Download PDF
Endoscopy 2006; 38: 88-93
DOI: 10.1055/s-2006-946664
Invited papers
Therapeutic EUS & new technology
© Georg Thieme Verlag KG Stuttgart · New York

EUS-guided fine needle injection (FNI) and anti-tumor therapy

K. J. Chang1
  • 1University of California, Irvine
Further Information

Publication History

Publication Date:
26 June 2006 (online)

Also available at
   Permissions and Reprints

Introduction

EUS has evolved from EUS imaging, to EUS-guided FNA, and now to EUS-guided fine needle injection (FNI). This advancement has paved the way for ”Interventional EUS” [1]. EUS-guided FNI includes delivery of contrast agents with subsequent drainage/anastomosis, pre-EMR solution, botulinum toxin, neurolytic agents (including intra-ganglion injections), sclerosing solutions/glue, radiofrequency energy, radioactive and inert seeds, light-activating laser, and a growing number of anti-tumor agents. These will all be addressed in this update.

References

  • 1 Chang K J, Wiersema M J. Endoscopic ultrasound-guided fine-needle aspiration biopsy and interventional endoscopic ultrasonography. Emerging technologies.  Gastrointest Endosc Clin N Am. 1997;  7 (2) 221-235
    PubMedGoogle Scholar
  • 2 Wiersema M J, Sandusky D, Carr R, Wiersema L M, Erdel W C, Frederick P K. Endosonography-guided cholangiopancreatography.  Gastrointest Endosc. 1996;  43 (2 Pt 1) 102-106
    Google Scholar
  • 3 Burmester E, Niehaus J, Leineweber T, Huetteroth T. EUS-cholangio-drainage of the bile duct: report of 4 cases.  Gastrointest Endosc. 2003;  57 (2) 246-251
    Google Scholar
  • 4 Seifert H, Dietrich C, Schmitt T, Caspary W, Wehrmann T. Endoscopic ultrasound-guided one-step transmural drainage of cystic abdominal lesions with a large-channel echo endoscope.  Endoscopy. 2000;  32 (3) 255-259
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Kahaleh M, Yoshida C, Yeaton P. EUS antegrade pancreatography with gastropancreatic duct stent placement: Review of two cases.  Gastrointest Endosc. 2003;  58 (6) 919-923
    CrossrefPubMedGoogle Scholar
  • 6 Mallery S, Matlock J, Freeman M L. EUS-guided rendezvous drainage of obstructed biliary and pancreatic ducts: Report of 6 cases.  Gastrointest Endosc. 2004;  59 (1) 100-107
    Google Scholar
  • 7 Kahaleh M, Wang P, Shami V M, Tokar J, Yeaton P. EUS-guided transhepatic cholangiography: report of 6 cases.  Gastrointest Endosc. 2005;  61 (2) 307-313
    CrossrefPubMedGoogle Scholar
  • 8 Giovannini M, Dotti M, Bories E, Moutardier V, Pesenti C, Danisi C. et al . Hepaticogastrostomy by echo-endoscopy as a palliative treatment in a patient with metastatic biliary obstruction.  Endoscopy. 2003;  35 1076-1078
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Sun S, Wang M, Sun S. Use of endoscopic ultrasound-guided injection in endoscopic resection of solid submucosal tumors.  Endoscopy. 2002;  34 (1) 82-85
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Pasricha P J, Rai R, Ravich W J, Hendrix T R, Kalloo A N. Botulinum toxin for achalasia: long-term outcome and predictors of response.  Gastroenterology. 1996;  110 1410-1415
    CrossrefPubMedGoogle Scholar
  • 11 Pasricha P J, Ravich W J, Hendrix T R, Sostre S, Jones B, Kalloo A N. Intrasphincteric botulinum toxin for the treatment of achalasia.  N Engl J Med. 1995;  332 (12) 774-778
    CrossrefPubMedGoogle Scholar
  • 12 Hoffman B J, Knapple W, Bhutani M S, Aabakken L, Verne N, Hawes R H. EUS-Guided Injection of Botulinum Toxin for Achalasia.  Gastrointest Endosc. 1996;  43 (4) A534
    PubMedGoogle Scholar
  • 13 Maiorana A, Fiorentino E, Genova E G, Murata Y, Suzuki S. Echo-guided injection of botulinum toxin in patients with achalasia: initial experience.  Endoscopy. 1999;  31 (2) 3S-4S
    PubMedGoogle Scholar
  • 14 Wiersema M, Wiersema L. Endosonography guided celiac plexus neurolysis (EUS CPN) in patients with pain due to intra-abdominal malignancy (IAM).  Gastrointest Endosc. 1996;  43 (4) A565
    PubMedGoogle Scholar
  • 15 Gress F, Schmitt C, Sherman S, Ciaccia D, Ikenberry S, Lehman G. Endoscopic ultrasound-guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience.  Am J Gastroenterol. 2001;  96 (2) 409-416
    CrossrefPubMedGoogle Scholar
  • 16 Grimm H, Binmoeller K F, Soehendra N. Endosonography-guided drainage of a pancreatic pseudocyst.  Gastrointest Endosc. 1992;  38 (2) 170-171
    CrossrefPubMedGoogle Scholar
  • 17 Brugge W R. The role of EUS in the diagnosis of cystic lesions of the pancreas.  Gastrointest Endosc. 2000;  52 (6 Suppl) S18-22
    CrossrefPubMedGoogle Scholar
