title: Endoscopic ultrasound in the diagnosis of pancreatic cancer.
abstract: BACKGROUND
  Cross sectional imaging is important for initial evaluation of pancreatic cancer, whereas endoscopic ultrasound (EUS) will often help better visualize, differentiate and make final tissue diagnosis. It plays an important role in the multi-disciplinary evaluation and staging of pancreatic cancer as accurate staging has significant impact on treatment decisions.
  
  
  METHODS
  This review will cover the yield and utility of EUS and EUS FNA for diagnosis of pancreas cancer. In addition, this article reviews the utility and diagnostic yield of the non-invasive imaging modalities, including surface ultrasound, CT scan, PET CT scan and MRI. Tumor size, histology and disease processes that mimic pancreatic cancers will also be reviewed.
  
  
  CONCLUSIONS
  The accurate diagnosis and staging of pancreatic neoplasms is essential for optimal patient management. Abdominal imaging with multidetector CT or MRI is the most important initial step in the evaluation of pancreatic cancer because they are widely available and can detect most masses and/or demonstrate dilated bile or pancreatic ducts indicative of obstruction. Endoscopic ultrasound will remain important for detecting small tumors, ruling out diseases that mimic adenocarcinoma and for obtaining tissue diagnosis with fine needle aspiration.
authors.affiliation: University of California, Division of Gastroenterology, San Diego, CA 92093, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Munroe
authors.forename: Syed M Abbas
authors.initials: SM
authors.lastname: Fehmi
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Savides
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D019160:Endosonography / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed