Prospective comparative evaluation of video and fiberoptic echoendoscopes

A. Chak, G. Isenberg, S. Mallery, J. Van Dam, M. V. Sivak

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The relatively large diameter, the long rigid tip, and the oblique narrow viewing optics of fiberoptic echoendoscopes (FIB) often makes it difficult to perform endosonography (EUS) without a concurrent diagnostic endoscopy on patients with intraluminal lesions. Aim: To prospectively determine whether the smaller diameter and improved optics of a new video echoendoscope (VID) allow the performance of endosonography without diagnostic endoscopy. Methods: All patients undergoing EUS at two centers were examined with a FIB (Olympus GF-UM20) for a period of 5 weeks. During the next month, all patients undergoing EUS were examined with a VID (Olympus GF-UM130). Note was made of need for concurrent diagnostic endoscopy as well as the reason for it. The endosonographer also rated the mechanical, optical, and sonographic performance of the VID in comparison to the FIB instrument. Results: Eighty seven (mean age = 63 yrs, 50 men) patients (pts) underwent EUS at the two centers during the study period. The FIB was used in 59 cases (37 non-retroperitoneal examinations) and the VID was used in 28 cases (20 non-retroperitoneal). Concurrent diagnostic endoscopy was performed during 23/37 (62%) FIB and during 5/20 (25%) VID EUS examinations of nonretroperitoneal lesions, p < 0.01. Reasons for performing diagnostic endoscopy were visualization of lesion in 17 FIB, traversal of stricture in 4 FIB and 1 VID, and biopsy of the lesion in 2 FIB and 4 VID examinations. Grading * (mean values) for various parameters designed to evaluate VID performance is shown below. Mechanical Optical Sonographic Length 5.4 Brightness 6.6 Sensitivity (7.5/12 MHz) 4.6 Stiffness 5.5 Illumination 6.7 Resolution (7.5/12 MHz) 4.8 Tip Deflection 5.9 Field of View 7.4 * 9 point scale (1 = much worse, 5 = equal to, and 9 = much better than FIB) Conclusions: Moderately improved optics and slightly better mechanical characteristics of the new video echoendoscope allow the performance of EUS without concurrent diagnostic endoscopy in the majority of patients. A slightly larger channel which allowed adequate biopsies could further reduce the need for diagnostic endoscopy at the time of EUS.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Issue number4
StatePublished - Dec 1 1998

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