  • 18 Lewandrowski K B, Southern J F, Pins M R, Compton C C, Warshaw A L. Cyst fluid analysis in the differential diagnosis of pancreatic cysts. A comparison of pseudocysts, serous cystadenomas, mucinous cystic neoplasms, and mucinous cystadenocarcinoma.  Ann Surg. 1993;  217 (1) 41-47
    CrossrefPubMedGoogle Scholar
  • 19 Giovannini M, Pesenti C, Rolland A L, Moutardier V, Delpero J R. Endoscopic ultrasound-guided drainage of pancreatic pseudocysts or pancreatic abscesses using a therapeutic echo endoscope.  Endoscopy. 2001;  33 (6) 473-477
    Google Scholar
  • 20 Seifert H, Faust D, Schmitt T, Dietrich C, Caspary W, Wehrmann T. Transmural drainage of cystic peripancreatic lesions with a new large-channel echo endoscope.  Endoscopy. 2001;  33 (12) 1022-1026
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Ribeiro A, Vazquez-Sequeiros E, Wiersema M J. Doppler EUS-guided treatment of gastric Dieulafoy’s lesion.  Gastrointest Endosc. 2001;  53 (7) 807-809
    CrossrefPubMedGoogle Scholar
  • 22 Pedersen F M, Vilmann P, Bytzer P. Gastric arteriovenous malformation: Doppler EUS-guided diagnosis and therapy.  Gastrointest Endosc. 2002;  55 (4) 597-599
    CrossrefPubMedGoogle Scholar
  • 23 Lee Y T, Chan F K, Ng E K, Leung V K, Law K B, Yung M Y. et al . EUS-guided injection of cyanoacrylate for bleeding gastric varices.  Gastrointest Endosc. 2000;  52 (2) 168-174
    CrossrefPubMedGoogle Scholar
  • 24 Lahoti S, Catalano M F, Alcocer E, Hogan W J, Geenen J E. Obliteration of esophageal varices using EUS-guided sclerotherapy with color Doppler.  Gastrointest Endosc. 2000;  51 (3) 331-333
    CrossrefPubMedGoogle Scholar
  • 25 Goldberg S N, Mallery S, Gazelle G S, Brugge W R. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model.  Gastrointestinal Endoscopy. 1999;  50 (3) 392-401
    CrossrefPubMedGoogle Scholar
  • 26 Bown S G, Rogowska A Z, Whitelaw D E, Lees W R, Lovat L B, Ripley P. et al . Photodynamic therapy for cancer of the pancreas.  Gut. 2002;  50 (4) 549-557
    CrossrefPubMedGoogle Scholar
  • 27 Chan H H, Nishioka N S, Mino M, Lauwers G Y, Puricelli W P, Collier K N. et al . EUS-guided photodynamic therapy of the pancreas: a pilot study.  Gastrointest Endosc. 2004;  59 (1) 95-99
    CrossrefPubMedGoogle Scholar
  • 28 Maier W, Henne K, Krebs A, Schipper J. Endoscopic ultrasound-guided brachytherapy of head and neck tumours. A new procedure for controlled application.  J Laryngol Otol. 1999;  113 (1) 41-48
    PubMedGoogle Scholar
  • 29 Lah J J, Kuo J V, Chang K J, Nguyen P T. EUS-guided brachytherapy.  Gastrointest Endosc. 2005;  62 (5) 805-808
    CrossrefPubMedGoogle Scholar
  • 30 Chang K J, Nguyen P T, Thompson J A, Kurosaki T T, Casey L R, Leung E C. et al . Phase I clinical trial of allogeneic mixed lymphocyte culture (cytoimplant) delivered by endoscopic ultrasound-guided fine-needle injection in patients with advanced pancreatic carcinoma.  Cancer. 2000;  88 (6) 1325-1335
    CrossrefPubMedGoogle Scholar
  • 31 Hecht J R, Bedford R, Abbruzzese J L, Lahoti S, Reid T R, Soetikno R M. et al . A phase I/II trial of intratumoral endoscopic ultrasound injection of ONYX-015 with intravenous gemcitabine in unresectable pancreatic carcinoma.  Clin Cancer Res. 2003;  9 (2) 555-561
    PubMedGoogle Scholar
  • 32 Chang K C, Senzer N, Chung T, Hecht J R, Vogel S, Rosemurgy A. et al .A novel gene transfer therapy against pancreatic cancer (TNFerade) delivered by endoscopic ultrasound(EUS) and percutaneous guided fine needle injection(FNI). Gastrointest Endosc 2004
    Google Scholar
  • 33 Farrell J J, Senzer N, Hecht J R, Hanna N, Chung T, Nemunaitis J, Rosemurgy A, Javle M, Reid T, Posner M, Macko J, Chang K J. Long-term data for endoscopic ultrasound (EUS) and percutaneous (PTA) guided intratumoral TNFerade gene delivery combined with chemoradiation in the treatment of locally advanced pancreatic cancer (LAPC).  Gastrointest Endosc. 2006;  63 (5) AB93
    PubMedGoogle Scholar
  • 34 Chang K J, Senzer N, Swisher S, Reid R, Mauer A, Posner M. et al . Multi-center Clinical Trial Using Endoscopy and Endoscopic Ultrasound (EUS) guided fine needle injection (FNI) of anti-tumor agent (TNFerade™) in patients with locally advanced Esophageal Cancer.  Gastrointest Endosc. 2006;  63 (5) AB84
    PubMedGoogle Scholar

Kenneth J. Chang, M.D.

University of California, Irvine

Director, H. H. Chao Comprehensive Digestive Disease Center

101 The City Drive, Bldg 23, Rt 81

Orange, CA 92868

Phone: (714) 456-6187

Fax: (714) 456-7520

Email: kchang@uci.edu

      >