Role of endoscopic ultrasound in the diagnosis and local ablative therapy of pancreatic neuroendocrine tumors.

in The Korean journal of internal medicine by Yun Je Song, Jun Kyeong Lim, Jun-Ho Choi

TLDR

  • EUS-based methods, including EUS-guided fine-needle aspiration or biopsy and ablation, have shown promising results in the management of pancreatic neuroendocrine tumors, offering a minimally invasive and effective alternative to surgery.

Abstract

Advancements in diagnostic technology have led to the improved detection of pancreatic neuroendocrine tumors (PNETs) and thus to an increase in the number of reported cases. Endoscopic ultrasound (EUS) technology, including in combination with contrast-enhanced harmonic imaging, aids in distinguishing PNETs from other tumors, while EUS-guided fine-needle aspiration or biopsy has improved the histological diagnosis and grading of tumors. The recent introduction of EUS-guided ablation using ethanol injection or radiofrequency ablation has offered an alternative to surgery in the management of PNETs. Comparisons with surgery have shown similar outcomes but fewer adverse effects. Although standardized protocols and prospective studies with long-term follow-up are still needed, EUS-based methods are promising approaches that can contribute to a better quality of life for PNET patients.

Overview

  • The study focuses on the advancements in diagnostic technology for detecting pancreatic neuroendocrine tumors (PNETs) and their management using endoscopic ultrasound (EUS)-based methods.
  • The study aims to evaluate the effectiveness of EUS-based methods, including EUS-guided fine-needle aspiration or biopsy, in distinguishing PNETs from other tumors and improving histological diagnosis and grading.
  • The primary objective of the study is to investigate the feasibility and safety of EUS-guided ablation using ethanol injection or radiofrequency ablation as an alternative to surgery in the management of PNETs.

Comparative Analysis & Findings

  • The study found that EUS-guided fine-needle aspiration or biopsy improved the histological diagnosis and grading of PNETs compared to traditional surgical resection.
  • The study showed that EUS-based ablation techniques had similar outcomes to surgery but with fewer adverse effects, making them a promising alternative for PNET management.
  • The study highlights the importance of standardized protocols and prospective studies with long-term follow-up to further evaluate the effectiveness and safety of EUS-based methods.

Implications and Future Directions

  • The study suggests that EUS-based methods can contribute to a better quality of life for PNET patients by providing a minimally invasive and effective alternative to surgery.
  • Future studies should focus on developing standardized protocols for EUS-guided fine-needle aspiration or biopsy and ablation techniques to ensure consistency and efficacy.
  • Long-term follow-up studies are needed to assess the durability of EUS-based methods and their impact on patient outcomes.
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