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Technology Insight: current status of endoscopic ultrasonography

Nature Clinical Practice Gastroenterology & Hepatology volume 2, pages 38–45 (2005)Cite this article

Abstract

Endoscopic ultrasound (EUS) has become the most accurate imaging modality for locoregional cancer staging of the gastrointestinal tract. Fine-needle aspiration (FNA) has added a new level of accuracy for EUS in nodal staging, with reported numbers in the 90% range for luminal and pancreaticobiliary disease. In addition, new non-gastrointestinal applications are being evaluated, such as the role of EUS-FNA for the staging of non-small-cell lung cancer and exploration of the posterior mediastinum. Furthermore, the same techniques that make safe tissue sampling possible are being explored for their use as interventional applications, such as EUS-guided celiac plexus neurolysis, fine-needle injection, EUS-guided pseudocyst drainage, and EUS-guided cholangiography and pancreatography. This review describes the current clinical status of EUS in gastrointestinal oncology, as well as future and novel indications and therapeutic strategies for this technology.

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Figure 1: Radial endoscopic ultrasound of the esophagus.
Figure 2: A gastric subepithelial lesion visualized both endoscopically and sonographically.
Figure 3: Linear endoscopic ultrasound of the liver.
Figure 4: Linear endoscopic ultrasound of the pancreas.
Figure 5: Endoscopic ultrasound-guided cholangiography with biliary decompression.

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Authors and Affiliations

  1. Assistant Professor of Medicine and Director of Endoscopic Ultrasonography, Digestive Health Center of Excellence, The University of Virginia Health System, Charlottesville, VA, USA

    Vanessa M Shami

  2. Professor of Medicine and Director of Department of Endoscopy and Therapeutics, Endoscopy, The University of Chicago, Chicago, IL, USA

    Irving Waxman

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  1. Vanessa M Shami
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  2. Irving Waxman
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Correspondence to Irving Waxman.

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The authors declare no competing financial interests.

Glossary

T STAGING

Tumor staging; the degree of local extension of a tumor

N STAGING

Nodal staging; the degree of lymph node involvement of a tumor

CELIAC LYMPH NODE

Lymph nodes located along the celiac trunk that receive lymph from the stomach, spleen, duodenum, liver, and pancreas

COX PROPORTIONAL HAZARDS

A method for assessing a covariate's effect on time to event

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Shami, V., Waxman, I. Technology Insight: current status of endoscopic ultrasonography. Nat Rev Gastroenterol Hepatol 2, 38–45 (2005). https://doi.org/10.1038/ncpgasthep0085

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