[Endoscopic sonography in cancer diagnosis]

Area of Science:

• Gastroenterology and Medical Imaging
• Oncology
• Diagnostic Endoscopy

Context:

• Endoscopic ultrasonography (EUS) utilizes intraluminal scanning for detailed sonographic visualization of tissue architecture.
• It offers high-resolution imaging of the gastrointestinal (GI) tract and adjacent organs, including the liver via sonolaparoscopy.

Purpose:

• To evaluate the efficacy of EUS in staging gastrointestinal malignancies, particularly in the stomach, esophagus, and rectum.
• To assess EUS's accuracy in differentiating between various GI pathologies, including carcinomas and submucosal tumors.
• To determine the role of EUS in evaluating regional lymph node involvement and its impact on treatment planning.

Summary:

• EUS accurately visualizes the five-layer structure of the GI tract, enabling precise assessment of wall involvement in malignancy, ulceration, and inflammation.
• The method effectively differentiates between carcinoma and submucosal tumors and accurately evaluates regional lymph node status.
• Studies show considerable agreement between EUS staging and histopathological findings in gastric cancer, despite occasional over-reading due to ulceration.
• Laparoscopic sonography demonstrates high accuracy in the differential diagnosis of small liver masses.

Impact:

• EUS offers a minimally invasive approach, opening new avenues in cancer diagnosis, especially for deep-seated neoplasms where other imaging techniques are limited.
• Its accuracy in staging and diagnosis supports informed medical and surgical treatment decisions.
• EUS enhances the diagnostic capabilities for GI tract and liver pathologies, improving patient management strategies.