duodenal neuroendocrine tumor close to the major papilla with traction from rubber band and clips.","authors":"Xiwei Ding, Guifang Xu, Shanshan Shen, Lei Wang","doi":"10.1055/a-2558-5086","DOIUrl":"https://doi.org/10.1055/a-2558-5086","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25585086"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of artificial intelligence to measure colorectal polyp size without a reference object.","authors":"Chin-Yuan Yii, Ding-Ek Toh, Tzu-An Chen, Wei-Lun Hsu, Huang-Jen Lai, Yin-Chen Wang, Chang-Ru Liu, Yow-Chii Kuo, Shih-Hao Young, Fu-Ming Chang, Chen Lin","doi":"10.1055/a-2556-1836","DOIUrl":"https://doi.org/10.1055/a-2556-1836","url":null,"abstract":"<p><strong>Background and study aims: </strong>Polyp size is crucial for determining colonoscopy surveillance intervals. We present an artificial intelligence (AI) model for colorectal polyp size measurement without a reference object.</p><p><strong>Methods: </strong>The regression model for polyp size estimation was developed using outputs from two SegFormer models, segmentation and depth estimation. Initially built on colonoscopic images of polyp phantoms, the model underwent transfer learning with 1,304 real-world images. Testing was conducted on 178 images from 52 polyps, independent of the training set, using a snare as the ground truth for size comparison with the AI-based model. Polyps were classified into three size groups: ≤ 5 mm, 5-10 mm, and ≥ 10 mm. Error rates were calculated to evaluate discrepancies in actual size values between the AI model and the snare method. Precision indicated the positive predictive value per size group and recall and Bland-Altman were also conducted.</p><p><strong>Results: </strong>The Bland-Altman analysis showed a mean bias of -0.03 mm between methods, with limits of agreement from -1.654 mm to 1.596 mm. AI model error rates for actual size discrepancies were 10.74%, 12.36%, and 9.89% for the ≤ 5 mm, 5-10 mm, and ≥ 10 mm groups, respectively, averaging 11.47%. Precision values were 0.870, 0.911, and 0.857, with overall recall of 0.846.</p><p><strong>Conclusions: </strong>Our study shows that colorectal polyp size measurement by AI model is practical and clinically useful, exhibiting low error rates and high precision. AI shows promise as an accurate tool for measurement without the need for a reference object during screening colonoscopy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25561836"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver variability in lymph node evaluation with endoscopic ultrasonography in cholangiocarcinoma.","authors":"David Michaël de Jong, Daniëlle Roosterman, Marco J Bruno, Lydi M J W van Driel, Wim J Lammers","doi":"10.1055/a-2577-5449","DOIUrl":"https://doi.org/10.1055/a-2577-5449","url":null,"abstract":"<p><strong>Background and study aims: </strong>Accurate preoperative lymph node (LN) assessment is crucial for patients with intrahepatic cholangiocarcinoma (iCCA) and perihilar cholangiocarcinoma (pCCA) because presence of LN metastases significantly reduces survival rates and can contraindicate surgical resection. Endoscopic ultrasound (EUS) provides a reliable method for LN assessment with the advantage of enabling tissue acquisition for pathological confirmation. This study aimed to assess interobserver agreement among endosonographers in evaluating LN characteristics in patients with iCCA and pCCA.</p><p><strong>Methods: </strong>A cross-sectional survey study was conducted among 24 endosonographers. Participants reviewed 42 EUS images from iCCA and pCCA patients, classifying LNs based on six characteristics (demarcation, shape, echogenicity, homogeneity, suspiciousness, and need to retrieve tissue). Interobserver agreement was determined using Light's kappa statistics. Accuracy, sensitivity, and specificity in identifying malignant LNs were calculated.</p><p><strong>Results: </strong>Overall kappa values indicated moderate to fair agreement on LN characteristics, with Kappa values of 0.24 for demarcation, 0.45 for shape, 0.38 for echogenicity, 0.52 for homogeneity, and 0.36 for suspiciousness. Overall accuracy of endosonographers in correctly identifying malignant LNs was 62%, with individual accuracy ranging from 44 to 75%. Sensitivity was 60% (range: 29%-90%) and specificity was 64% (range: 28%-89%).</p><p><strong>Conclusions: </strong>Endosonographic assessment of LN morphology and characterization demonstrates considerable variability among endosonographers. Thus, there is a clear need for standardization in preoperative LN evaluation, including establishing consensus about when to perform tissue acquisition, based on objective criteria such as short-axis diameter. Further research is required to refine and optimize these guidelines.