Current Status of Endoscopic Ultrasonography

Endoscopic ultrasound (EUS) has become the most accurate imaging modality for the gallbladder/bileduct/liver and 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 posteriormediastinum.Furthermore, the same techniques that makes safe tissue sampling possible are being explored for their use as interventional applications, such as EUS-guided celiac plexus neurolysis, fine-needle injection, EUSguided pseudocyst drainage, and EUS-guided cholangiography and pancreatography.This review describes the current clinical status of EUS in gastrointestinal and pancreatobiliary diseases as well as future and novel indications and therapeutic strategies for this technology.