Endoscopic Ultrasound in Gastrointestinal Oncology: Expanding Diagnostic and Therapeutic Indications

Endoscopic ultrasound (EUS) has transitioned from a purely diagnostic imaging technique to a comprehensive platform integrating staging, tissue acquisition, and therapeutic interventions. In gastrointestinal oncology, EUS provides high accuracy in the staging of esophageal and rectal cancers [1,2], enables tissue acquisition in pancreatic masses with fine-needle biopsy (FNB) as the current standard [3-6], and refines the characerization of pancreatic cystic neoplasms [7,8]. EUS-guided biliary drainage (EUS-BD) is now recommended over percutaneous drainage after failed ERCP in expert centers [9-11], while lumen-apposing metal stents (LAMS) have revolutionized the management of pancreatic fluid collections [12-15]. Emerging technologies such as contrast-enhanced EUS (CE-EUS), elastography, and artificial intelligence (AI) are expanding diagnostic confidence [16-18]. This short communication reviews current evidence and highlights the evolving role of EUS in gastrointestinal oncology.