EUS from a 53-year-old woman with PC demonstrating an ideal pattern and extent of intratumoral spread of gemcitabine that was assigned a score of 4 out of 4. A, EUS appearance before EUS-FNI reveals a hypoechoic, homogenous, well-defined mass. B, After EUS-FNI, the hyperechoic-appearing gemcitabine infiltrated throughout the mass with a uniform pattern of spread that resulted in a more hyperechoic-appearing mass secondarily resulting in a more inhomogeneous echotexture and less well-defined borders as compared with the pretreatment appearance. PC, pancreatic cancer; FNI, fine-needle injection.