Title: 7234 Usefulness of three-dimensional expression by endoscopic ultrasonography in the diagnosis of gastric cancer invasion.
Abstract: Objective: Many studies have reported the usefulness of endoscopic ultrasonography (EUS) in the diagnosis of gastric cancer invasion. However, the diagnostic capacity of EUS should be further improved. In this study, we examined the usefulness of three-dimensional expression by EUS in the diagnosis of gastric cancer invasion. Subjects and Methods: In 54 gastric cancer lesions that were histologically diagnosed after April 1995 by EUS using an ultrasonic miniprobe in our department, the rate of accurately diagnosing invasion was compared between period A and period B. The period between April 1995 and October 1996, when examination of threedimensional expression was started at our department, was regarded as period A (35 lesions) , while the period from October 1996 to date was regarded as period B (19 lesions). Furthermore, the usefulness of threedimensional expression was examined in l9 lesions during period B. In the three-dimensional expression, we pulled ultrasonic miniprobe out at definite speed manually, and recorded the images on VTR.We connected VTR output to images processing equipment (IndigO<sub>2</sub>, Silicon Graphics), and compressed each tomographic image (30 frame/sec) by EUS by Motion JPEG method. We selected necessary frames from the images, and converted them into volume data by the three-dimensional image processing software (Medical Design Composer 1.0) which we developed. We determined arbitrary cross sections and the external form on volume data, and observed the lesions spatially. Result: The rate of accurate diagnosis of invasion by EUS was 77.8% (42/54) , overall. Percentages were 74.3% (26/35: T1-m 71.4%, T1-sm 83.3%, T2-pm 50%) during period A and 84.2% (6/19: T1-m 87.5%, T1-sm 66.7%) during period B. During period B, the whole lesion was scanned in each direction for three-dimensional expression. Furthermore, more detailed examination could be performed by expressing random cross sections from three-dimensional data, improving the diagnostic capacity of this procedure. In 8 of 19 patients, superficial expression was possible. In these lesions, the rate of accurately diagnosed invasion was 100% (8/8). Although these patients were selected based on lesion size and the absence of the influence of heart beats, it was suggested that three-dimensional expression contributes to improving the diagnosis of invasion. Conclusion: Three-dimensional expression of EUS findings in patients with gastric cancer may improve the diagnosis of invasion.
Publication Year: 2000
Publication Date: 2000-04-01
Language: en
Type: article
Indexed In: ['crossref']
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