Inglis, S.; Ramnarine, K.V.; Plevris, J.N.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA5
Academic Journal
Introduction: Endoscopic ultrasound (EUS) is routinely used to stage upper Gl cancers. This technique estimates depth of invasion, but may not provide reliable information on tumour length. 3D EUS could improve staging and treatment monitoring by providing complete datasets, detailing the progression of the tumour along the oesophagus and accurate dimensional measurements. Aims: To compare (a) the measurement capabilities of 2D and 3D EUS in an oesophageal cancer phantom; and (b) the staging of patients with oesophageal cancer from 2D and 3D EUS. Methods: Two experienced endoscopists used the Olympus GF-UM200 scope/EU-M30 processor to scan the phantom and patients at 7.5 and 12 MHz. Images were captured at 25 frames/sec. (a) In vitro 3D data were acquired from an EUS anthropomorphic oesophageal cancer phantom with known dimensions. (b) In vivo 3D data were obtained during conventional 2D EUS as the scope was withdrawn. 3D volumes were reconstructed from a series of parallel B-mode images. Dimensional measurements and cancer staging was performed during the routine test. A retrospective comparison was made between the cancer staging and dimensions obtained from 2D EUS and from our 3D EUS system. Results: Routine 2D length measurements performed on the phantom had a mean error of 9% (max 23%). Identical measurements performed using 3D EUS had a mean error of 1.7% (max 3.7%). 3D EUS could visuaiise nodes < 5 mm and detected nodes not observed during routine EUS. The 3D system improved the reproducibility of the X, Y, and Z measurements of tumour and nodes with mean intra and inter observer coefficient of variation < 5%. Conclusions: This study has shown that the 3D technique can accurately measure tumour and node dimensions with good reproducibility. Since the main in vitro error was estimating the length of embedded objects, it is likely that 2D EUS cannot estimate tumour and node length as accurately as previously thought. This preliminary work suggests that 3D...


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