Abstract
Endoscopic ultrasonography (EUS) has greater spatial resolution than other diagnostic imaging modalities. In addition, if gallbladder lesions are found and gallbladder cancer is suspected, EUS is an indispensable modality, enabling detailed tests for invasion depth evaluation using the Doppler mode and ultrasound agents. Furthermore, for gallbladder lesions, EUS fine-needle aspiration (EUS-FNA) can be used to differentiate benign and malignant forms of conditions, such as xanthogranulomatous cholecystitis, and collect evidence before chemotherapy. EUS-FNA is also useful for highly precise and specific diagnoses. However, the prevention of bile leakage, an accidental symptom, is highly important. Advancements in next-generation sequencing (NGS) technologies facilitate the application of multiple parallel sequencing to EUS-FNA samples. Several biomarkers are expected to stratify treatment for gallbladder cancer; however, NGS can unveil potential predictive genomic biomarkers for the treatment response. It is believed that NGS may be feasible with samples obtained using EUS-FNA, further increasing the demand for EUS-FNA.
Highlights
Endoscopic ultrasonography (EUS) plays a major role in the diagnosis of gallbladder lesions
The digitization of diagnostic ultrasound imaging devices and advancements in ultrasound contrast media help obtain the blood flow information with the Doppler-mode and contrast-enhanced EUS, and more detailed EUS investigations can be performed to determine the presence of gallbladder lesions and invasion depth for suspected gallbladder cancer
EUS combined with fine-needle aspiration (EUS-FNA) is useful for distinguishing between benign and malignant gallbladder lesions
Summary
Endoscopic ultrasonography (EUS) plays a major role in the diagnosis of gallbladder lesions. High ultrasound frequencies (5 mHz to 20 mHz) are used for EUS, and it has a high spatial resolution, thereby facilitating a detailed examination of the gallbladder because it can approach and examine the organ at a closer range than the conventional US [2,3,4]. This helps in the qualitative diagnosis of lesions and evaluation of tumor invasion depth [5]. Kaneko et al [6] reported that there was no significant difference in visualization between these two types of devices in the examination of the pancreaticobiliary region
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