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World J Gastrointest Endosc. Oct 16, 2017; 9(10): 499-505
Published online Oct 16, 2017. doi: 10.4253/wjge.v9.i10.499
Endoscopic ultrasound: Current roles and future directions
Scott R Friedberg, Jesse Lachter
Scott R Friedberg, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Jesse Lachter, Rambam Healthcare Campus, Technion Israel Institute of Technology, Haifa 3109601, Israel
Author contributions: Friedberg SR wrote the paper; Lachter J edited the paper.
Conflict-of-interest statement: There were no conflicts of interest in writing this review.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Scott R Friedberg, MD, Department of Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213, United States. friedbergsr@upmc.edu
Telephone: +1-305-6324895
Received: April 1, 2017
Peer-review started: April 10, 2017
First decision: May 11, 2017
Revised: May 20, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: October 16, 2017
Processing time: 194 Days and 18.6 Hours
Abstract

Endoscopic ultrasound (EUS), developed in the 1980s, was initially predominantly used for guidance of fine needle aspiration; the last 25 years, however, have witnessed a major expansion of EUS to various applications, both diagnostic and therapeutic. EUS has become much more than a tool to differentiate different tissue densities; tissue can now be characterized in great detail using modalities such as elastography; the extent of tissue vascularity can now be learned with increasing precision. Using these various techniques, targets for biopsy can be precisely pinpointed. Upon reaching the target, tissue can then be examined microscopically in real-time, ensuring optimal targeting and diagnosis. This article provides a comprehensive review of the various current roles of EUS, including drainage of lesions, visualization and characterization of lesions, injection, surgery, and vascular intervention. With EUS technology continuing to develop exponentially, the article emphasizes the future directions of each modality.

Keywords: Endoscopic ultrasound; Future; Trends; Roles

Core tip: In recent years, endoscopic ultrasound (EUS) has evolved and is now used in various applications, both diagnostic and therapeutic. Classically used to differentiate different tissue densities, EUS is now used to characterize and localize tissue with much more precision. Upon reaching the target, tissue can then be examined microscopically in real-time, ensuring optimal targeting and diagnosis. This article provides a comprehensive review of the various current roles of EUS, including drainage of lesions, visualization and characterization of lesions, injection, surgery, and vascular intervention. With EUS technology continuing to develop exponentially, the article emphasizes the future directions of each modality.