The Clinical Utility of Evaluating the Luminal Upper Gastrointestinal Tract during Linear Endoscopic Ultrasonography

Stephen Kim, Chris Hamerski, Kourosh Ghassemi, Janak Shah, Yasser Bhat, Jason Klapman, Sri Komanduri, Rajesh N. Keswani, Kiran Bidari, Sachin Wani, Rabindra R. Watson, Venkataraman R. Muthusamy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The clinical utility of performing esophagogastroduodenoscopy (EGD) before linear endoscopic ultrasonography (L-EUS) to evaluate the luminal upper gastrointestinal (GI) tract is not well established. Goals: The study was aimed to determine the prevalence of clinically meaningful luminal abnormalities (any luminal finding requiring further evaluation with mucosal biopsy or initiation of treatment) in patients undergoing L-EUS. The study also sought to compare the ability of the gastroscope and the linear echoendoscope in identifying these lesions. Study: A prospective, multicenter cohort study enrolled patients undergoing L-EUS for nonluminal indications. All patients underwent EGD followed by L-EUS by 2 different endoscopists. The second endoscopist was blinded to the results of the initial EGD. The identification of clinically meaningful luminal lesions and quality of endoscopic visualization of the upper GI tract were measured. Results: In the cohort of 175 patients, 52 (29.7%) patients had clinically meaningful luminal findings seen in the upper GI tract. There was no significant difference in the number of clinically meaningful lesions identified on EGD and L-EUS (25.1% vs. 22.9%, P=0.39). No significant difference was found in the miss rate of clinically meaningful lesions between the 2 modalities (EGD: 4.5% vs. EUS: 6.9%, P=0.39). Conclusions: A substantial minority of patients undergoing L-EUS for nonluminal indications will have clinically meaningful luminal findings. The endoscopic evaluation of the luminal upper GI tractcan be adequately achieved using the linear echoendoscope.

Original languageEnglish (US)
Pages (from-to)538-544
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume50
Issue number7
DOIs
StatePublished - Aug 1 2016

Keywords

  • echoendoscope
  • endoscopic ultrasonography
  • endoscopic ultrasound
  • esophagogastroduodenoscopy
  • gastroscope
  • upper gastrointestinal tract

ASJC Scopus subject areas

  • Gastroenterology

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