The role of EUS and EUS-FNA for gallbladder benign or malignant resion

Abstract

Endoscopic ultrasonography (EUS) has greater spatial resolution than other types of diagnostic imaging modalities. In addition, if gallbladder lesions are found and gallbladder cancer is suspected, EUS is an indispensable modality, enabling detailed tests, using the Doppler mode and ultrasound agents, for invasion depth diagnosis, and so on. Furthermore, with gallbladder lesions, EUS combined with fine needle aspiration (EUS-FNA) is available for distinguishing between benign and malignant forms of conditions such as xanthogranulomatous cholecystitis, and collecting evidence before chemotherapy, and is useful for a highly precise and specific diagnosis. However, prevention of bile leakage, an accidental symptom, is highly important. As a result of widespread use of next-generation sequencers, there have been reports of driver genes even in biliary tract cancers, including gall bladder cancer, and clinical studies are now being carried out on molecular therapeutic agents targeting these genes. It is considered that gene-panel assays using next-generation sequencers will be feasible with samples obtained by EUS-FNA, further increasing the demand for EUS-FNA.