Doctors use endoscopic ultrasound (EUS) to assess digestive (gastrointestinal) and lung diseases. This nonsurgical procedure uses high-frequency sound waves to produce detailed images of the lining and walls of the upper and lower digestive tract and nearby organs such as the pancreas, liver and gallbladder.

Endoscopic ultrasound is a minimally invasive procedure. Mayo Clinic has offered endoscopic ultrasounds since 1989, and doctors perform more than 3,000 each year.

To perform an endoscopic ultrasound, your doctor passes a thin, flexible tube (endoscope) through your mouth or anus. A small ultrasound device (transducer) within the tube produces sound waves that create a precise image of surrounding tissue.

Doctors at Mayo Clinic use two types of transducers. One, a radial imaging device, produces a 360-degree, cross-sectional image (also called a "slice"). The other device, a curved linear array, can guide a biopsy (fine-needle aspiration) of your lymph nodes and any tumors.

Another kind of ultrasound allows very high-resolution imaging of the surface of your digestive tract. Doctors use this image to help determine the size and depth of small tumors (nodules) within the wall of your digestive tract.

When combined with fine-needle aspiration, endoscopic ultrasound is a minimally invasive alternative to exploratory surgery for removing tissue samples. Doctors also use endoscopic ultrasound to guide drainage of pseudocysts, injections and pain-relieving treatments.

Your doctor may use endoscopic ultrasound for:

  • Abdominal mass assessment and cancer staging. Endoscopic ultrasound can accurately determine how deeply a tumor penetrates your gut wall in esophageal, gastric, rectal, pancreatic and lung cancers. Examining the size, shape and ultrasound appearance of adjacent lymph nodes also helps your doctor determine whether cancer has spread.
  • Bile duct stone detection. Doctors traditionally detected stones in the bile tubes leading from your gallbladder to your intestine using an endoscopic retrograde cholangiogram (ERCP). Endoscopic ultrasound is less invasive than is ERCP and can detect these stones with equal accuracy.
  • Disease diagnosis. Endoscopic ultrasound can help your doctor diagnose diseases of the internal organs such as chronic pancreatitis or pancreatic cysts.
  • Fluid collection. Endoscopic ultrasound allows your doctor to safely and accurately collect fluid samples from your lungs or abdominal cavity for analysis.

Conditions diagnosed with endoscopic ultrasound

Your doctor may use endoscopic ultrasound to determine the cause of symptoms such as abdominal pain, to evaluate a growth (tumor), or to diagnose and stage diseases of your digestive tract and lungs, including:

  • Integrated team approach. Mayo Clinic doctors work together to help develop the most appropriate treatment plan for you.
  • Experience. Mayo Clinic doctors trained in diseases of the digestive tract (gastroenterologists) who have advanced training in endoscopic ultrasound care for you.
  • Research. Doctors at Mayo Clinic actively study the use of endoscopic ultrasound in pancreatic disease, lung cancer, esophageal cancer and other conditions.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Doctors trained in diseases of the digestive tract (gastroenterologists) who have advanced training in endoscopic procedures provide endoscopic ultrasound at Mayo Clinic in Arizona.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Doctors trained in diseases of the digestive tract (gastroenterologists) who have advanced training in endoscopic procedures perform more than a thousand endoscopic ultrasounds a year at Mayo Clinic in Florida.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Doctors trained in digestive diseases (gastroenterologists) who have advanced training in endoscopic procedures perform more than a thousand endoscopic ultrasounds a year at Mayo Clinic in Minnesota.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Doctors at Mayo Clinic actively research the use of endoscopic ultrasound in pancreatic disease, lung cancer and esophageal cancer. These research activities include:

  • The role of endoscopic ultrasound in lung cancer staging
  • Genomic detection of micrometastases in mediastinal lymph nodes in people who have lung cancer
  • Endoscopic ultrasound and secretin-stimulated pancreatic juice for cytokines in the evaluation of chronic pancreatitis, pancreatic cancer and cystic neoplasms
  • Genomic array evaluation of esophageal cancer before and after chemo-radiotherapy
  • Genomic and proteomic evaluation of cyst fluid in pancreatic cystic neoplasms
  • Ablation of pre-cancer pancreatic cysts with endoscopic ultrasound-guided ethanol injection
  • Using endoscopic ultrasound and ultrasound within the airway (endobronchial) to detect cancerous lymph nodes in the central chest (mediastinum)
  • Using endoscopic ultrasound, fine-needle aspiration and molecular diagnostic methods (real-time polymerase chain reaction) to detect microscopic cancer deposits in otherwise normal-appearing mediastinal lymph nodes
  • Detecting pancreatitis and pancreatic cancer with endoscopic ultrasound and endoscopic collection of pancreatic juice after stimulation with secretin
  • Detecting precancerous cystic lesions of the pancreas using fine-needle aspiration and protein analysis (proteomics) of cyst fluid
  • Improved control of pancreatic cancer pain with endoscopic ultrasound-guided celiac plexus neurolysis

See a list of Mayo Clinic publications at PubMed, a service of the National Library of Medicine.