Feasibility of Newly Developed Endoscopic Ultrasound with Zone Sonography Technology for Diagnosis of Pancreatic Diseases

Abstract

Background/AimsTo confirm the feasibility of using newly developed endoscopic ultrasound (EUS) with Zone sonography™ technology (ZST; Fujifilm Corp.).MethodsSeventy-five patients with pancreatic disorders were enrolled: 45 with intraductal papillary mucinous neoplasm; 15 with ductal carcinoma; five with neuroendocrine tumors; three with serous cystic neoplasms; and seven with simple cysts. The endoscopes used were EG-530UR2 and EG-530UT2 (Fujifilm Corp.). Two items were evaluated: visualization depth among four frequencies and image quality after automatic adjustment of sound speed (AASS), assessed using a 5-scale Likert scale by two endosonographers blinded to disease status. Because sound speed could be manually controlled, besides AASS, image quality at sound speeds of 1,440 and 1,600 m/sec were also assessed.ResultsIn all cases, sufficient images were obtained in the range of 3 cm from the EUS probe. Judgments of image quality before AASS were 3.49±0.50, 3.65±0.48, respectively. After AASS, A and B scored 4.36±0.48 and 4.40±0.49 (p<0.0001). There were significant differences in the data before and after AASS and plus 60 m/sec, but no significant difference between the datasets were seen after AASS and at sound speeds manually set for minus 100 m/sec.ConclusionsEUS with ZST was shown to be feasible in this preliminary experiment. Further evaluation of this novel technology is necessary and awaited.

Clinical value of endoscopic ultrasound sound speed in differential diagnosis of pancreatic solid lesion and prognosis of pancreatic cancer

“…In another study, Hirooka et al reported no different SS provided by automatic adjustment of SS according to pancreatic cystic lesions and solid lesions. 27 It may be more advantageous to use other imaging modalities to differentiate between solid and cystic pancreatic lesions before performing SS.…”

Basic concept and clinical applications of quantitative ultrasound (QUS) technologies

“…Technologies for evaluation of the speed of sound (and thus image quality improvement) have also been implemented in clinical ultrasound diagnostic equipment, and various applications have been reported. Hirooka has reported the clinical applications of this technology, since the early stages of its development [ 44 ]. Imbault has reported clinical data and proposed various methods for improving the accuracy of speed of sound evaluation technology [ 45 – 47 ].…”

Diagnostic application of sound speed correction for endoscopic ultrasound-guided tissue acquisition of pancreatic mass

“…It is thus imperative to acquire adequate tissue specimens to improve the accuracy of histological examination [4]. As a new ultrasound technique, sound speed correction can quantitatively measure the tissue hardness [5], and it has been applied to differentiate between healthy and diseased tissues. We therefore used sound speed correction to guide performing EUS-FNA (▶ Video 1).…”