title: Clinical oncology for pancreatic and biliary cancers: Advances and current limitations.
abstract: In the early 2000s, the main stream of endoscopic ultrasonography (EUS) changed from a mechanical scanning method to electronic radial or linear scanning methods. Subsequently, useful applications in trans-abdominal ultrasonography came within reach of EUS. In particular, contrast-enhanced EUS (CE-EUS) and EUS-elastography became cutting-edge diagnostic modalities for pancreatic disorders. Each type of pancreatic disorder has characteristic hemodynamics. CE-EUS uses color Doppler flow imaging and harmonic imaging to classify pancreatic lesions. EUS-elastography can assess tissue hardness by measuring its elasticity. This parameter appears to correlate with the malignant potential of the lesions. Tissue elasticity studies can provide information on both its pattern and distribution. The former is the conventional method of morphological diagnosis, but it is restricted to observations made in a region of interest (ROI). The latter is an unbiased analysis that can be performed by image analysis software and is theoretically constant, regardless of the ROI. Though EUS-fine needle aspiration (FNA) is also a very useful diagnostic tool, there are several limitations. Diagnostic EUS-FNA of pancreatic cystic lesions has marginal utility mainly due to low sensitivity. Therefore, in particular, endoscopists should keep this limitation in mind.
authors: Yoshiki Hirooka, Yosuke Nakamura, Ryoji Miyahara, Hidemi Goto, Department of Endoscopy, Nagoya University Hospital, 65, Tsuruma-Cho, Showa-Ku, Nagoya City, Aichi Prefecture 81-466-8550, Japan.
authors: Yoshiki
authors: Y
authors: Hirooka
authors: Akihiro
authors: A
authors: Itoh
authors: Hiroki
authors: H
authors: Kawashima
authors: Eizaburo
authors: E
authors: Ohno
authors: Takuya
authors: T
authors: Ishikawa
authors: Yuya
authors: Y
authors: Itoh
authors: Yosuke
authors: Y
authors: Nakamura
authors: Takeshi
authors: T
authors: Hiramatsu
authors: Masanao
authors: M
authors: Nakamura
authors: Ryoji
authors: R
authors: Miyahara
authors: Naoki
authors: N
authors: Ohmiya
authors: Masatoshi
authors: M
authors: Ishigami
authors: Yoshiaki
authors: Y
authors: Katano
authors: Hidemi
authors: H
authors: Goto
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