Technical considerations in the performance of endoluminal ultrasonography using new catheter probes

Marcia Canto, A. Chak, P. Stevens, C. J. Lightdale, F. Van De Mierop, G. Cooper, B. Pollack, M. V. Sivak

Research output: Contribution to journalArticle

Abstract

AIM: To define technical advantages and limitations of endosonographic imaging using a new through the-scope catheter system. METHODS: Catheter based ultrasonography (C-EUS) was performed with newly developed 2.3 mm, 12 MHz (Olympus 2R) and/or 20 MHz (Olympus 3R) catheter probes introduced via accessory channel of standard diagnostic upper endoscopes or duodenoscopes. Standard endoscopic ultrasonography (S-EUS) with an ultrasound endoscope (Olympus GF-UM20) was subsequently performed on all patients. Ease of performing C-EUS (5-point scale), imaging depth, image clarity compared to S-EUS, time taken to perform C-EUS, and number of sonographic layers seen at C-EUS were all recorded. RESULTS: C-EUS was performed on 21 patients (ptsl with esophageal lesions (Gp1), 12 pts with gastric lesions (Gp2), and 6 pts with pancreaticobiliary strictures (Gp3). C-EUS was easy to perform (no or little manipulation) in 19/21 (90%) Gp1 pts, 10/12 (83%) Gp2 pts, and 5/6 (83%) Gp3 pts. Compared to S-EUS, C-EUS was rated as providing a clearer image in 6/21 (29%) Gp1 pts, 8/12 (66%) Gp2 pts, and 4/6 (66%) Gp3 patients. Lack of image clarity in Gp 1 pts was generally due to an inability to retain water in esophagus. Poor image clarity in Gp 3 pts was noted only when the catheter failed to traverse a stricture. Mean imaging depth was 2.9 cm. for 12 MHz catheter and 1.8 cm. for the 20 MHz catheter. The 12 MHz probe defined 5 sonographic layers when scanning the esophageal and gastric wall in all but one examination (7 layers seen in 1 gastric exam). The 20 MHz probe also imaged 6 sonographic layers in the esophagus and stomach except in 3 cases where 7 layers were seen. Both the 12 and 20 MHz probes demonstrated 3 layers when imaging the normal bile duct wall. Mean time for C-EUS imaging with endoscopy was 16.4 minutes (Gp1), 16.0 minutes (Gp2), and 23.7 minutes (Gp3). Catheters broke during 3 of the first 25 examinations. Following modifications to strengthen catheters, breakage occurred only in 1 of 18 examinations. CONCLUSIONS: Catheter ultrasonography with the new Olympus 2R/3R system can be performed relatively easily and quickly during diagnostic endoscopy. C-EUS provides clean sonographic images, although imaging depth is limited. Imaging in the esophagus with C-EUS is hampered by the inability to achieve good acoustical contact, but may be improved in future by development of a balloon sheath.

Original languageEnglish (US)
Pages (from-to)292
Number of pages1
JournalGastrointestinal Endoscopy
Volume43
Issue number4
StatePublished - 1996
Externally publishedYes

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Ultrasonography
Catheters
Endosonography
Stomach
Esophagus
Endoscopes
Endoscopy
Pathologic Constriction
Duodenoscopes
Bile Ducts

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Canto, M., Chak, A., Stevens, P., Lightdale, C. J., Van De Mierop, F., Cooper, G., ... Sivak, M. V. (1996). Technical considerations in the performance of endoluminal ultrasonography using new catheter probes. Gastrointestinal Endoscopy, 43(4), 292.

Technical considerations in the performance of endoluminal ultrasonography using new catheter probes. / Canto, Marcia; Chak, A.; Stevens, P.; Lightdale, C. J.; Van De Mierop, F.; Cooper, G.; Pollack, B.; Sivak, M. V.

In: Gastrointestinal Endoscopy, Vol. 43, No. 4, 1996, p. 292.

