• early gastric cancer
• endoscopic submucosal dissection
• endoscopic treatment
• gray zone
• surgical treatment

• Humans
• Cholangiopancreatography, Endoscopic Retrograde/standards
• Cholangiopancreatography, Endoscopic Retrograde/methods
• Endosonography
• Constriction, Pathologic/diagnosis
• Cholestasis/diagnosis
• Cholestasis/pathology
• Cholestasis/etiology
• Biopsy/methods

• cancer
• iatrogenic
• instrumentation
• seeding
• tumor seeding

• Endoscopic ultrasonography
• Endoscopic ultrasound
• High-risk individuals
• Pancreatic cancer
• Screening
• Surveillance

• Humans
• Endosonography/methods
• Pancreatic Neoplasms/diagnostic imaging
• Carcinoma, Pancreatic Ductal/diagnostic imaging
• Carcinoma, Pancreatic Ductal/pathology
• Early Detection of Cancer/methods
• Magnetic Resonance Imaging/methods
• Cholangiopancreatography, Magnetic Resonance/methods

• Benign biliary stricture
• Endoscopic retrograde cholangiopancreatography
• Endoscopic ultrasound
• Indeterminate biliary stricture
• Malignant biliary stricture
• Primary sclerosing cholangitis

• Humans
• Pancreas/diagnostic imaging
• Pancreatic Neoplasms/diagnostic imaging
• Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects

• Gangliocytoma
• case report
• mediastinum
• surgery

Reports of needle tract seeding (NTS) as a complication of endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) have been increasing. To date, most of the reported cases of NTS have been diagnosed during the postoperative follow‐up period. Herein, we report a case of NTS that occurred during preoperative neoadjuvant chemotherapy after EUS‐FNA for resectable pancreatic cancer. The patient underwent transgastric EUS‐FNA for a pancreatic tail tumor. He was diagnosed as having resectable pancreatic cancer and received preoperative neoadjuvant chemotherapy. After completion of the chemotherapy, computed tomography showed a thick‐walled cyst‐like structure appearing between the pancreas and the gastric wall. Combined resection revealed adenocarcinoma invasion into the cyst‐like structure. Based on the clinical course, and surgical and pathological findings, the condition was diagnosed as NTS. It is thus crucial that after EUS‐FNA, a detailed review of the imaging findings be conducted in the preoperative period. If adhesions between the stomach and the pancreas are observed after transgastric EUS‐FNA, combined resection of the gastric wall should be considered.

• endoscopic ultrasound‐guided fine‐needle aspiration
• needle tract seeding
• pancreatic ductal adenocarcinoma

• Computer-aided detection
• Machine learning
• Pancreatic cancer
• Pancreatic ductal adenocarcinoma
• Radiomics

There is growing evidence supporting the substantial, essential and indispensable role of endoscopic ultrasound (EUS) as a key diagnostic armamentarium for upper GI oncologic surgery. Well described in countless publications, EUS holds that position in gastroenterological expert centers all over Europe. Despite its undisputable contributions to oncologic upper GI surgery, the availability of this technique at the expert level shows up in an irregular spread pattern. Endoscopic ultrasound’s primary use during the first few years after its creation was the detection of pancreatic cancer. From then on, EUS developed in different directions, becoming a diagnostic tool that increasingly better defines its status as a method of minimally invasive therapeutic applications and a useful addition to surgical options. As a result, several surgical interventions could even be replaced by ultrasound-targeted interventions. This process took place in just a few years and was made possible by technical development that sensibly combined high-resolution ultrasound with therapeutic endoscopy. The present article will serve to cover the most prevalent uses with supporting data considering the growing list of suggested indications for EUS while also examining cutting-edge initiatives that might soon become the standard of clinical practice. Endoscopic centers with high expertise are needed to train future experts in the growing field of EUS interventions.

