Current status and future applications of contrast-enhanced endoscopic ultrasonography

Endoscopic ultrasonography(EUS) is currently an in-tegral investigation of many gastrointestinal disorders.It has been shown to have a higher efficacy thanconventional computed tomography in detection andcharacterization of small lesions especially in the pan-creas. Much effort has been put to further improvethe sensitivity, specificity and overall accuracy of EUS.One of the major advances is the utilization of contrastagents for better delineation of the vascularity and tis-sue perfusion of the target lesion. This article describesthe basic principles of ultrasound contrast agents andthe different modalities used in contrast-enhanced EUS(CE-EUS) including contrast-enhanced Doppler EUS(CED-EUS) and contrast-enhanced harmonic EUS(CEH-EUS). In addition, the current applications of contrastenhanced EUS in different gastrointestinal conditionswere discussed. Furthermore, the future developmentof hybrid approaches combining CE-EUS with other im-aging modalities and the potential therapeutic aspectof using it as a vector for drug delivery were also dis-cussed.