Research output: Contribution to journalArticle

Canto, M, Chak, A, Stevens, P, Lightdale, CJ, Van De Mierop, F, Cooper, G, Pollack, B & Sivak, MV 1996, 'Technical considerations in the performance of endoluminal ultrasonography using new catheter probes', Gastrointestinal Endoscopy, vol. 43, no. 4, pp. 292.
Canto, Marcia ; Chak, A. ; Stevens, P. ; Lightdale, C. J. ; Van De Mierop, F. ; Cooper, G. ; Pollack, B. ; Sivak, M. V. / Technical considerations in the performance of endoluminal ultrasonography using new catheter probes. In: Gastrointestinal Endoscopy. 1996 ; Vol. 43, No. 4. pp. 292.
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abstract = "AIM: To define technical advantages and limitations of endosonographic imaging using a new through the-scope catheter system. METHODS: Catheter based ultrasonography (C-EUS) was performed with newly developed 2.3 mm, 12 MHz (Olympus 2R) and/or 20 MHz (Olympus 3R) catheter probes introduced via accessory channel of standard diagnostic upper endoscopes or duodenoscopes. Standard endoscopic ultrasonography (S-EUS) with an ultrasound endoscope (Olympus GF-UM20) was subsequently performed on all patients. Ease of performing C-EUS (5-point scale), imaging depth, image clarity compared to S-EUS, time taken to perform C-EUS, and number of sonographic layers seen at C-EUS were all recorded. RESULTS: C-EUS was performed on 21 patients (ptsl with esophageal lesions (Gp1), 12 pts with gastric lesions (Gp2), and 6 pts with pancreaticobiliary strictures (Gp3). C-EUS was easy to perform (no or little manipulation) in 19/21 (90{\%}) Gp1 pts, 10/12 (83{\%}) Gp2 pts, and 5/6 (83{\%}) Gp3 pts. Compared to S-EUS, C-EUS was rated as providing a clearer image in 6/21 (29{\%}) Gp1 pts, 8/12 (66{\%}) Gp2 pts, and 4/6 (66{\%}) Gp3 patients. Lack of image clarity in Gp 1 pts was generally due to an inability to retain water in esophagus. Poor image clarity in Gp 3 pts was noted only when the catheter failed to traverse a stricture. Mean imaging depth was 2.9 cm. for 12 MHz catheter and 1.8 cm. for the 20 MHz catheter. The 12 MHz probe defined 5 sonographic layers when scanning the esophageal and gastric wall in all but one examination (7 layers seen in 1 gastric exam). The 20 MHz probe also imaged 6 sonographic layers in the esophagus and stomach except in 3 cases where 7 layers were seen. Both the 12 and 20 MHz probes demonstrated 3 layers when imaging the normal bile duct wall. Mean time for C-EUS imaging with endoscopy was 16.4 minutes (Gp1), 16.0 minutes (Gp2), and 23.7 minutes (Gp3). Catheters broke during 3 of the first 25 examinations. Following modifications to strengthen catheters, breakage occurred only in 1 of 18 examinations. CONCLUSIONS: Catheter ultrasonography with the new Olympus 2R/3R system can be performed relatively easily and quickly during diagnostic endoscopy. C-EUS provides clean sonographic images, although imaging depth is limited. Imaging in the esophagus with C-EUS is hampered by the inability to achieve good acoustical contact, but may be improved in future by development of a balloon sheath.",
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AU - Chak, A.

AU - Stevens, P.

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AU - Van De Mierop, F.

AU - Cooper, G.

