Endoscopic Ultrasound Applications in Gastric Cancer Staging
Summary
Endoscopic ultrasonography is established as a cornerstone for the locoregional staging of gastric cancer, offering unparalleled resolution of the gastric wall layers and adjacent lymphatic structures. By combining endoscopic visualisation with high-frequency ultrasound, this imaging modality achieves detailed assessment of tumour penetration (T staging) into the mucosa, submucosa, muscularis propria and serosa, as well as evaluation of perigastric lymph nodes (N staging). Accurate staging informs therapeutic decisions ranging from endoscopic resection for early lesions to multidisciplinary management of advanced disease. Recent advances include contrast-enhanced techniques to distinguish vascular patterns, elastography for tissue stiffness mapping and artificial intelligence algorithms to refine invasion depth predictions. While limitations persist in distinguishing subtle serosal invasion or small nodal metastases, ongoing technological integration promises enhanced diagnostic accuracy and personalised treatment planning, with global implications for reducing morbidity and optimising outcomes.
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Endoscopic Ultrasound Applications in Gastric Cancer Staging publication trend
The graph below shows the total number of articles in endoscopic ultrasound applications in gastric cancer staging across all publications each year (not limited to Nature Index journals).
Technical terms
Endoscopic ultrasound (EUS): A minimally invasive imaging technique combining endoscopy and ultrasonography for high-resolution visualisation of the gastrointestinal wall and adjacent structures.
T staging: Classification of tumour penetration depth within the gastric wall, ranging from mucosal involvement to serosal invasion.
N staging: Assessment of regional lymph node metastasis based on size and echogenic characteristics observed during EUS.
Early gastric cancer (EGC): Gastric carcinoma confined to the mucosa or submucosa, regardless of lymph node status.
Area under the curve (AUC): A statistical measure of diagnostic test performance, indicating the ability to discriminate between disease states.
References
- A novel artificial intelligence-based endoscopic ultrasonography diagnostic system for diagnosing the invasion depth of early gastric cancer. Journal of Gastroenterology (2024).
- Factors Affecting the Accuracy of Endoscopic Ultrasonography in the Diagnosis of Early Gastric Cancer Invasion Depth: A Meta‐analysis. Gastroenterology Research and Practice (2019).
- Diagnostic accuracy of the gastric cancer T-category with respect to tumor localization. Langenbeck's Archives of Surgery (2020).
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