Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Endoscopic Ultrasound (EUS) is a relatively new modality. Its high resolution makes it possible to detect tumors of 5mm in diameter otherwise missed by other imaging modalities. It is more accurate than computerized tomography (CT) scan, Transabdominal Ultrasound (US) and Magnetic Resonance Imaging (MRI) in diagnosing pancreatic lesions, especially those less than 20mm in diameter. EUS can be used to obtain pancreatic and nodal tissue using ultrasound- guided fine needle aspiration increasing the diagnostic yield and helping determining further management. It can also determine vascular involvement by pancreatic cancer with a sensitivity of more than 90%. The current indications for EUS in the diagnosis and management of pancreatic cancer will be reviewed.