4598 Is 3d-eus useful for determination of the depth of cancer invasion in upper gi tract?

Abstract

Recently, 3D image in endoscopic ultrasonography has been developed, so that examination become easier than 2D image. However, is it offer better result than 2D image. We investigated if it is useful for determination of the depth of cancer invasion and what factors influence the result. Ultrasound imaging system (Olympus Co.) is used. The method: Anticholinergic agent or glucagon is injected in order to suppress the peristalsis andthe 2 channel scope was inserted to the lesion vicinity. After the lesion is observed, the probe was inserted from the working channel, and water was irrigated from the other channel. When the lesions was covered the water, the scan was carried out. To stop respiration was directed under scan. One of the judgment of the depth of cancer invasion by images from radial scan, the other judgment of the depth of cancer invasion by made liner image, simulation three-dimensional image or multiple images from the computer taken images, they were separately determined. In 50 cases of esophageal cancer and 47 cases of gastric cancer, each results were compared with histological findings. Result 1. In esophageal cancer, the probe passed through the carcinoma in 49 cases, and whole scanning was possible in 98%. In judgment from radial scan, Tis and cancer invading the lamina propria were correctly determined in 67%, the cancer invading the muscularis mucosa (including slightly invasion the submucosa) in 59%, the submucosa in 92% , T2 in 100%, T3 in 63% , T4 in 100% and total on 72%. On the other hand judgment from images by computer, Tis and cancer invading the lamina propria were accurately determined in 83%, cancer invading the muscularis mucosa (including slight invasion the submucosa) in 66%, cancer invading the submucosa in 92%, T2 in 100%, T3 in 73%, T4 in 100% and total in 80%. 2. In gastric cancer, the judgment from radial scan, mucosal cancer was correctly determined in 81%, cancer invading the submucosa in 92% , T2 in 33% and total 81%. On the other hand, the judgment from images by taken computer, mucosal cancer was accurately determined in 84%, cancer invading the submucosa in 100%, T2 in 67% and total in 85%. 3. In the image with the big tumor, the invasion depth became the inaccuracy by the attenuation. The most important point in the judgment from images by computer was that judgment was made two direction, consecutive images of lesions. Conclusion: EUS 3D images were offer more accurate judgments than 2D. Information from two-direction and consecutive images of the lesion let us precise judgments.