Endoscopic Ultrasonography in Pancreatic Tumors: When and Why?
EUS has shown to be superior to other imaging techniques in the diagnosis of pancreatic cancer, especially in tumors < 2cm in diameter. Since the negative predictive value of EUS is 95-100%, EUS should be considered the technique of choice to rule out pancreatic cancer in patients with clinical suspicion and inconclusive previous image techniques. However, there is no agreement on the best technique (EUS or CT) to stage and assess ressectability in pancreatic adenocarcinoma. The most reliable sequential approach consists of a helical CT as the initial test and EUS as a confirmatory technique. EUS FNA is the most accurate and safe modality for tissue diagnosis in patients with suspected pancreatic cancer and is mandatory in unresectable disease. In the case of resectable tumors, the need of EUS FNA is still controversial.
KeywordsPancreatic Cancer Chronic Pancreatitis Negative Predictive Value Intraductal Papillary Mucinous Neoplasm Autoimmune Pancreatitis
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