Our doctors use endoscopic ultrasound (EUS) to diagnose and stage esophageal, pancreatic, gastric, colorectal and bile duct cancers. In some cases, we may use EUS for therapeutic purposes as well.
Endoscopic ultrasound often produces more accurate and detailed images than those obtained by traditional ultrasound. This is because a small ultrasound transducer is located on the tip of the endoscope, which allows us to get closer to the tumor and surrounding areas.
In this minimally invasive imaging procedure, we insert an endoscope (a long, flexible, lighted tube with an attached camera) into the mouth or rectum. Then, ultrasound waves produce images of internal parts of the body, such as the digestive tract, as well as surrounding tissues and organs.
For diagnostic purposes, endoscopic ultrasound allows us to perform a biopsy to diagnose a tumor and plan treatment, and to check for recurrence after treatment. This is done using fine needle aspiration (FNA). During this process, a thin needle is placed through the endoscope and directed into the mass or surrounding lymph nodes to obtain a biopsy specimen.
In cases where more tissue is required to make a definitive diagnosis, a core needle biopsy (which uses a larger needle) can be performed during endoscopic ultrasound.
For pancreatic tumors, EUS can also be a therapeutic tool. For example, we can inject medication into the celiac ganglion (mass of nerve tissue in the upper abdomen) to alleviate pain associated with pancreatic cancer.
The EUS procedure typically takes 10-60 minutes, depending on whether it is for diagnostic or therapeutic reasons. An anesthesiologist may administer moderate sedation so the patient is asleep during the procedure. Usually, with a lower EUS, no sedation or little sedation is required.