Endosonographic diagnosis of advanced neoplasia in intraductal papillary mucinous neoplasms

World Journal of Gastroenterology : WJG
Andrew EitermanSomashekar G Krishna

Abstract

Pancreatic cancer has a high mortality rate with minimal proven interventions. Intraductal Papillary Mucinous Neoplasms (IPMNs) are known precursor lesions for pancreatic cancer. Identification of pancreatic cysts has improved from advances in abdominal imaging. Despite multiple revisions of the international consensus recommendations and various guidelines by other major societies, successful risk stratification of the malignant potential of mucinous pancreatic cysts remains challenging. Specifically, detection and accurate classification of advanced neoplasia (high-grade dysplasia and/or adenocarcinoma) in IPMNs is suboptimal with current diagnostic strategies. Development of interventional techniques utilizing endoscopic ultrasound include - through-the-needle microforceps biopsy, next-generation or whole genome molecular analysis of cyst fluid, and needle-based confocal laser endomicroscopy. These techniques suffer from a series of limitations in technical success, diagnostic yield, and clinical feasibility, but a combination approach may offer a solution that optimizes their cyst evaluation and risk stratification. Assessment and comparison of these techniques is restricted by lack of adequate surgical specimens for testin...Continue Reading

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Citations

Aug 13, 2021·Digestive Diseases and Sciences·Andrew Canakis, Linda S Lee

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Methods Mentioned

BETA
imaging techniques
biopsy
PCL
surgical resection
biopsies
imaging technique

Software Mentioned

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