Preface: EUS-Guided Tissue Acquisition

Shyam Varadarajulu, MD, Editor

Robert H. Hawes, MD, Editor

There has been a significant shift in the practice of EUS-guided tissue acquisition since the technique was first reported 21 years ago. The FNA needles are now available in different sizes, design, and flexibility. Depending on clinical need, both cytological aspirate and/or a histological core tissue can be procured with relative ease. Various techniques of tissue sampling have been described and validated in algorithms and clinical trials. These developments have enabled the establishment of a specific tissue diagnosis in a majority of patients, thereby enabling surgeons and oncologists to deliver “planned” treatment with optimal clinical outcomes. In addition to establishing cytologic or histologic diagnosis, we are now able to diagnose lymphomatous and other rare diseases as well as assess tumors for molecular markers to enable tailored chemotherapy regimens. However, despite these advances, certain limitations such as the dependence on an onsite cytopathologist for achieving high diagnostic accuracy, technical difficulty in accessing small pancreatic lesions in the uncinate process, inability to reliably procure core tissue, and controversies on the best technique to collect and process specimens still persist.

In this supplement of the Gastrointestinal Endoscopy Clinics of North America we have attempted to provide a comprehensive review of the existing practices in EUS-guided tissue acquisition and shed light on some of the controversies listed above. We hope this will serve as a valuable reference to enable you to improve your EUS service for the benefit of your patients. We are very grateful to the authors who have selflessly contributed to this issue to make our discipline better for tomorrow.

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