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Diagnostics
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Endoscopic Ultrasound (EUS) in Gastrointestinal Diseases
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Endoscopic Ultrasound (EUS) in Gastrointestinal Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 3011

Special Issue Editors

Dr. Elia Armellini

E-Mail
Guest Editor
Digestive Endoscopy Unit, ASST-Bergamoest, Bergamo, Italy
Interests: interventional ultrasonography; endoscopy; NET; pancreatic cancer; EUS; endo-hepatology; ERCP
Special Issues, Collections and Topics in MDPI journals
Dr. Stefano Francesco Crinò

E-Mail Website
Guest Editor
Digestive Endoscopy Unit, University of Verona, Verona, Italy
Interests: pancreatic cancer; endoscopic ultrasound; ERCP; pancreatic cysts; IPMN; neuroendocrine tumors

Special Issue Information

Dear Colleagues,

Over the years, digestive endoscopy has evolved from a diagnostic technique to a major interventional technique. Endoscopic ultrasound (EUS) has witnessed this evolution that has changed the treatment algorithms of digestive and pancreaticobiliary diseases.

EUS has been widely used for the diagnosis of gastrointestinal diseases providing detailed imaging information, which helps physicians determine the location, nature, and extent of lesions. EUS is particularly useful in the diagnosis and staging of gastric and oesophageal cancers, as it can detect early lesions, evaluate the depth and spread of cancer, and determine lymph node involvement. Moreover, the availability of ev. contrast media or elastosonography has further added to its potential in the characterization of lesions.

The availability of sophisticated devices has made it possible to achieve therapeutic solutions for diseases that affect areas beyond the gastrointestinal tract, improving treatment outcomes for patients.

Nowadays, endoscopic ultrasound is used in an operative setting to treat complications of pancreatitis, access and drain the biliary tree and gallbladder, and create gastrointestinal anastomoses. Pancreatic tumours can be treated via the injection of substances or ablation. A vascular procedure can also be performed.

This Special Issue aims to depict the progress of digestive endoscopy and offer an overview of future perspectives.

Reviews, systematic reviews, meta-analyses, case reports, and research papers are solicited on interventional endoscopy, pancreatic cancer, biliopancreatic endoscopy, endohepatology, EUS, ERCP, cholangioscopy, and artificial intelligence.

Dr. Elia Armellini
Dr. Stefano Francesco Crinò
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at mdpi.longhoe.net by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (4 papers)

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Research

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13 pages, 996 KiB  
Article
The Role of Endoscopic Ultrasonography (EUS) in Metastatic Tumors in the Pancreas: 10 Years of Experience from a Single High-Volume Center
by Alessandro Aversano, Laura Lissandrini, Daniele Macor, Martina Carbone, Sara Cassarano, Marco Marino, Mauro Giuffrè, Alessandro De Pellegrin, Giovanni Terrosu and Debora Berretti
Diagnostics 2024, 14(12), 1250; https://doi.org/10.3390/diagnostics14121250 - 13 Jun 2024
Viewed by 361
Abstract
Background: Metastatic pancreatic lesions (MPLs) are relatively uncommon, constituting 2 to 5% of all pancreatic tumors. They often manifest as solitary lesions without distinct clinical symptoms, usually identified incidentally during radiologic imaging for the surveillance of prior malignancies. Differentiating these lesions from primary [...] Read more.
Background: Metastatic pancreatic lesions (MPLs) are relatively uncommon, constituting 2 to 5% of all pancreatic tumors. They often manifest as solitary lesions without distinct clinical symptoms, usually identified incidentally during radiologic imaging for the surveillance of prior malignancies. Differentiating these lesions from primary pancreatic tumors presents a significant challenge due to their nonspecific presentation. Methods: We aimed to prospectively assess the effectiveness of endoscopic ultrasound (EUS) and EUS-guided fine needle aspiration/biopsy (EUS-FNA/B) in diagnosing MPLs in a carefully selected cohort of patients presenting with pancreatic masses. Additionally, we sought to examine the relevance of specific EUS findings in supporting the initial diagnosis of MPLs and their agreement with the definitive cytological diagnosis. This study retrospectively analyzed data from 41 patients diagnosed with MPLs between 2013 and 2023, focusing on their clinical and pathological characteristics, the echogenic features of the pancreatic lesions, and the techniques used for tissue acquisition. Results: The incidence of MPLs in our cohort was 3.53%, with the most frequent primary tumors originating in the kidney (43.90%), colorectum (9.76%), lung (9.76%), lymphoma (9.76%), and breast (4.88%). MPLs typically presented as hypoechoic, oval-shaped lesions with well-defined borders and were predominantly hypervascular. Interestingly, 68.29% of the cases were discovered incidentally during follow-up of the primary tumors, while the involvement of the common bile duct was uncommon (19.51%). Conclusions: EUS and EUS-FNA/B have been validated as valuable diagnostic tools for identifying MPLs. While our findings are promising, further multicenter studies are necessary to corroborate these results and elucidate the predictive value of specific EUS characteristics in determining the metastatic origin of pancreatic lesions. Full article
(This article belongs to the Special Issue Endoscopic Ultrasound (EUS) in Gastrointestinal Diseases)
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Review

