NEW OPPORTUNITIES OF THE QUALIFYING ENDOSCOPIC DIAGNOSTICS OF PANCREAS NEOPLASMS

Area of Science:

• Gastroenterology and Hepatology
• Medical Imaging
• Oncology

Background:

• Advanced pancreatic diseases require accurate diagnostic tools.
• Endoscopic Ultrasound-Fine Needle Aspiration (EUS-FNA) is a key diagnostic modality.
• Integrating advanced imaging techniques can enhance diagnostic capabilities.

Purpose of the Study:

• To evaluate the combined use of EUS, sonoelastography, and needle-based confocal laser endomicroscopy (nCLE) in clinical practice.
• To assess the diagnostic performance of this combined approach for pancreatic diseases.
• To introduce and refine these techniques for advanced pancreatic diagnostics.

Main Methods:

• EUS-FNA was performed in 72 patients with pancreatic pathology using various needle sizes (19G, 22G, 25G).
• Sonoelastography was applied in 20 patients to assess tissue elasticity.
• nCLE was utilized in 8 patients for in-vivo microscopic examination of pancreatic lesions.

Main Results:

• EUS-FNA procedures showed no complications and provided pathology verification in all cases.
• Sonoelastography differentiated normal tissue, chronic pancreatitis, adenocarcinoma, and neuroendocrine tumors based on color patterns.
• nCLE revealed characteristic cellular and glandular changes in adenocarcinoma, confirming morphological findings.

Conclusions:

• The combination of EUS-FNA, sonoelastography, and nCLE is effective for advanced pancreatic disease diagnosis.
• These integrated techniques offer improved diagnostic accuracy and potential for expanded clinical application.
• Further refinement and wider adoption of these advanced EUS-based methods are warranted.