Feasibility of newly developed endoscopic ultrasound with zone sonography technology for diagnosis of pancreatic diseases.

Background/Aims: To confirm the feasibility of using newly developed endoscopic ultrasound (EUS) with Zone sonography (TM) technology (ZST; Fujifilm Corp.). Methods: Seventy-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-53OUR2 and EG-53OUT2 (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 PASS, image quality at sound speeds of 1,440 and 1,600 m/sec were also assessed. Results: In 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 PASS and plus 60 m/sec, but no significant difference between the datasets were seen after PASS and at sound speeds manually set for minus 100 m/sec. Conclusions: EUS with ZST was shown to be feasible in this preliminary experiment. Further evaluation of this novel technology is necessary and awaited.