Proposal of classification and terminology of interventional endoscopic ultrasonography/endosonography

• Published in: Digestive endoscopy 2025-01, Vol.37 (1), p.5-17
• Main Authors: Isayama, Hiroyuki, Nakai, Yousuke, Matsuda, Koji, Kanno, Yoshihide, Hara, Kazuo, Ogura, Takeshi, Abe, Nobutsugu, Katanuma, Akio, Kitano, Masayuki, Yasuda, Ichiro, Okano, Naoki, Tsuchiya, Takayoshi, Fujita, Naotaka, Inui, Kazuo, Ueki, Toshiharu, Irisawa, Atsushi, Yamano, Hiro‐o
• Format: Article
• Language: English
• Subjects: endosonographically/EUS‐guided created route (ESCR); Endosonography - methods; EUS‐FNA/FNB; EUS‐guided drainage/anastomosis (EUS‐D/A); Humans; interventional endoscopic ultrasonography/endosongraphy (EUS); Japan; Terminology as Topic; Ultrasonography, Interventional - methods
• ISSN: 0915-5635; 1443-1661; 1443-1661
• DOI: 10.1111/den.14927

Interventional endoscopic ultrasonography/endosongraphy (I‐EUS) procedures have rapidly evolved since their introduction three decades ago; however, the classification and terminology for these procedures remain unstandardized. To address this, the Subcommittee for Terminology of I‐EUS in the Japan Gastroenterological Endoscopy Society was established to define classifications and a glossary of I‐EUS terms. They categorized I‐EUS procedures into five types based on purpose and method: (i) EUS‐guided sampling; (ii) EUS‐guided through‐the‐needle examination; (iii) EUS‐guided drainage/anastomosis (EUS‐D/A); (iv) trans‐endosonographically/EUS‐guided created route (ESCR) procedures; and (v) EUS‐guided delivery. EUS‐guided sampling includes tissue acquisition and fluid sampling, classified by needle type into fine needle aspiration and fine needle biopsy. Through‐the‐needle examinations include imaging, measurements, and biopsies. EUS‐D/A includes organ drainage/anastomosis, fluid collection drainage, and digestive tract anastomosis. In the EUS‐D/A route, “anastomosis” is used for organ‐to‐organ procedures, whereas “tract” is for fluid drainage. ESCR is a newly proposed term for procedures via anastomosis or tract, such as endoscopic necrosectomy and EUS‐guided antegrade stenting. The term “trans‐luminal drainage/anastomosis stent” is used for stents that maintain the ESCR rather than treating strictures. EUS‐guided delivery involves the delivery of substances, such as fluids, drugs, medical devices, and energy. This proposed categorization and terminology aimed to clarify I‐EUS procedures and will require updates as new techniques and concepts emerge.