Browsing by Author "Ali, Meer Akbar"

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    Basic Principles and Role of Endoscopic Ultrasound in Diagnosis and Differentiation of Pancreatic Cancer from Other Pancreatic Lesions: A Comprehensive Review of Endoscopic Ultrasound for Pancreatic Cancer
    (MDPI, 2024-04-28) Dahiya, Dushyant Singh; Shah, Yash R.; Ali, Hassam; Chandan, Saurabh; Gangwani, Manesh Kumar; Canakis, Andrew; Ramai, Daryl; Hayat, Umar; Pinnam, Bhanu Siva Mohan; Iqbal, Amna; Malik, Sheza; Singh, Sahib; Jaber, Fouad; Alsakarneh, Saqr; Mohamed, Islam; Ali, Meer Akbar; Al-Haddad, Mohammad; Inamdar, Sumant; Medicine, School of Medicine
    Pancreatic cancer is one of the leading causes of cancer-related deaths worldwide. Pancreatic lesions consist of both neoplastic and non-neoplastic lesions and often pose a diagnostic and therapeutic challenge due to similar clinical and radiological features. In recent years, pancreatic lesions have been discovered more frequently as incidental findings due to the increased utilization and widespread availability of abdominal cross-sectional imaging. Therefore, it becomes imperative to establish an early and appropriate diagnosis with meticulous differentiation in an attempt to balance unnecessary treatment of benign pancreatic lesions and missing the opportunity for early intervention in malignant lesions. Endoscopic ultrasound (EUS) has become an important diagnostic modality for the identification and risk stratification of pancreatic lesions due to its ability to provide detailed imaging and acquisition of tissue samples for analysis with the help of fine-needle aspiration/biopsy. The recent development of EUS-based technology, including contrast-enhanced endoscopic ultrasound, real-time elastography–endoscopic ultrasound, miniature probe ultrasound, confocal laser endomicroscopy, and the application of artificial intelligence has significantly augmented the diagnostic accuracy of EUS as it enables better evaluation of the number, location, dimension, wall thickness, and contents of these lesions. This article provides a comprehensive overview of the role of the different types of EUS available for the diagnosis and differentiation of pancreatic cancer from other pancreatic lesions while discussing their key strengths and important limitations.
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    A Prospective Multicenter Study Evaluating Learning Curves and Competence in Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography Among Advanced Endoscopy Trainees: The Rapid Assessment of Trainee Endoscopy Skills (RATES) Study
    (Elsevier, 2017) Wani, Sachin; Keswani, Rajesh; Hall, Matt; Han, Samuel; Ali, Meer Akbar; Brauer, Brian; Carlin, Linda; Chak, Amitabh; Collins, Dan; Cote, Gregory A.; Diehl, David L.; DiMaio, Christopher J.; Dries, Andrew; El-Hajj, Ihab; Ellert, Swan; Fairley, Kimberley; Faulx, Ashley; Fujii-Lau, Larissa; Gaddam, Srinivas; Gan, Seng-Ian; Gaspar, Jonathan P.; Gautamy, Chitiki; Gordon, Stuart; Harris, Cynthia; Hyder, Sarah; Jones, Ross; Kim, Stephen; Komanduri, Srinadh; Law, Ryan; Lee, Linda; Mounzer, Rawad; Mullady, Daniel; Muthusamy, V. Raman; Olyaee, Mojtaba; Pfau, Patrick; Saligram, Shreyas; Piraka, Cyrus; Rastogi, Amit; Rosenkranz, Laura; Rzouq, Fadi; Saxena, Aditi; Shah, Raj J.; Simon, Violette C.; Small, Aaron; Sreenarasimhaiah, Jayaprakash; Walker, Andrew; Wang, Andrew Y.; Watson, Rabindra R.; Wilson, Robert H.; Yachimski, Patrick; Yang, Dennis; Edmundowicz, Steven; Early, Dayna S.; Department of Medicine, IU School of Medicine
    Background and aims Based on the Next Accreditation System, trainee assessment should occur on a continuous basis with individualized feedback. We aimed to validate endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) learning curves among advanced endoscopy trainees (AETs) using a large national sample of training programs and to develop a centralized database that allows assessment of performance in relation to peers. Methods ASGE recognized training programs were invited to participate and AETs were graded on ERCP and EUS exams using a validated competency assessment tool that assesses technical and cognitive competence in a continuous fashion. Grading for each skill was done using a 4-point scoring system and a comprehensive data collection and reporting system was built to create learning curves using cumulative sum analysis. Individual results and benchmarking to peers were shared with AETs and trainers quarterly. Results Of the 62 programs invited, 20 programs and 22 AETs participated in this study. At the end of training, median number of EUS and ERCP performed/AET was 300 (range 155-650) and 350 (125-500). Overall, 3786 exams were graded (EUS:1137; ERCP–biliary 2280, pancreatic 369). Learning curves for individual endpoints, and overall technical/cognitive aspects in EUS and ERCP demonstrated substantial variability and were successfully shared with all programs. The majority of trainees achieved overall technical (EUS: 82%; ERCP: 60%) and cognitive (EUS: 76%; ERCP: 100%) competence at conclusion of training. Conclusions These results demonstrate the feasibility of establishing a centralized database to report individualized learning curves and confirm the substantial variability in time to achieve competence among AETs in EUS and ERCP.