Endoscopic diagnosis of gastric subepithelial lesions < 20 mm: Current strategies and emerging solutions

Small gastric subepithelial lesions under 20 mm are common and require histological confirmation due to malignant potential in gastrointestinal stromal tumors. While EUS-TA faces technical limitations for small lesions, mucosal incision–assisted biopsy offers a practical sampling alternative. Emerging nonsampling techniques, like AI and elastography, provide complementary data to support accurate diagnostic and clinical decision-making.