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Endoscopic ultrasound-guided fine-needle aspiration for gastrointestinal subepithelial lesions

  • Special Feature: Review Article
  • Cutting edge of EUS-FNA
  • Published:
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Abstract

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the first-choice procedure for obtaining pathological tissue samples from gastrointestinal (GI) subepithelial lesions (SELs). However, its diagnostic accuracy is lower than that for pancreatic masses owing to puncture difficulty and the need for immunostaining for definitive diagnosis. The advent of fine-needle biopsy needles, which have become well known in recent years, improves the diagnostic accuracy of EUS-FNA for GI SELs. The forward-viewing echoendoscope and rapid on-site evaluation (ROSE) have also helped to improve diagnostic accuracy. Furthermore, in facilities where ROSE is not available, endosonographers perform a macroscopic on-site evaluation. With these procedural innovations, EUS-FNA is now performed aggressively even for SELs smaller than 20 mm. The incidence of procedure-related adverse events such as bleeding and infection is low, and thus, EUS-FNA can be safely performed to diagnose SELs.

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Acknowledgements

We thank Prof. Yuko Hashimoto in the Department of Diagnostic Pathology, Fukushima Medical University, for her advice on histopathological findings. We also express our gratitude to Dr. Mika Takasumi, Dr. Hitomi Kikuchi, Dr. Yuichi Waragai, and Dr. Ryoichiro Kobashi for their performance of EUS-FNA.

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Authors and Affiliations

  1. Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Takuto Hikichi, Minami Hashimoto, Takumi Yanagita, Tsunetaka Kato & Jun Nakamura

Authors
  1. Takuto Hikichi
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  2. Minami Hashimoto
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  3. Takumi Yanagita
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  4. Tsunetaka Kato
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  5. Jun Nakamura
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Contributions

Conceptualization: TH. Methodology: TH Formal Analysis: TH, MH, JN. Investigation: TY and TK. Data Curation: TH. Writing—original draft preparation: TH. Writing—review and editing: MH, TY, TK, JN project administration: TH.

Corresponding author

Correspondence to Takuto Hikichi.

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Conflict of interest

Takuto Hikichi, Minami Hashimoto, Takumi Yanagita, Tsunetaka Kato, and Jun Nakamura declare that there are no conflicts of interest.

Ethical approval

This is a review article based on the previously reported literature. However, regarding EUS-FNA performed at our institution, all procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all EUS-FNA patients.

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Hikichi, T., Hashimoto, M., Yanagita, T. et al. Endoscopic ultrasound-guided fine-needle aspiration for gastrointestinal subepithelial lesions. J Med Ultrasonics 51, 195–207 (2024). https://doi.org/10.1007/s10396-023-01342-7

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  • DOI: https://doi.org/10.1007/s10396-023-01342-7

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