EUS-Guided Diagnosis of Gastric Subepithelial Lesions, What Is New?

Gastric subepithelial lesions (SELs) are intramural lesions that arise underneath the gastric mucosa. SELs can be benign, but can also be malignant or have malignant potential. Therefore, correct diagnosis is crucial. Endosonography has been established as the diagnostic gold standard. Although the identification of some of these lesions can be carried out immediately, solely based on their echo characteristics, for certain lesions histological examination is necessary. Sometimes histology can be inconclusive, especially for smaller lesions. Therefore, new methods have been developed in recent years to assist decision making, such as contrast enhanced endosonography, EUS elastography, and artificial intelligence systems. In this narrative review we provide a complete overview of the gastric SELs and summarize the new data of the last ten years concerning the diagnostic advances of endosonography on this topic.

Automated summary

Gastric subepithelial lesions (SELs) are intramural lesions beneath the gastric mucosa. Accurate diagnosis is crucial as SELs can be benign, malignant, or have malignant potential. Endosonography is the gold standard for diagnosis, but histological examination may be necessary for certain lesions, particularly smaller ones. New methods such as contrast enhanced endosonography, EUS elastography, and artificial intelligence systems have been developed to assist decision making. This review provides a comprehensive overview and summarizes the latest diagnostic advances in endosonography for gastric SELs in the past decade.