Clinical Endoscopy

Ahmed Youssef Altonbary

2 Articles

Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Portal Vein Thrombus in the Diagnosis and Staging of Hepatocellular Carcinoma: Dina Eskandere, Hazem Hakim, Magdy Attwa, Wagdi Elkashef, Ahmed Youssef Altonbary; Clin Endosc 2021;54(5):745-753. Published online March 15, 2021; DOI: https://doi.org/10.5946/ce.2020.240

Background
/Aims: Malignant portal vein thrombus (PVT) is found in up to 44% of patients with hepatocellular carcinoma (HCC). The nature of the thrombus influences treatment selection. The aim of this study was to assess the safety and efficacy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in determining the nature of PVT in liver cirrhosis and/or HCC.
Methods
A prospective study was conducted in 34 patients with liver cirrhosis and/or HCC with PVT. Under EUS guidance, PVT was punctured using a 22 G FNA needle (Cook Medical, Bloomington, IN, USA) followed by monitoring of the puncture tract using color Doppler. Patients were followed for adverse events 2 hours after recovery.
Results
Throughout the 30-month study period, 34 patients, including 24 males with a mean age of 59±8 years, were enrolled. There were 8 patients with known HCC and 26 with no liver masses detected by computed tomography (CT). EUS-FNA from PVT was positive for malignancy in 3 patients (8.8%), of which only 1 patient was diagnosed with HCC by CT and 2 patients were newly diagnosed with HCC after EUS-FNA. No major complications were reported.
Conclusions
EUS-FNA is a safe and effective technique for determining the nature of PVT that does not fulfill the malignant criteria via imaging studies in patients with liver cirrhosis and/or HCC.

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Endoscopic ultrasound–guided vascular interventions: A review (with videos)
Praveer Rai, Pankaj Kumar, Umair Shamsul Hoda, Kartik Balankhe
Indian Journal of Gastroenterology.2024; 43(5): 927. CrossRef
Endoscopic ultrasound-guided vascular interventions: An overview of current and emerging techniques
Ahmed Youssef Altonbary
International Journal of Gastrointestinal Intervention.2023; 12(1): 16. CrossRef
Endoscopic ultrasound in portal hypertension: navigating venous hemodynamics and treatment efficacy
Irina Dragomir, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Bogdan Procopet, Andrada Seicean
Gastroenterology Report.2023;[Epub] CrossRef

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Diagnostic Efficacy of Endoscopic Ultrasound Elastography in Differentiating Solid Pancreatic Lesions: A Single-Center Experience: Ahmed Youssef Altonbary, Hazem Hakim, Ahmed Mohamed El-Shamy; Clin Endosc 2019;52(4):360-364. Published online January 8, 2019; DOI: https://doi.org/10.5946/ce.2018.160

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic ultrasound (EUS) has a limited ability to determine the nature of solid pancreatic lesions (SPLs). Most recent ultrasound processors are provided with elastography software, which allows quantification of the tissue hardness. The aim of this study is to evaluate the effectiveness of the elasticity score (ES) and strain ratio (SR) in the differentiation of benign pancreatic lesions from malignant pancreatic lesions.
Methods
The study had a retrospective design; it included 97 patients with SPLs and 19 patients with inflammatory lesions. The ES and SR were determined during the examination; finally, EUS-guided fine needle aspiration was performed.
Results
In this 2-year study, 116 patients were enrolled (97 with malignant lesions and 19 with benign lesions). There were 69 men and 47 women. Their median age was 55.9 years. A cut-off point was detected at SR of 7.75 with a specificity of 99.9%, sensitivity of 90.7%, positive predictive value (PPV) of 99.9%, negative predictive value (NPV) of 67.9%, and accuracy of 92.2%. After adding the ES to the SR, the cut-off point at 7.75 resulted in a specificity of 94.6%, sensitivity of 99%, PPV of 98%, NPV of 98.5%, and accuracy of 97%.
Conclusions
The use of the ES combined with the SR increases the accuracy of differentiation between benign and malignant SPLs and is an effective method for the evaluation of pancreatic masses.

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Citations to this article as recorded by

Diagnostic performance of endoscopic ultrasound elastography for differential diagnosis of solid pancreatic lesions: A propensity score-matched analysis
In Rae Cho, Seok-Hoo Jeong, Huapyong Kang, Eui Joo Kim, Yeon Suk Kim, Soyoung Jeon, Jae Hee Cho
Pancreatology.2023; 23(1): 105. CrossRef
The expanding role of endoscopic ultrasound elastography
Jahnvi Dhar, Jayanta Samanta
Clinical Journal of Gastroenterology.2022; 15(5): 841. CrossRef
Endoscopic ultrasound elastography for malignant pancreatic masses and associated lymph nodes: Critical evaluation of strain ratio cutoff value
Miguel Puga-Tejada, Raquel Del Valle, Roberto Oleas, Maria Egas-Izquierdo, Martha Arevalo-Mora, Jorge Baquerizo-Burgos, Jesenia Ospina, Miguel Soria-Alcivar, Hannah Pitanga-Lukashok, Carlos Robles-Medranda
World Journal of Gastrointestinal Endoscopy.2022; 14(9): 524. CrossRef
Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer
Yasutaka Ishii, Masahiro Serikawa, Tomofumi Tsuboi, Ryota Kawamura, Ken Tsushima, Shinya Nakamura, Tetsuro Hirano, Ayami Fukiage, Takeshi Mori, Juri Ikemoto, Yusuke Kiyoshita, Sho Saeki, Yosuke Tamura, Sayaka Miyamoto, Kazuaki Chayama
Diagnostics.2021; 11(2): 238. CrossRef
Impact of endoscopic ultrasound elastography in pancreatic lesion evaluation
Cosmas Rinaldi Adithya Lesmana, Maria Satya Paramitha
Artificial Intelligence in Gastrointestinal Endoscopy.2021; 2(4): 168. CrossRef
Utilidad de la elastografía cuantitativa por ultrasonografía endoscópica (USE), para el diagnóstico de las lesiones sólidas del páncreas (LSP).
Martín Alonso Gómez Zuleta, Oscar Fernando Ruíz Morales, Diego Fernando Cano Rosales
Revista colombiana de Gastroenterología.2021; 36(4): 434. CrossRef

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