Contrast-enhanced harmonic endoscopic ultrasound: Future per
Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) can be applied as not only unprecedented new imaging method but also the treatment of cancer in the future. We provided a review article on the future of CH-EUS, especially in terms of targeted endoscopic ultrasound fine-needle aspiration (EUS-FNA), evaluation of chemotherapy, molecular imaging, local drug delivery, and local ablation in this section.

Conventional endoscopic ultrasound (EUS) sometimes fails to depict margins and the structure of the target for EUS-FNA. CH-EUS helps identification of these subtle lesions. Fusaroli et al. examined ninety patients who were suspected of having pancreatic solid neoplasm. CH-EUS allowed detection of small lesions in seven patients who had uncertain standard EUS findings and targeted EUS-FNA was performed on these lesions. Seicean et al. evaluated diagnostic accuracy of EUS-FNA with CH-EUS for solid tumors in the pancreas. They avoided nonenhanced parts for the target during EUS-FNA with CH-EUS. The sensitivity of EUS-FNA with CH-EUS (83.9%) was higher than that with conventional EUS (73.2%), although these values did not differ significantly. Sugimoto et al. compared the diagnostic yield of EUS-FNA and CH-EUS in the diagnosis of solid pancreatic lesions. In their report, fewer needle passes were required to obtain samples from solid pancreatic lesions using CH-EUS than conventional EUS during EUS-FNA.