Endoscopic Ultrasound Advanced Techniques for Diagnosis of Gastrointestinal Stromal Tumours
by
, , , , , and
Socrate Pallio
1,
Stefano Francesco Crinò
2,*,
Marcello Maida
3,
Emanuele Sinagra
4, 
Vincenzo Francesco Tripodi
5
,
Antonio Facciorusso
6
,
Andrew Ofosu
7,
Maria Cristina Conti Bellocchi
2
,
Endrit Shahini
8 and
Giuseppinella Melita
5 1
Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
2
Digestive Endoscopy Unit, University of Verona, 37100 Verona, Italy
3
Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
4
Gastroenterology and Endoscopy Unit, Fondazione Istituto San Raffaele Giglio, 90015 Cefalù, Italy
5
Human Pathology of Adult and Child Department, University of Messina, 98100 Messina, Italy
6
Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy
7
Division of Digestive Diseases, University of Cincinnati, Cincinnati, OH 45201, USA
8
Gastroenterology Unit, National Institute of Gastroenterology—IRCCS “Saverio de Bellis” Castellana Grotte, 70013 Castellana Grotte, Italy
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(4), 1285; https://doi.org/10.3390/cancers15041285
Submission received: 9 January 2023
/
Revised: 8 February 2023
/
Accepted: 15 February 2023
/
Published: 17 February 2023
(This article belongs to the Special Issue Diagnosis and Staging of Gastroesophageal Cancer)
Simple Summary
Endoscopic ultrasound is now regarded as a valuable technique for assessing subepithelial lesions and determining their potential malignancy. The objective of this article is to thoroughly review the most recent advancements in the endoscopic field that can provide an accurate diagnosis and, as a result, establish the best treatment and outcomes for these types of lesions.
Abstract
Gastrointestinal Stromal Tumors (GISTs) are subepithelial lesions (SELs) that commonly develop in the gastrointestinal tract. GISTs, unlike other SELs, can exhibit malignant behavior, so differential diagnosis is critical to the decision-making process. Endoscopic ultrasound (EUS) is considered the most accurate imaging method for diagnosing and differentiating SELs in the gastrointestinal tract by assessing the lesions precisely and evaluating their malignant risk. Due to their overlapping imaging characteristics, endosonographers may have difficulty distinguishing GISTs from other SELs using conventional EUS alone, and the collection of tissue samples from these lesions may be technically challenging. Even though it appears to be less effective in the case of smaller lesions, histology is now the gold standard for achieving a final diagnosis and avoiding unnecessary and invasive treatment for benign SELs. The use of enhanced EUS modalities and elastography has improved the diagnostic ability of EUS. Furthermore, recent advancements in artificial intelligence systems that use EUS images have allowed them to distinguish GISTs from other SELs, thereby improving their diagnostic accuracy.
