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Endoscopic Ultrasound (EUS)
Endoscopy allows the visualization of the inner lining of the digestive system, such as the esophagus (feeding tube), stomach, small intestines and colon, with a flexible camera through the mouth or anus. Ultrasound uses high-frequency sound waves to image internal organs. EUS is a state-of-the art technology that combines endoscopy with ultrasound. By combining these two technologies, EUS is capable of detailed examinations of the lining and walls of the gastrointestinal tract and internal organs that lie next to the gastrointestinal tract such as the pancreas, bile duct and gallbladder.

When is EUS helpful?
EUS is a very sensitive test that may be helpful when other tests are inconclusive. There are numerous indications for EUS; here are some of the ways EUS can help:

What is cancer staging and why is staging important?
For cancer patients, staging describes the extent of a patient’s cancer, how early or advanced it is. Staging is important because it helps your doctors plan treatment (e.g. surgery, chemotherapy, radiation therapy, no treatment, etc.). EUS is the most accurate non-invasive way to determine the local extent of many gastrointestinal (GI) cancers (T stage), such as those listed above. In addition, EUS can be used to biopsy many tumors or lymph nodes close to the digestive tract.

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What are some alternatives to EUS?
Prior to EUS, many digestive disorders and cancers were difficult to diagnosis or exclude because they can be hidden “deep” beneath organs and intestines. EUS can image or “see” beneath the surface of the digestive tract and into internal organs adjacent to the gastrointestinal tract. The close proximity of the EUS imaging probe allows very detailed images that can provide additional information when other tests are inconclusive.

In patients with suspected cancer, biopsies of cancer tissue (“tissue diagnosis”) are needed to confirm the diagnosis before any treatment can be started. CT scan (CAT scan) or conventional ultrasound-guided biopsies are good methods for “tissue diagnosis” in tumors close to the skin. However, EUS is safer and more accurate for “deep” tumors, such as those listed above. EUS can biopsy from across the digestive tract (esophagus, stomach, intestines and rectum) avoiding damage to overlying vital organs and blood vessels. Surgery for a diagnosis is an alternative to EUS but is much more invasive and requires general anesthesia.

Why should you choose to have your care with Gastroenterology Consultants?
Gastroenterology Consultants is currently the only and first practice to offer endoscopic ultrasound (EUS) in Northern Nevada and Reno. EUS requires highly sophisticated and advanced medical equipment that is available only at few highly specialized medical centers. With the support of Renown (Washoe) Regional Medical Center, the most current and best EUS technologies are available to Dr. Chen. The American Society for Gastrointestinal Endoscopy (ASGE) stated: “the limited availability of EUS is largely due to the lack of skilled endosonographers” [physicians with specialized training and expertise to perform EUS]. Dr. Chen trained at one of the few ASGE recognized EUS training institutions. He has published numerous medical articles on EUS in national peer-reviewed medical journals, and has been an invited speaker at national medical meetings.

PATIENTS:

If you are a patient who is being referred for an endoscopic ultrasound (EUS), please visit this link to read more information about EUS:“ASGE Understanding EUS”

For patient preparation instructions on how to prepare for your procedure: please click here.

REFERRING PHYSICIANS:

Please click here for a printable list of EUS indications.

Please click here if you are interested in reading EUS or ERCP review articles. Medical articles are downloadable in Adobe Reader PDF format for your convenience.

Physician Profile
Victor K. Chen, M.D., M.S.P.H.
Jonathan P. Pezanoski, M.D.