3491 Preliminary experiences of three-dimensional endoscopic ultrasonography in the united states.

Abstract

INTRODUCTION: The advent of low cost computer power has greatly impacted body imaging resulting in a proliferation of technologies incorporating 3-D reconstruction. AIM: To image a variety of UGI lesions with a prototype 3-D EUS catheter probe to determine its potential clinical applications. METHOD: The 3D-EUS imaging system (Olympus Optical, Tokyo) consists of a 12 and 20 MHz ultrasonic probe (UM-3D2R, UM-3D3R), a motor unit, an ultrasound processor (EU-M30), and a computer for image processing (EU-IP2). Scanning and storing time is 4 to 13 sec. The ultrasound probe is housed in a clear sheath filled with water. The motor moves the probe radially (360°) and linearly (4cm). Images are stored and processed later. In all cases, the radial and linear images were reviewed and judgment was rendered as to whether combined imaging provided clinical benefit. Esophageal cases were performed using a condom placed over the end of a two channel endoscope. RESULT: Between 5/99 and 11/99, 13 3-D EUS cases were performed (2 esophageal cancer, 3 Barrett's esophagus, 4 esophageal SMT, 1 gastric SMT, 1 mucinous ductal ectasia, 1 common bile duct stricture). The simultaneous display of linear and radial images made imaging and interpretation of images of SMT easier but did not provide unique and significant advantages. Imaging and evaluation of Barrett's esophagus and biliary strictures was significantly better with the 3-D system because of the volume of area that can be scannedfrom a single position. CONCLUSION:We suggest that the simultaneous linear and radial images produced by this instrument may improve diagnosis in some circumstances. Prospective trials based on this data are ongoing. Volume rendering will be possible in the near future which may further expand the application of 3-D EUS.