High frequency balloon catheter ultrasound (CUS) folowing chromoendoscopy in assessing esophageal dysplasia and cancer in Linxian, China: A Comparison with 20 MHZ EUS

T. L. Tio, D. E. Fleischer, G. Q. Wang, S. M. Dawsey, B. Zhou, J. A. Kidwell

Research output: Contribution to journalArticle

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Abstract

Backgound:EUS has been established in staging esophageal cancer with limitations such as large diameter, low US frequency. Recently, a high frequency 20Mhz videoechoendoscope for EUS and a 20MHz catheter probe (CUS) attachable to a balloon sheath (Oympus MH-246H) for endoscopic (Olympus 2T) guided exam have become available. The aim of the study was to determine whether CUS exam performed during chromoendoscopy in patients with dysplasia, carcinoma in-situ(CIS), squamous or adenocarcinoma of the esophagus in Linxian would have a similar result to EUS . Methods: 13 patients (10 M/3 F;age range 52-75 yr.) were studied in Sept 1996 using a 20 MHz CUS (UM-3R) and a 20 MHz prototype video-echoendoscope (Olympus EUM-Q200, diameter 13 mm). Following iodine chromoendoscopy CUS was performed with particular attention to the unstained lesions (USL). Subsequentially, EUS was performed for comparison. Results: USL were seen endoscopically through the inflated balloon attached to CUS. EUS could only partially visualized USL because of the lateral view endoscope. Diagnosis * n CUS EUS Moderate Dysplasia 1 transmural transmural Severe Dysplasia or 4 3= T1m1 N0 3=T1mN0 (2), T1smN0 (1) CIS 1=T1sm2N1 1=T1smN1 Squamous cancer 5 3-T1smN0(2), T1smN1 (1) 3=T1smN1 M0 1-T4N1 1=T4 N1 M0 1=T2 N1 1=Tx Nx Mx3 Adenocarcinoma 3 2=T2 N0 2=T2 N0 Mx(1), T2 N1Mx(1) 1=T3 NX4 1=T4 N2 Mx4 * From previous endoscopy 16 months before the current exam. 1 m, mucosa; 2 sm, submucosa; 3 Perforation occurred during insertion of EUS. 4 Stenosis was impassable with 2T endoscope but passable with echoendoscope. Conclusions: 1. Direct visualization of USL is possible with CUS but not with EUS.2. Superficial lesions can be equally evaluated with both CUS and EUS. 3. Regional lymph nodes, distant metastases and advanced cancers are better imaged with EUS. 4. Stenotic cardia lesions impassable with 2T endoscope prohibit adequate CUS. 5. Perforation may occur with EUS but less likely with CUS. 6. EUS requires an additional intubation after chromoendoscopy.

Original languageEnglish (US)
Pages (from-to)AB183
JournalGastrointestinal endoscopy
Volume45
Issue number4
DOIs
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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