• Apparent diffusion coefficient
• Computed tomography
• Diagnosis
• Diffusion-weighted imaging
• Hamartoma
• Magnetic resonance imaging
• Pancreas

• Diffusion Magnetic Resonance Imaging/methods
• Female
• Hamartoma/diagnostic imaging
• Hamartoma/surgery
• Humans
• Middle Aged
• Pancreas/diagnostic imaging
• Pancreas/pathology
• Pancreatic Neoplasms/diagnostic imaging
• Pancreatic Neoplasms/surgery
• Tomography, X-Ray Computed

• Cytology
• Early diagnosis
• Endoscopic retrograde pancreatography
• Endoscopic ultrasound-guided fine needle aspiration
• Pancreatic ductal adenocarcinoma

• Carcinoma, Pancreatic Ductal/diagnosis
• Carcinoma, Pancreatic Ductal/pathology
• Endoscopic Ultrasound-Guided Fine Needle Aspiration
• Humans
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/pathology
• Retrospective Studies
• Pancreatic Neoplasms

Endoscopic ultrasound (EUS) has emerged as an invaluable tool for the diagnosis, staging and treatment of pancreatic ductal adenocarcinoma (PDAC). EUS is currently the most sensitive imaging tool for the detection of solid pancreatic tumors. Conventional EUS has evolved, and new imaging techniques, such as contrast-enhanced harmonics and elastography, have been developed to improve diagnostic accuracy during the evaluation of focal pancreatic lesions. More recently, evaluation with artificial intelligence has shown promising results to overcome operator-related flaws during EUS imaging evaluation. Currently, an appropriate diagnosis is based on a proper histological assessment, and EUS-guided tissue acquisition is the standard procedure for pancreatic sampling. Newly developed cutting needles with core tissue procurement provide the possibility of molecular evaluation for personalized oncological treatment. Interventional EUS has modified the therapeutic approach, primarily for advanced pancreatic cancer. EUS-guided fiducial placement for local targeted radiotherapy treatment or EUS-guided radiofrequency ablation has been developed for local treatment, especially for patients with pancreatic cancer not suitable for surgical resection. Additionally, EUS-guided therapeutic procedures, such as celiac plexus neurolysis for pain control and EUS-guided biliary drainage for biliary obstruction, have dramatically improved in recent years toward a more effective and less invasive procedure to palliate complications related to PDAC. All the current benefits of EUS in the diagnosis and management of PDAC will be thoroughly discussed.

• Endoscopic ultrasound
• Contrast-enhanced harmonic
• Elastography
• Artificial intelligence
• Radiofrequency ablation
• Celiac plexus neurolysis
• Biliary drainage

• Humans
• Needles/adverse effects
• Osteomyelitis/etiology
• Punctures/adverse effects

• Clinicopathological features of pancreatic cancer
• Large-duct pattern invasive carcinoma of the pancreas
• Pancreatic cancer subtype
• Pancreatic cystic disease
• Pancreatic ductal adenocarcinoma

• Carcinoma, Pancreatic Ductal/diagnostic imaging
• Carcinoma, Pancreatic Ductal/genetics
• Humans
• Mutation
• Pancreas
• Pancreatic Ducts
• Pancreatic Neoplasms/diagnostic imaging
• Pancreatic Neoplasms/genetics

This paper presents the performance analysis of the system for real-time reconstruction of the shape of the rigid medical needle used for minimally invasive surgeries. The system is based on four optical fibers glued along the needle at 90 degrees from each other to measure distributed strain along the needle from four different sides. The distributed measurement is achieved by the interrogator which detects the light scattered from each section of the fiber connected to it and calculates the strain exposed to the fiber from the spectral shift of that backscattered light. This working principle has a limitation of discriminating only a single fiber because of the overlap of backscattering light from several fibers. In order to use four sensing fibers, the Scattering-Level Multiplexing (SLMux) methodology is applied. SLMux is based on fibers with different scattering levels: standard single-mode fibers (SMF) and MgO-nanoparticles doped fibers with a 35–40 dB higher scattering power. Doped fibers are used as sensing fibers and SMFs are used to spatially separate one sensing fiber from another by selecting appropriate lengths of SMFs. The system with four fibers allows obtaining two pairs of opposite fibers used to reconstruct the needle shape along two perpendicular axes. The performance analysis is conducted by moving the needle tip from 0 to 1 cm by 0.1 cm to four main directions (corresponding to the locations of fibers) and to four intermediate directions (between neighboring fibers). The system accuracy for small bending (0.1–0.5 cm) is 90\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\%$$\end{document}% and for large bending (0.6–1 cm) is approximately 92\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\%$$\end{document}%.

• ERCP
• EUS
• EUS-FNA
• biliary strictures
• cholangioscopy
• confocal laser endomicroscopy
• endoscopic retrograde cholangiopancreatography
• endoscopic ultrasound

• early diagnosis
• endoscopic retrograde cholangiopancreatography
• endoscopic ultrasonography
• pancreatic cancer