Dr. Leon Yoder: Endoscopic ultrasound is a newer technique that involves high resolution imaging. That means it’s an image there where we can see the wall now of the intestinal track, and we can see the wall of the intestinal track in the esophagus, the stomach, first part of the small intestine, and the rectum.
And what does that mean? Once we see the wall that means there’s usually about five layers of the wall of the intestinal track. We can see where a tumor has penetrated, how deep it goes into the wall. Sometimes it goes all the way through the wall, sometimes it stops at the outer level or the surosin, but it often times will let the medical oncologists know or the radiation oncologists know that how far we can treat now and also helps the surgeon know 'can this area be resected now?'
So, it’s very, very good now for staging that we use endoscopic ultrasound. We can also see the adjacent structures in these areas. That means that we can look at the mediastinum which is in the chest, we can look for lymph nodes that are in the chest and we can even biopsy those if necessary. We can look into the stomach and because the adjacent structures are so close by, such as a pancreas we can see that very well, we can see the liver very well we can see the bioducts.
So, it’s a very complimentary type of examination when we’re looking at these areas that might have been picked up on a CT or an MRI. We can also, through the endoscopic ultrasound, do fine-needle aspirations. That means that we can take biopsies, which are really sections of the involved organs that are adjacent to the intestinal track such as the pancreas such as a pancreatic mass.
We can biopsy through that we can also take biopsies of involved lymph nodes, and these procedures can be done as outpatients. They are safe procedures, they are still invasive procedures, but they are safe procedures that can be performed.