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25775449"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot evaluation of a novel, automated ergonomics assessment tool.","authors":"Bara El Kurdi, Sumbal Babar, Ali Soroush, Jay Bapaye, Reid D Wasserman, Juan Echavarria, Omer Shahab, Cameron Locke, Jamie Yang, Michael Koachman, Klaus Mönkemüller, Aasma Shaukat","doi":"10.1055/a-2568-9610","DOIUrl":"10.1055/a-2568-9610","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastroenterologists are prone to endoscopy-related musculoskeletal injuries (ERI). Current interventions lack real-time monitoring and feedback. ErgoGenius, a novel artificial intelligence computer-vision tool, addresses this gap by providing continuous posture assessment and feedback without wearable motion trackers. The aim of this study was to determine the feasibility of ErgoGenius, its accuracy compared with human appraisers, and its ability to detect abnormal posture.</p><p><strong>Methods: </strong>The study was conducted at two large academic centers. The Rapid Entire Body Assessment (REBA) score was used as a surrogate for ergonomic performance and risk of injury. Ten endoscopists of varying gender, height, and weight were recorded performing endoscopic tasks in optimal vs. lowered bed positions. Videos were analyzed by ErgoGenius. A paired <i>t</i> -test was used to compare REBA scores between bed positions.</p><p><strong>Results: </strong>ErgoGenius was successfully deployed in a controlled endoscopy setting. ErgoGenius achieved perfect internal agreement (rho = 1) and closely correlated with human appraisers (rho = 0.987). Average REBA scores were notably higher in the lowered bed position (mean 4.64) compared with the optimal position (mean 2.55), ( <i>P</i> = 0.006).</p><p><strong>Conclusions: </strong>ErgoGenius was successfully deployed to detect abnormal postures related to changes in bed position and quantify ERI risk. It performed at par with human appraisers. This tool shows promise in enhancing ergonomic practices among gastroenterologists and trainees, potentially leading to better health outcomes and reduced injury.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25689610"},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-enhanced vs. standard endoscopic ultrasound fine-needle aspiration for diagnosing malignant biliary tumors: Randomized controlled trial.","authors":"Rares Ilie Orzan, Sorana D Bolboacă, Cristina Pojoga, Claudia Hagiu, Ofelia Mosteanu, Ioana Rusu, Voicu Rednic, Radu Seicean, Nadim Al Hajjar, Renata Agoston, Andrada Seicean","doi":"10.1055/a-2569-8969","DOIUrl":"https://doi.org/10.1055/a-2569-8969","url":null,"abstract":"<p><strong>Background and study aims: </strong>Contrast-enhanced endoscopic ultrasound (CH-EUS) is superior to standard EUS for staging biliary duct tumors (BDTs), but its role in guiding EUS-guided fine needle aspiration (EUS-FNA) remains unclear. We compared diagnostic accuracy of CH-EUS-fine needle aspiration (CH-EUS-FNA) and standard EUS-FNA in patients with suspected malignant biliary stenosis.</p><p><strong>Patients and methods: </strong>A parallel randomized controlled trial was conducted in a tertiary medical center and included jaundiced patients with suspected malignant biliary stenosis on computed tomography. The patients were assigned randomly to EUS-FNA or CH-EUS-FNA groups. Final diagnosis was determined based on EUS-FNA, surgical specimen results, endoscopic retrograde cholangiopancreatography (ERCP), or 12-month follow-up.</p><p><strong>Results: </strong>Sixty-one patients were included in the study, 31 in the EUS-FNA group and 30 in the CH-EUS-FNA group. Mean age of participants was 74 ± 11.04 years and mean tumor size was 20.39 ± 9.17 mm, with 43 tumors in the distal bile duct. Final diagnoses were cholangiocarcinoma (37 cases), pancreatic ductal carcinoma (12 cases), other malignancies (3 cases), and benign lesion (9 cases). Diagnostic sensitivity, specificity, and accuracy were 83.3%, 100%, and 87.1% for EUS-FNA, and 82.1%, 100%, and 83.3% for CH-EUS-FNA. Plastic biliary stent placement and tumor location did not influence results. Hyperenhancement in the CH-EUS with rapid washout was observed in 90.9% of cholangiocarcinoma cases.</p><p><strong>Conclusions: </strong>Standard EUS-FNA and CH-EUS-FNA demonstrated comparable diagnostic accuracy in evaluation of extrahepatic bile duct tumors, but with better slightly efficiency and inaccuracy indices than standard EUS-FNA.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25698969"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}