Comments on New Technology - Endoscopic ultrasonography (EUS) Routine method and new applications

Jan Janssen and Lucas Greiner

EUS started in the early 1980s with radial mechanical scanners causing an imaging revolution. For the first time, the visualization of the gastrointestinal wall layers became possible and thus improved the locoregional staging of gastrointestinal tumors. Nearly at the same time, the method was extended to biliopancreatic disease and further clinical applications.

The second revolution in connection with EUS was the introduction of longitudinal electronic scanners in the 1990s enabling and establishing fine-needle aspiration biopsy (FNAB) under realtime EUS control. Electronic scanners have significantly improved the spatial resolution and the quality of imaging within the near field. Therefore, this technology is nowadays also implemented in radial scanners. EUS guided FNAB allows to obtain histologic specimen from the surroundings of the gastrointestinal (GI) tract. Furthermore, FNAB proved to be the first step towards EUS guided interventions like injection treatment (e.g. neurolysis of the celiac plexus) or drainage of pancreatic pseudocysts.

In the meantime, many indications for the use of diagnostic and interventional EUS have been investigated and the reader may be interested to know which of them are currently accepted or have been dropped. The second focus may concern new EUS developments.