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19 pages, 3427 KiB  
Review
The Role of Endoscopic Ultrasound and Ancillary Techniques in the Diagnosis of Autoimmune Pancreatitis: A Comprehensive Review
by Flavio Metelli, Guido Manfredi, Nico Pagano, Elisabetta Buscarini, Stefano Francesco Crinò and Elia Armellini
Diagnostics 2024, 14(12), 1233; https://doi.org/10.3390/diagnostics14121233 - 12 Jun 2024
Viewed by 398
Abstract
Autoimmune pancreatitis (AIP) is a unique form of chronic pancreatitis with a multifactorial pathogenesis. Historically, it has been classified as type 1 and type 2, according to its clinical and histological features. The diagnosis of AIP is challenging and relies on a combination [...] Read more.
Autoimmune pancreatitis (AIP) is a unique form of chronic pancreatitis with a multifactorial pathogenesis. Historically, it has been classified as type 1 and type 2, according to its clinical and histological features. The diagnosis of AIP is challenging and relies on a combination of clinical, histopathologic, serologic, and imaging characteristics. In the available guidelines, the imaging hallmarks of AIP are based on cross-sectional imaging and cholangiopancreatography retrograde endoscopic findings. Endoscopic ultrasound (EUS) is generally used for pancreatic tissue acquisition to rule out pancreatic cancer and diagnose AIP with limited accuracy. Several papers reported the reliability of EUS for providing informative morphologic features of AIP. Nowadays, the improvement in the resolution of EUS conventional images and the development of new ancillary technologies have further increased the diagnostic yield of EUS: contrast-enhanced EUS and EUS elastography are non-invasive and real-time techniques that strongly support the diagnosis and management of pancreatic diseases. In this review article, we will present the role of conventional EUS and ancillary diagnostic techniques in the diagnosis of AIP to support clinicians and endosonographers in managing this condition. Full article
(This article belongs to the Special Issue Endoscopic Ultrasound (EUS) in Gastrointestinal Diseases)
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21 pages, 4264 KiB  
Review
Diagnostic Endoscopic Ultrasound (EUS) of the Luminal Gastrointestinal Tract
by Giovanna Impellizzeri, Giulio Donato, Claudio De Angelis and Nico Pagano
Diagnostics 2024, 14(10), 996; https://doi.org/10.3390/diagnostics14100996 - 11 May 2024
Viewed by 721
Abstract
The purpose of this review is to focus on the diagnostic endoscopic ultrasound of the gastrointestinal tract. In the last decades, EUS has gained a central role in the staging of epithelial and sub-epithelial lesions of the gastrointestinal tract. With the evolution of [...] Read more.
The purpose of this review is to focus on the diagnostic endoscopic ultrasound of the gastrointestinal tract. In the last decades, EUS has gained a central role in the staging of epithelial and sub-epithelial lesions of the gastrointestinal tract. With the evolution of imaging, the position of EUS in the diagnostic work-up and the staging flow-chart has continuously changed with two extreme positions: some gastroenterologists think that EUS is absolutely indispensable, and some think it is utterly useless. The truth is, as always, somewhere in between the two extremes. Analyzing the most up-to-date and strong evidence, we will try to give EUS the correct position in our daily practice. Full article
(This article belongs to the Special Issue Endoscopic Ultrasound (EUS) in Gastrointestinal Diseases)
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15 pages, 1469 KiB  
Review
Endoscopic Biliary Drainage in Surgically Altered Anatomy
by Marco Spadaccini, Carmelo Marco Giacchetto, Matteo Fiacca, Matteo Colombo, Marta Andreozzi, Silvia Carrara, Roberta Maselli, Fabio Saccà, Alessandro De Marco, Gianluca Franchellucci, Kareem Khalaf, Glenn Koleth, Cesare Hassan, Andrea Anderloni, Alessandro Repici and Alessandro Fugazza
Diagnostics 2023, 13(24), 3623; https://doi.org/10.3390/diagnostics13243623 - 8 Dec 2023
Cited by 3 | Viewed by 1111
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is considered the preferred method for managing biliary obstructions. However, the prevalence of surgically modified anatomies often poses challenges, making the standard side-viewing duodenoscope unable to reach the papilla in most cases. The increasing instances of surgically altered anatomies [...] Read more.
Endoscopic retrograde cholangiopancreatography (ERCP) is considered the preferred method for managing biliary obstructions. However, the prevalence of surgically modified anatomies often poses challenges, making the standard side-viewing duodenoscope unable to reach the papilla in most cases. The increasing instances of surgically altered anatomies (SAAs) result from higher rates of bariatric procedures and surgical interventions for pancreatic malignancies. Conventional ERCP with a side-viewing endoscope remains effective when there is continuity between the stomach and duodenum. Nonetheless, percutaneous transhepatic biliary drainage (PTBD) or surgery has historically been used as an alternative for biliary drainage in malignant or benign conditions. The evolving landscape has seen various endoscopic approaches tailored to anatomical variations. Innovative methodologies such as cap-assisted forward-viewing endoscopy and enteroscopy have enabled the performance of ERCP. Despite their utilization, procedural complexities, prolonged durations, and accessibility challenges have emerged. As a result, there is a growing interest in novel enteroscopy and endoscopic ultrasound (EUS) techniques to ensure the overall success of endoscopic biliary drainage. Notably, EUS has revolutionized this domain, particularly through several techniques detailed in the review. The rendezvous approach has been pivotal in this field. The antegrade approach, involving biliary tree puncturing, allows for the validation and treatment of strictures in an antegrade fashion. The EUS-transmural approach involves connecting a tract of the biliary system with the GI tract lumen. Moreover, the EUS-directed transgastric ERCP (EDGE) procedure, combining EUS and ERCP, presents a promising solution after gastric bypass. These advancements hold promise for expanding the horizons of comprehensive and successful biliary drainage interventions, laying the groundwork for further advancements in endoscopic procedures. Full article
(This article belongs to the Special Issue Endoscopic Ultrasound (EUS) in Gastrointestinal Diseases)
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