AGA White Paper: Interventional Endoscopic Ultrasound - Current Status and Future Directions. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association DeWitt, J. M., Arain, M. n., Chang, K. J., Sharaiha, R. n., Komanduri, S. n., Muthusamy, V. R., Hwang, J. H. 2020


The evolution of endoscopic ultrasound (EUS) from a diagnostic to a therapeutic procedure has resulted in a paradigm shift towards endoscopic management of disease states that have previously required percutaneous or surgical approaches. The last few years have seen additional techniques and devices that have enabled endoscopists to expand its diagnostic and therapeutic capabilities. Some of these techniques were initially reported over a decade ago; however, with further device development and refinement in techniques there is potential for expanding the application of these techniques and new technologies to a broader group of interventional gastroenterologists. Lack of formalized training, devices and prospective data regarding their use in addition to a scarcity of guidelines on implementation of these technologies into clinical practice are contributing factors impeding the growth of the field of interventional EUS. In April 2019, the American Gastroenterological Association's Center for GI Innovation and Technology (CGIT) conducted its annual Tech Summit and a key session focused on interventional EUS. This article represents a white paper generated from the conference and discusses the published literature pertaining to the topic of interventional EUS and outlines a proposed framework for the implementation of interventional EUS techniques into clinical practice. Three primary areas of interventional EUS are addressed: (1) EUS-guided access; (2) EUS-guided tumor ablation; and (3) Endo-Hepatology. There was general agreement among participants on several key components. The introduction of these novel interventions requires better tools, more data on safety/outcomes and improved training for endoscopists. Participants also agreed that widespread implementation and use of these techniques will require support from GI societies and other key stakeholders including payers. Continued work by the GI societies and manufacturers to provide training programs, appropriate equipment/work environments and policies that motivate endoscopists to adopt new techniques is essential for growing the field of interventional EUS.

View details for DOI 10.1016/j.cgh.2020.09.029

View details for PubMedID 32950747