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Diagnostics
Special Issues
Advanced Role of Endoscopic Ultrasound in Clinical Medicine
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Advanced Role of Endoscopic Ultrasound in Clinical Medicine

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 April 2026 | Viewed by 4338

Special Issue Editor

Dr. Germana De Nucci

E-Mail Website
Guest Editor
Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, 20094 Garbagnate Milanese, Italy
Interests: endoscopy; gastric cancer; pancreatic diseases; gastrointestinal diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endoscopic Ultrasound has significantly impacted the diagnosis and treatment of digestive diseases. This technology combines endoscopy and ultrasonography, enabling detailed observation of mucosal surface lesions and the scanning of intra-cavity lesions to assess their depth and relationship with adjacent structures. EUS excels in staging rectal cancer and evaluating subepithelial lesions, providing highly accurate assessments of tumor infiltration. Recent developments include EUS-guided fine needle aspiration and image enhancement techniques, such as contrast agents and elastography, further enhancing its diagnostic capabilities. EUS has become an important diagnostic method for digestive diseases, offering superior resolution and depth penetration.

Dr. Germana De Nucci
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endoscopic ultrasound (EUS)
  • diagnostic imaging
  • fine needle aspiration (FNA)
  • contrast-enhanced EUS
  • elastography techniques

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Published Papers (3 papers)

