EUS-Guided Fine Needle Injection and Brachytherapy

EUS has evolved from EUS imaging, to EUS-guided FNA, and now to EUS-guided fine needle injection (FNI). This advancement has paved the way for “interventional EUS.” EUS-guided FNI includes delivery of contrast agents with subsequent drainage/anastomosis, pre-EMR solution, botulinum toxin, neurolytic agents (including intraganglion injections), sclerosing solutions/glue, radiofrequency energy, radioactive and inert seeds, light-activating laser, and a growing number of antitumor agents. This chapter will focus on EUS-guided FNI of antitumor agents and antitumor ablative techniques including brachytherapy.