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Evaluation of the Feasibility and Efficacy of Forward-Viewing Endoscopic Ultrasound

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Background/Aims: We aimed to evaluate the feasibility and efficacy of a forward-viewing linear endoscopic ultrasound (FV-EUS) in diagnostic EUS procedures compared to standard oblique-viewing EUS (OV-EUS). Methods: This study was a prospective, randomized study that permitted cross-over. Fifty-one patients with subepithelial pancreatobiliary and upper gastrointestinal lesions underwent FV-EUS and OV-EUS sequentially, in random order. The EUS visualization was performed by a novice endosonographer, and the image quality of specific lesions was scored by an expert endosonographer. If fine-needle aspiration (FNA) was indicated, it was performed using both echoendoscopes by an expert endosonographer. Results: Both of the EUS procedures had similar visualization times and image quality. In general, the visualization time was inversely related to the diameter of the specific lesions. In subepithelial lesions of the stomach and duodenum, the visualization time (98.8±62.2 seconds vs 139.0±66.6 seconds, p=0.008) and image quality (4.1±1.3 vs 3.3±1.7, p=0.02) of FV-EUS were significantly superior to OV-EUS. FV-EUS-guided FNA of pancreatic masses was successful in seven patients (87.5%). Conclusions: FV-EUS may increase the ease of access to gastrointestinal subepithelial lesions compared to conventional OV-EUS. The performance of FV-EUS for evaluating pancreatobiliary diseases and performing interventions was comparable to conventional OV-EUS.

Abstract

Background/Aims: We aimed to evaluate the feasibility and efficacy of a forward-viewing linear endoscopic ultrasound (FV-EUS) in diagnostic EUS procedures compared to standard oblique-viewing EUS (OV-EUS). Methods: This study was a prospective, randomized study that permitted cross-over. Fifty-one patients with subepithelial pancreatobiliary and upper gastrointestinal lesions underwent FV-EUS and OV-EUS sequentially, in random order. The EUS visualization was performed by a novice endosonographer, and the image quality of specific lesions was scored by an expert endosonographer. If fine-needle aspiration (FNA) was indicated, it was performed using both echoendoscopes by an expert endosonographer. Results: Both of the EUS procedures had similar visualization times and image quality. In general, the visualization time was inversely related to the diameter of the specific lesions. In subepithelial lesions of the stomach and duodenum, the visualization time (98.8±62.2 seconds vs 139.0±66.6 seconds, p=0.008) and image quality (4.1±1.3 vs 3.3±1.7, p=0.02) of FV-EUS were significantly superior to OV-EUS. FV-EUS-guided FNA of pancreatic masses was successful in seven patients (87.5%). Conclusions: FV-EUS may increase the ease of access to gastrointestinal subepithelial lesions compared to conventional OV-EUS. The performance of FV-EUS for evaluating pancreatobiliary diseases and performing interventions was comparable to conventional OV-EUS.

참고문헌 (7)

  1. Eloubeidi MA, "Initial evaluation of the forward-viewing echoendoscope prototype for performing fine-needle aspiration, Tru-cut biopsy, and celiac plexus neurolysis", J Gastroenterol Hepatol, 26, pp.63~67 (2011)
  2. Erickson RA, "EUS-guided FNA", Gastrointest Endosc, 60, pp.267~279 (2004)
  3. Sepe PS, "EUS-guided FNA for the diagnosis of GI stromal cell tumors: sensitivity and cytologic yield", Gastrointest Endosc, 70, pp.254~261 (2009)
  4. Larghi A, "Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience", Gastrointest Endosc, 69, pp.356~360 (2009)
  5. Fusaroli P, "EUS-FNA using a forward-view echoendoscope in difficult cases", J Gastrointestin Liver Dis, 20, pp.216~217 (2011)
  6. Nguyen-Tang T, "Use of the front-view forward-array echoendoscope to evaluate right colonic subepithelial lesions", Gastrointest Endosc, 72, pp.606~610 (2010)
  7. Trevino JM, "Initial experience with the prototype forward-viewing echoendoscope for therapeutic interventions other than pancreatic pseudocyst drainage", Gastrointest Endosc, 69, pp.361~365 (2009)

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