Needle device systems for interventional endoscopic ultrasound and general technique of endoscopic ultrasound-guided fine-needle aspiration

The ability to obtain tissue with fine-needle aspiration (FNA) techniques has been a major advance for endoscopic ultrasound (EUS). Using proper technique, EUS FNA is a minimally invasive, highly effective, and safe method for tissue sampling. EUS FNA has broad applicability to the staging and diagnosis of tumors of the esophagus, stomach, duodenum, ampulla, pancreas, and rectum. Recently, EUS FNA techniques have been applied to mediastinal staging of lung cancer. The epidemiology, and clinical impact of lung cancer has already made this the single most important use of EUS for cancer staging in many centers, and this trend is likely to increase. This article summarizes the evidence for the effectiveness and safety of EUS FNA. It also provides detailed information of the practical techniques for EUS FNA of tumors, cysts, and lymph nodes. The increasing array of endoscopic and accessory devices available will also be discussed.