Identification of cancers and gastroenterological diseases can be challenging, as clinicians must ensure the process for identification is accurate while minimizing complications and ensuring sustainability associated with procedures. In addition, for those with cancer, accurate staging is vital for guiding the most appropriate therapy.
There are a number of minimally invasive imaging strategies that may be used for identifying and staging different types of cancers, as well as identifying gastroentological disease.1,2 Examples of imaging strategies include computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS).1–3 Each strategy is associated with differing accuracy for different diseases, as well as when comparing diagnosis and staging of illness. In addition, each strategy is associated with other benefits and limitations.3 For example, EUS is often less expensive and more readily available relative to other imaging modalities like CT, PET and MRI, but CT, PET and MRI allow for visualization of a larger area compared with EUS.3,4 Also, the amount of radiation exposure, and need for contrast media, differs between each modality.5 Lastly, these imaging modalities may be complementary to one another, for example, using EUS to minimize exposure to the more invasive ERCP in people with acute biliary pancreatitis.2
The purpose of this review was to evaluate the evidence for clinical effectiveness, safety, and cost effectiveness of EUS compared to other imaging modalities including CT, MRI, PET, or ERCP.
