Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation

Linear endoscopic ultrasound (EUS) has evolved into an essential modality for diagnostic and therapeutic gastrointestinal interventions. Despite its growing utilization, the learning curve for mastering linear EUS remains steep, largely due to the complexity of anatomical orientation and image inter...

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Main Authors: Radhika Chavan, Dario Quintini, Chaiti Gandhi, Suprabhat Giri, Zaheer Nabi, Sundeep Lakhtakia, Sanjay Rajput
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2025-06-01
Series:Journal of Digestive Endoscopy
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1809384
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author Radhika Chavan
Dario Quintini
Chaiti Gandhi
Suprabhat Giri
Zaheer Nabi
Sundeep Lakhtakia
Sanjay Rajput
author_facet Radhika Chavan
Dario Quintini
Chaiti Gandhi
Suprabhat Giri
Zaheer Nabi
Sundeep Lakhtakia
Sanjay Rajput
author_sort Radhika Chavan
collection DOAJ
description Linear endoscopic ultrasound (EUS) has evolved into an essential modality for diagnostic and therapeutic gastrointestinal interventions. Despite its growing utilization, the learning curve for mastering linear EUS remains steep, largely due to the complexity of anatomical orientation and image interpretation. This article provides a systematic, step-by-step approach to understanding the basics of linear EUS, focusing on spatial anatomy and procedural technique. Core topics include image orientation, in vivo scope rotation with the “rule of 360,” organ and structure tracing, understanding EUS scanning planes, and a station-wise evaluation strategy. A structured checklist is proposed to enhance procedural quality and prevent anatomical oversight. Additionally, the manuscript emphasizes the often-overlooked aspect of image optimization, detailing key parameters such as frequency, gain, contrast, focus, and Doppler techniques. The article aims to demystify orientation and facilitate accurate structure identification through a systematic approach. The comprehensive yet practical framework outlined in this manuscript is designed to support both novice endosonographers in achieving procedural proficiency. Integrating these fundamental principles into routine EUS practice can enhance overall understanding of the linear EUS, and likely to reduce the learning curve.
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issn 0976-5042
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language English
publishDate 2025-06-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Journal of Digestive Endoscopy
spelling doaj-art-d6f2ea4bb86b452db6cc94dc63ff4b742025-08-20T02:22:55ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502025-06-01160207709010.1055/s-0045-1809384Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and OrientationRadhika Chavan0https://orcid.org/0000-0002-5363-597XDario Quintini1https://orcid.org/0009-0004-7296-4332Chaiti Gandhi2https://orcid.org/0000-0002-6023-1471Suprabhat Giri3https://orcid.org/0000-0002-9626-5243Zaheer Nabi4https://orcid.org/0000-0003-2713-4781Sundeep Lakhtakia5https://orcid.org/0000-0001-7562-8060Sanjay Rajput6https://orcid.org/0000-0001-7453-5591Department of Gastroenterology and Advanced Endoscopy, Bharati Vidyapeeth (Deemed University), Katraj, Pune, Maharashtra, IndiaDepartment of Diagnostic and Therapeutic Services, ISMETT – UPMC, Palermo, ItalyDepartment of Gastroenterology and Advanced Endoscopy, Ansh Clinic, Ahmedabad, Gujrat, IndiaDepartment of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, IndiaDepartment of Therapeutic Endoscopy, Asian Institute of Gastroenterology Hospital, Hyderabad, Telangana, IndiaDepartment of Therapeutic Endoscopy, Asian Institute of Gastroenterology Hospital, Hyderabad, Telangana, IndiaDepartment of Gastroenterology and Advanced Endoscopy, Ansh Clinic, Ahmedabad, Gujrat, IndiaLinear endoscopic ultrasound (EUS) has evolved into an essential modality for diagnostic and therapeutic gastrointestinal interventions. Despite its growing utilization, the learning curve for mastering linear EUS remains steep, largely due to the complexity of anatomical orientation and image interpretation. This article provides a systematic, step-by-step approach to understanding the basics of linear EUS, focusing on spatial anatomy and procedural technique. Core topics include image orientation, in vivo scope rotation with the “rule of 360,” organ and structure tracing, understanding EUS scanning planes, and a station-wise evaluation strategy. A structured checklist is proposed to enhance procedural quality and prevent anatomical oversight. Additionally, the manuscript emphasizes the often-overlooked aspect of image optimization, detailing key parameters such as frequency, gain, contrast, focus, and Doppler techniques. The article aims to demystify orientation and facilitate accurate structure identification through a systematic approach. The comprehensive yet practical framework outlined in this manuscript is designed to support both novice endosonographers in achieving procedural proficiency. Integrating these fundamental principles into routine EUS practice can enhance overall understanding of the linear EUS, and likely to reduce the learning curve.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1809384echoendoscopeendoscopic ultrasoundanatomyorientationstation-wise approach
spellingShingle Radhika Chavan
Dario Quintini
Chaiti Gandhi
Suprabhat Giri
Zaheer Nabi
Sundeep Lakhtakia
Sanjay Rajput
Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation
Journal of Digestive Endoscopy
echoendoscope
endoscopic ultrasound
anatomy
orientation
station-wise approach
title Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation
title_full Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation
title_fullStr Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation
title_full_unstemmed Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation
title_short Understanding the Basics of Linear Endoscopic Ultrasound: A Step-by-Step Guide to Anatomy and Orientation
title_sort understanding the basics of linear endoscopic ultrasound a step by step guide to anatomy and orientation
topic echoendoscope
endoscopic ultrasound
anatomy
orientation
station-wise approach
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1809384
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