WHAT IS EUS?
Endoscopic ultrasound (EUS) is an advance in gastrointestinal endoscopy. First developed in the 1980s to overcome the limitations of transabdominal ultrasound for imaging of the pancreas, it is now an established tool in the management of pancreaticobiliary disease and the examination of subepithelial lesions in the upper and lower GI tract. It is also a sensitive tool for staging of esophageal and rectal cancers.
When combined with a procedure called fine-needle aspiration (FNA), EUS allows for sampling of fluid and tissue from the abdomen. EUS with FNA can be a minimally-invasive alternative to exploratory surgery. Despite its superiority, EUS is underutilized when compared to other endoscopic procedures. EUS is provided by a very limited number of gastroenterologists, mainly in academic and tertiary centers.
A retrospective study done by Dr. Purohit-Goyal and endosonographers at Allegheny General Hospital in Pittsburgh was published in Digestive Diseases and Sciences in 2014. The study proved that EUS is a low-risk, high-yield technique that should be made more widely available so that patients do not have to wait for months to undergo a diagnostic work up.
The study also showed that there is no difference between the cytological yield of EUS-FNA for solid lesions, cysts, or lymph nodes. At the community hospital where the study was performed there were no major acute complications, suggesting that with adequately trained endosonographers and cytologists and rapid onsite evaluation, community hospitals can achieve outcomes similar to well-established academic centers and can meet tertiary care standards for EUS. https://www.ncbi.nlm.nih.gov/pubmed/24573718
PHYSICIAN SPOTLIGHT: DR. TRETA PUROHIT-GOYAL