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Newly‐developed, forward‐viewing echoendoscope: A comparative pilot study to the standard echoendoscope in the imaging of abdominal organs and feasibility of endoscopic ultrasound‐guided interventions
Author(s) -
Iwashita Takuji,
Nakai Yousuke,
Lee John G,
Park Do Hyun,
Muthusamy V Raman,
Chang Kenneth J
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06923.x
Subject(s) - medicine , endoscopic ultrasound , radiology
Background and Aim: Multiple diagnostic and therapeutic endoscopic ultrasound (EUS) procedures have been widely performed using a standard oblique‐viewing (OV) curvilinear array (CLA) echoendoscope. Recently, a new, forward‐viewing (FV) CLA was developed, with the advantages of improved endoscopic viewing and manipulation of devices. However, the FV–CLA echoendoscope has a narrower ultrasound scanning field, and lacks an elevator, which might represent obstacles for clinical use. The aim of this study was to compare the FV–CLA echoendoscope to the OV–CLA echoendoscope for EUS imaging of abdominal organs, and to assess the feasibility of EUS‐guided interventions using the FV–CLA echoendoscope. Methods: EUS examinations were first performed and recorded using the OV–CLA echoendoscope, followed immediately by the FV–CLA echoendoscope. Video recordings were then assessed by two independent endosonographers in a blinded fashion. The EUS visualization and image quality of specific abdominal organs/structures were scored. Any indicated fine‐needle aspiration (FNA) or intervention was performed using the FV–CLA echoendoscope, with the OV–CLA echoendoscope as salvage upon failure. Results: A total of 21 patients were examined in the study. Both echoendoscopes had similar visualization and image quality for all organs/structures, except the common hepatic duct (CHD), which was seen significantly better with the FV–CLA echoendoscope. EUS interventions were conducted in eight patients, including FNA of pancreatic mass (3), pancreatic cyst (3), and cystgastrostomy (2). The FV–CLA echoendoscope was successful in seven patients. One failed FNA of the pancreatic head cyst was salvaged using the OV–CLA echoendoscope. Conclusions: There were no differences between the FV–CLA echoendoscope and the OV–CLA echoendoscope in visualization or image quality on upper EUS, except for the superior image quality of CHD using the FV–CLA echoendoscope. Therefore, the disadvantages of the FV–CLA echoendoscope appear minimal in light of the potential advantages.