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N2 - AIM: To define technical advantages and limitations of endosonographic imaging using a new through the-scope catheter system. METHODS: Catheter based ultrasonography (C-EUS) was performed with newly developed 2.3 mm, 12 MHz (Olympus 2R) and/or 20 MHz (Olympus 3R) catheter probes introduced via accessory channel of standard diagnostic upper endoscopes or duodenoscopes. Standard endoscopic ultrasonography (S-EUS) with an ultrasound endoscope (Olympus GF-UM20) was subsequently performed on all patients. Ease of performing C-EUS (5-point scale), imaging depth, image clarity compared to S-EUS, time taken to perform C-EUS, and number of sonographic layers seen at C-EUS were all recorded. RESULTS: C-EUS was performed on 21 patients (ptsl with esophageal lesions (Gp1), 12 pts with gastric lesions (Gp2), and 6 pts with pancreaticobiliary strictures (Gp3). C-EUS was easy to perform (no or little manipulation) in 19/21 (90%) Gp1 pts, 10/12 (83%) Gp2 pts, and 5/6 (83%) Gp3 pts. Compared to S-EUS, C-EUS was rated as providing a clearer image in 6/21 (29%) Gp1 pts, 8/12 (66%) Gp2 pts, and 4/6 (66%) Gp3 patients. Lack of image clarity in Gp 1 pts was generally due to an inability to retain water in esophagus. Poor image clarity in Gp 3 pts was noted only when the catheter failed to traverse a stricture. Mean imaging depth was 2.9 cm. for 12 MHz catheter and 1.8 cm. for the 20 MHz catheter. The 12 MHz probe defined 5 sonographic layers when scanning the esophageal and gastric wall in all but one examination (7 layers seen in 1 gastric exam). The 20 MHz probe also imaged 6 sonographic layers in the esophagus and stomach except in 3 cases where 7 layers were seen. Both the 12 and 20 MHz probes demonstrated 3 layers when imaging the normal bile duct wall. Mean time for C-EUS imaging with endoscopy was 16.4 minutes (Gp1), 16.0 minutes (Gp2), and 23.7 minutes (Gp3). Catheters broke during 3 of the first 25 examinations. Following modifications to strengthen catheters, breakage occurred only in 1 of 18 examinations. CONCLUSIONS: Catheter ultrasonography with the new Olympus 2R/3R system can be performed relatively easily and quickly during diagnostic endoscopy. C-EUS provides clean sonographic images, although imaging depth is limited. Imaging in the esophagus with C-EUS is hampered by the inability to achieve good acoustical contact, but may be improved in future by development of a balloon sheath.

AB - AIM: To define technical advantages and limitations of endosonographic imaging using a new through the-scope catheter system. METHODS: Catheter based ultrasonography (C-EUS) was performed with newly developed 2.3 mm, 12 MHz (Olympus 2R) and/or 20 MHz (Olympus 3R) catheter probes introduced via accessory channel of standard diagnostic upper endoscopes or duodenoscopes. Standard endoscopic ultrasonography (S-EUS) with an ultrasound endoscope (Olympus GF-UM20) was subsequently performed on all patients. Ease of performing C-EUS (5-point scale), imaging depth, image clarity compared to S-EUS, time taken to perform C-EUS, and number of sonographic layers seen at C-EUS were all recorded. RESULTS: C-EUS was performed on 21 patients (ptsl with esophageal lesions (Gp1), 12 pts with gastric lesions (Gp2), and 6 pts with pancreaticobiliary strictures (Gp3). C-EUS was easy to perform (no or little manipulation) in 19/21 (90%) Gp1 pts, 10/12 (83%) Gp2 pts, and 5/6 (83%) Gp3 pts. Compared to S-EUS, C-EUS was rated as providing a clearer image in 6/21 (29%) Gp1 pts, 8/12 (66%) Gp2 pts, and 4/6 (66%) Gp3 patients. Lack of image clarity in Gp 1 pts was generally due to an inability to retain water in esophagus. Poor image clarity in Gp 3 pts was noted only when the catheter failed to traverse a stricture. Mean imaging depth was 2.9 cm. for 12 MHz catheter and 1.8 cm. for the 20 MHz catheter. The 12 MHz probe defined 5 sonographic layers when scanning the esophageal and gastric wall in all but one examination (7 layers seen in 1 gastric exam). The 20 MHz probe also imaged 6 sonographic layers in the esophagus and stomach except in 3 cases where 7 layers were seen. Both the 12 and 20 MHz probes demonstrated 3 layers when imaging the normal bile duct wall. Mean time for C-EUS imaging with endoscopy was 16.4 minutes (Gp1), 16.0 minutes (Gp2), and 23.7 minutes (Gp3). Catheters broke during 3 of the first 25 examinations. Following modifications to strengthen catheters, breakage occurred only in 1 of 18 examinations. CONCLUSIONS: Catheter ultrasonography with the new Olympus 2R/3R system can be performed relatively easily and quickly during diagnostic endoscopy. C-EUS provides clean sonographic images, although imaging depth is limited. Imaging in the esophagus with C-EUS is hampered by the inability to achieve good acoustical contact, but may be improved in future by development of a balloon sheath.

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