A station-wise approach to liver anatomy for linear EUS

Linear EUS has emerged as a key tool for liver assessment and intervention. However, its adoption for liver segmentation remains limited because of the absence of fixed anatomical landmarks and overlapping views. This study proposes a station-wise approach to simplify liver anatomy interpretation during EUS, correlating these findings with computed tomography imaging for greater comprehensibility.

EUS examinations were conducted using a linear echoendoscope with the patient in a left lateral position under deep sedation. A systematic station-wise methodology was applied to identify liver segments, leveraging anatomical landmarks such as portal vein branches, hepatic veins, and the inferior vena cava. Images were evaluated from 6 different stations.

The station-wise approach successfully delineated all liver segments. Stations 1 through 3 provided comprehensive visualization of the superior and inferior segments from the gastroesophageal junction and stomach. Stations 4, 5, and 6 enabled additional imaging of challenging segments (eg, caudate lobe and posterior right liver segments).

This study provides a practical framework for systematic liver evaluation using linear EUS. Incorporating this station-wise methodology into EUS training programs could expand its role in diagnostic and therapeutic endohepatology.