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Prospective comparison of catheter‐based endoscopic sonography versus standard endoscopic sonography: Evaluation of gastrointestinal‐wall abnormalities and staging of gastrointestinal malignancies
Author(s) -
Koch Johannes,
Halvorsen Robert A.,
Levenson Scott D.,
Cello John P.
Publication year - 2001
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/1097-0096(200103/04)29:3<117::aid-jcu1010>3.0.co;2-1
Subject(s) - medicine , endoscopic ultrasound , radiology , malignancy , endoscopic ultrasonography , endoscopy , lumen (anatomy) , catheter , gastrointestinal cancer , gastrointestinal tract , cancer , colorectal cancer
Purpose Endoscopic sonography (EUS) is an important imaging modality for evaluating benign and malignant luminal gastrointestinal‐tract abnormalities. The objectives of this study were to evaluate the feasibility of catheter‐based EUS (C‐EUS) during standard upper and lower endoscopy in patients with malignancies and other abnormalities of the gastrointestinal‐tract lumen, to assess the image quality obtained with the 12.5‐MHz catheter‐based ultrasound transducer, and to prospectively compare the interpretations of C‐EUS images with those of the standard EUS (S‐EUS) images. Methods One hundred thirty‐seven consecutive patients referred for EUS were evaluated with C‐EUS followed by S‐EUS. The patients were assigned to 1 of 2 groups: group A, patients with intramural masses or intestinal wall thickening, with biopsies negative for malignancy; and group B, patients with esophageal, gastric, duodenal, or rectal cancer referred for staging. The results of C‐EUS and S‐EUS were compared for each group. Results C‐EUS was completed in 134 patients: 81 patients with 83 lesions in group A and 53 patients in group B. For group A, C‐EUS image interpretation concurred with that of S‐EUS in 74 (89%) of 83 lesions. For group B, C‐EUS concurred with S‐EUS for tumor depth (T) and nodal (N) classifications in 19 cases (36%) and 26 cases (49%), respectively. The depth of invasion was underestimated by C‐EUS in all 34 cases in which the T classifications by C‐EUS and S‐EUS were discordant. In 1 of 6 patients with stenotic cancer that was nontraversable by S‐EUS, C‐EUS identified lymphadenopathy (incorrectly classified as N0 by S‐EUS). Conclusions C‐EUS was easily performed, and the C‐EUS images were comparable to the S‐EUS images in assessing mucosal and intramural lesions. The limited depth of penetration of the catheter‐based transducer resulted in understaging the extent of tumor invasion and underestimating the nodal spread. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:117–124, 2001.