Abstract:
In summary, EUS is an accurate modality for the diagnosis of IPMT. Certain endosonographic features are highly indicative of a malignancy. The addition of FNA capability further enhances diagnostic capability through sampling of the mural nodules or aspiration of the pancreatic juice for cytology and tumor marker determination. IDUS provides high-resolution imaging of the pancretic duct and can be used for the localization and prediction of extension of IPMT. IDUS can be used in conjunction with other modalities (like EUS or pancreatoscopy) to further improve the diagnostic yield. Nevertheless, the exact role of endosonography in distinguishing malignant from benign IPMT remains to be proven. Larger studies evaluating the clinical utility of EUS in IPMT are awaited. Because of the low incidence of IPMT, multicenter trials appear to be the most reasonable methods to prove the efficacy of this new approach.