Gastrointestinal stromal tumor (GIST) is a common tumor originating from the mesenchymal tissue of the gastrointestinal tract. Pathological diagnosis, immunohistochemical detection, and gene mutation analysis before treatment are crucial for formulating treatment plans, and accurate biopsy sampling is the core prerequisite for achieving the above goals. Conventional ultrasound-guided biopsy has limitations such as a low diagnostic accuracy rate and insufficient quality of tissue samples when sampling small lesions and lesions in special anatomical sites because it cannot distinguish between tumor active areas and necrotic/hemorrhagic areas. Contrast-enhanced ultrasound (CEUS) technology can clearly show the tumor microcirculation perfusion status, accurately identify the active areas, and provide accurate targeted guidance for biopsy, which has gradually shown significant advantages. This article reviews the research progress of ultrasound-related technologies such as conventional ultrasound guidance and contrast-enhanced ultrasound guidance in GIST biopsy, systematically analyzes the application value and limitations of various technologies, and briefly describes the application status of other imaging guidance methods. It further explores the problems existing in current research, such as insufficient sample size, lack of unified operating standards, and great influence by operator experience, and looks forward to future development directions such as new ultrasound imaging technologies, artificial intelligence-assisted diagnosis, and “one-stop” diagnosis and treatment models, so as to provide a reference for improving the accuracy of GIST biopsy and optimizing clinical diagnosis and treatment strategies.
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