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Review

15 pages, 2469 KB  
Review
The Effect of Lumen-Apposing Metal Stent (LAMS) in Acute Cholecystitis Unfit for Surgery: Good Tidings
by Valentina Zadro, Giulia Bertoncini, Giuliano Francesco Bonura, Pablo Cortegoso Valdivia, Noemi Gualandi, Paola Soriani, Tommaso Gabbani and Mauro Manno
Diagnostics 2025, 15(22), 2835; https://doi.org/10.3390/diagnostics15222835 - 9 Nov 2025
Viewed by 563
Abstract
Acute cholecystitis in patients unfit for surgery presents a significant therapeutic challenge, often requiring alternatives to traditional cholecystectomy. In recent years, endoscopic ultrasound (EUS)-guided gallbladder drainage using Lumen-Apposing Metal Stents (LAMSs) has emerged as a promising minimally invasive approach. This umbrella review synthesizes [...] Read more.
Acute cholecystitis in patients unfit for surgery presents a significant therapeutic challenge, often requiring alternatives to traditional cholecystectomy. In recent years, endoscopic ultrasound (EUS)-guided gallbladder drainage using Lumen-Apposing Metal Stents (LAMSs) has emerged as a promising minimally invasive approach. This umbrella review synthesizes evidence from existing systematic reviews and meta-analyses evaluating the efficacy and safety of EUS-guided gallbladder drainage with LAMSs in high-surgical-risk patients. The pooled data demonstrate that this approach provides effective symptomatic relief, with high technical and clinical success rates and a low incidence of adverse events. The use of EUS allows real-time visualization and precise access to the gallbladder, contributing to the safety and efficacy of the procedure. These results reinforce the expanding role of endoscopic techniques in managing complex biliary conditions, suggesting that the use of diagnostic EUS in combination with LAMS placement can lead to a significant reduction in the need for surgical intervention among frail patients. Full article
(This article belongs to the Special Issue Advanced Role of Endoscopic Ultrasound in Clinical Medicine)
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19 pages, 1727 KB  
Review
Role of the EUS in the Treatment of Biliopancreatic Disease in Patients with Surgically Altered Anatomy
by Marcello Cintolo, Edoardo Forti, Giulia Bonato, Michele Puricelli, Lorenzo Dioscoridi, Marianna Bravo, Camilla Gallo, Francesco Pugliese, Andrea Palermo, Alessia La Mantia and Massimiliano Mutignani
Diagnostics 2025, 15(21), 2707; https://doi.org/10.3390/diagnostics15212707 - 26 Oct 2025
Viewed by 622
Abstract
Background: The rising prevalence of gastric, biliary, and pancreatic surgeries has led to an increasing population of patients with surgically altered anatomy (SAA). In this setting, conventional endoscopic retrograde cholangiopancreatography (ERCP) is often limited by anatomical barriers, resulting in high rates of technical [...] Read more.
Background: The rising prevalence of gastric, biliary, and pancreatic surgeries has led to an increasing population of patients with surgically altered anatomy (SAA). In this setting, conventional endoscopic retrograde cholangiopancreatography (ERCP) is often limited by anatomical barriers, resulting in high rates of technical failure and complications. While device-assisted enteroscopy (DAE) has expanded therapeutic possibilities, its efficacy remains modest in complex reconstructions. Methods: This review analyzed recent literature from PubMed, Embase, and Scopus up to April 2025, focusing on diagnostic and therapeutic roles of endoscopic ultrasound (EUS) in SAA. Particular attention was given to cases where standard endoscopic, percutaneous, or surgical techniques failed and to studies comparing EUS-guided approaches with alternative modalities. Results: EUS has transitioned from a primarily diagnostic modality to a versatile therapeutic platform in SAA. Techniques such as EUS-guided rendezvous, antegrade drainage, and hepaticogastrostomy have shown technical and clinical success rates exceeding 80–90%, often comparable or superior to interventional radiology, while reducing the need for external drains. Innovative procedures, including EUS-directed transgastric ERCP (EDGE) and EUS-directed enteroenteric bypass (EDEE), have transformed the management of Roux-en-Y gastric bypass and bilioenteric anastomoses, providing durable and reusable access for repeated interventions. Despite these advances, EUS-guided interventions remain technically demanding, requiring advanced endoscopic and radiologic skills, specialized devices, and are best performed in tertiary referral centers. Conclusions: EUS has redefined the treatment paradigm of biliopancreatic diseases in patients with SAA, increasingly emerging as the preferred minimally invasive approach when conventional techniques fail. Future developments will focus on dedicated devices, standardized guidelines, and structured training programs to optimize outcomes. Multidisciplinary collaboration and centralization in high-volume centers remain essential to ensure safety, efficacy, and reproducibility. Full article
(This article belongs to the Special Issue Advanced Role of Endoscopic Ultrasound in Clinical Medicine)
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19 pages, 10040 KB  
Review
Advances in Endo-Hepatology: The Role of Endoscopic Ultrasound in the Management of Portal Hypertension
by Angelo Bruni, Giuseppe Dell’Anna, Jayanta Samanta, Jacopo Fanizza, Francesco Vito Mandarino, Jahnvi Dhar, Antonio Facciorusso, Vito Annese, Sara Massironi, Alberto Malesci, Giovanni Marasco, Elton Dajti, Leonardo Henry Eusebi, Giovanni Barbara, Gianfranco Donatelli, Silvio Danese and Lorenzo Fuccio
Diagnostics 2025, 15(8), 967; https://doi.org/10.3390/diagnostics15080967 - 10 Apr 2025
Cited by 1 | Viewed by 2749
Abstract
Portal hypertension (PH) is a complication of advanced liver diseases, including cirrhosis and hepatocellular carcinoma, often leading to unfavorable outcomes. Endo-hepatology, particularly endoscopic ultrasound (EUS) has revolutionized the assessment of PH. Notably, EUS-guided portal pressure gradient (EUS-PPG) enables measurement of portal and hepatic [...] Read more.
Portal hypertension (PH) is a complication of advanced liver diseases, including cirrhosis and hepatocellular carcinoma, often leading to unfavorable outcomes. Endo-hepatology, particularly endoscopic ultrasound (EUS) has revolutionized the assessment of PH. Notably, EUS-guided portal pressure gradient (EUS-PPG) enables measurement of portal and hepatic venous pressures, offering diagnostic precision for both cirrhotic and non-cirrhotic forms of PH, including porto-sinusoidal vascular disorder (PSVD). EUS-based assessment of PH in advanced liver disease can refine diagnostic workup and prognostication, supporting therapeutic decisions. Additionally, EUS-guided liver biopsy (EUS-LB) achieves high-quality histological samples with fewer complications compared to percutaneous techniques, enabling thorough evaluation of chronic liver diseases and vascular abnormalities. EUS-shear wave elastography (EUS-SWE) further refines stiffness measurements where standard imaging fails. Moreover, EUS plays a major role in controlling variceal hemorrhage, a severe PH complication. EUS-guided coil and cyanoacrylate injection for gastric varices demonstrate a great efficacy, often surpassing conventional endoscopy. Similarly, EUS-based identification and treatment of perforator vessels feeding esophageal varices reduce rebleeding risks, particularly in challenging patients. The combination of these state-of-the-art interventions supports a “one-stop strategy”, integrating variceal screening, biopsy, and portal pressure measurement within a single procedure. Despite these advancements, refinements in sedation protocols, patient selection, and cost-effectiveness data are necessary. While noninvasive tools remain central in guidelines, EUS-based methods continue to expand their role, especially in complex cases. This review summarizes the applications and impact of EUS in evaluating PH, emphasizing its importance in contemporary hepatology and its potential as a pivotal diagnostic modality in cirrhosis complicated by PH. Full article
(This article belongs to the Special Issue Advanced Role of Endoscopic Ultrasound in Clinical Medicine)
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