Recent Advances in Endoscopic, Metabolomic, and Ultrasound Approaches to Gastrointestinal, Hepatic, and Pancreatic Tumors

Dear Colleagues,

Gastrointestinal, hepatic, and pancreatic tumors remain among the leading causes of cancer-related morbidity and mortality worldwide, representing a major clinical and public health challenge. In recent years, we have made remarkable progress in understanding their complex etiopathogenesis, molecular heterogeneity, and metabolic reprogramming. The integration of metabolomics—specific oncometabolites, such as succinate, fumarate, and 2-hydroxyglutarate, and alterations in lipidomic and short-chain fatty acid pathways that modulate tumor hypoxia, immune evasion, and angiogenesis—and molecular imaging with endoscopic and ultrasound-based techniques have significantly improved our ability to characterize tumor biology, detect early lesions, and tailor personalized therapeutic strategies.

Advanced endoscopic technologies—such as high-resolution and confocal endomicroscopy, capsule endoscopy, and endoscopic ultrasound (EUS) with contrast-enhanced or elastographic evaluation—allow unprecedented visualization and tissue characterization at both structural and functional levels. In parallel, metabolomic profiling, liquid biopsy, and radiomic analysis have provided novel insights into tumor metabolism, oxidative stress, and the microenvironment, enabling the identification of predictive biomarkers and therapeutic targets.

In hepatobiliary and pancreatic oncology, molecular imaging modalities such as contrast-enhanced MRI and contrast-enhanced ultrasound (CEUS), including novel microbubble and targeted agents, are now fundamental in non-invasive tumor characterization and treatment monitoring. Image-guided interventions—radiofrequency and microwave ablation, irreversible electroporation, cryoablation, and targeted chemo- or radio-embolization—have evolved into precision-guided therapies integrated with molecular and immunomodulatory approaches.

This Special Issue will gather cutting-edge research and comprehensive reviews addressing recent advances in the endoscopic, metabolomic, and ultrasound assessment of gastrointestinal, hepatic, and pancreatic tumors. Contributions focusing on translational imaging, metabolic signatures, and image-guided molecular or locoregional therapies are particularly welcome.

Modern surgical management of gastrointestinal, hepatic, and pancreatic tumors increasingly combines robotic and laparoscopic techniques with real-time molecular imaging and intraoperative navigation, allowing for precision resection and improved oncologic outcomes.

Prof. Dr. Ciprian Brisc
Prof. Dr. Nadim Al Hajjar
Guest Editors

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