High-Resolution Endoscopic Ultrasound: Clinical T-Staging of Mucosal Neoplasms

  • Yuichiro Kuroki
  • Toshio Uraoka
  • Gernot W. WolkersdörferEmail author


High-resolution endoscopic ultrasound (hrEUS) with miniprobes performed during diagnostic endoscopy complements information on invasiveness of suspected malignant mucosal neoplasias. The diagnostic essentials of hrEUS images of early neoplasias are explained and discussed. Imaging by hrEUS per se distinguishes mucosal or sm-microinvasive lesions vs. deeply sm-invasive neoplasias at about 90 % accuracy in most locations of the GI tract. HrEUS imaging should be available for the decision between endoscopic ablation and surgical resection of such lesions.


  1. 1.
    Menzel J, et al. Gastrointestinal miniprobe sonography: the current status. Am J Gastroenterol. 2000;95:605–16.PubMedCrossRefGoogle Scholar
  2. 2.
    Yamanaka T. JGES consensus meeting report in DDW-Japan 2000. Kobe: interpretation of the layered structure of gastrointestinal wall with endoscopic ultrasonography. Dig Endosc. 2002;14:39–40.CrossRefGoogle Scholar
  3. 3.
    Hunerbein M, et al. Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound. Surg Endosc. 2003;17:615–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Akahoshi K, et al. Pretreatment staging of endoscopically early gastric cancer with a 15 MHz ultrasound catheter probe. Gastrointest Endosc. 1998;48:470–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Chemaly M, et al. Miniprobe EUS in the pretherapeutic assessment of early esophageal neoplasia. Endoscopy. 2008;40:2–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Hamada S, et al. Preoperative staging of colorectal cancer by a 15 MHz ultrasound miniprobe. Surgery. 1998;123:264–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Hasegawa N, et al. Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoscopic ultrasonography. Gastrointest Endosc. 1996;44:388–93.PubMedCrossRefGoogle Scholar
  8. 8.
    Matsumoto Y, et al. Endoscopic ultrasonography for diagnosis of submucosal invasion in early gastric cancer. J Gastroenterol. 2000;35:326–31.PubMedCrossRefGoogle Scholar
  9. 9.
    May A, et al. Accuracy of staging in early oesophageal cancer using high resolution endoscopy and high resolution endosonography: a comparative, prospective, and blinded trial. Gut. 2004;53:634–40.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Menzel J, et al. Preoperative staging of esophageal carcinoma: miniprobe sonography versus conventional endoscopic ultrasound in a prospective histopathologically verified study. Endoscopy. 1999;31:291–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Pech O, et al. The impact of endoscopic ultrasound and computed tomography on the TNM staging of early cancer in Barrett's esophagus. Am J Gastroenterol. 2006;101:2223–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Saitoh Y, et al. Efficacy of high-frequency ultrasound probes for the preoperative staging of invasion depth in flat and depressed colorectal tumors. Gastrointest Endosc. 1996;44:34–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Tsuda S, et al. Endoscopic ultrasonography versus probe for diagnosis of depth of infiltration of colorectal cancer. Endoscopy. 1998;30 Suppl 1:A85–7.PubMedGoogle Scholar
  14. 14.
    Tsuruta O, et al. Usefulness of the high-frequency ultrasound probe in pretherapeutic staging of superficial-type colorectal tumors. Int J Oncol. 1998;13:677–84.PubMedGoogle Scholar
  15. 15.
    Yanai H, et al. A blind comparison of the effectiveness of endoscopic ultrasonography and endoscopy in staging early gastric cancer. Gut. 1999;44:361–5.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Yoshida S, et al. Diagnostic ability of high-frequency ultrasound probe sonography in staging early gastric cancer, especially for submucosal invasion. Abdom Imaging. 2005;30:518–23.PubMedCrossRefGoogle Scholar
  17. 17.
    Hunerbein M, et al. Transendoscopic ultrasound of esophageal and gastric cancer using miniaturized ultrasound catheter probes. Gastrointest Endosc. 1998;48:371–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Murata Y, et al. Endoscopic ultrasonography in diagnosis and mucosal resection for early esophageal cancer. Endoscopy. 1998;30 Suppl 1:A44–6.PubMedGoogle Scholar
  19. 19.
    Tsuruta O, et al. Endoscopic ultrasonography staging of superficial-type colorectal neoplasms for mucosectomy. Endoscopy. 1998;30 Suppl 1:A92–3.PubMedGoogle Scholar
  20. 20.
    Akashi K, et al. Ulcerous change decreases the accuracy of endoscopic ultrasonography diagnosis for the invasive depth of early gastric cancer. Int J Gastrointest Cancer. 2006;37:133–8.PubMedGoogle Scholar
  21. 21.
    Kim GH, et al. Accuracy of high-frequency catheter-based endoscopic ultrasonography according to the indications for endoscopic treatment of early gastric cancer. J Gastroenterol Hepatol. 2010;25:506–11.PubMedCrossRefGoogle Scholar
  22. 22.
    Tsung PC, et al. Miniprobe endoscopic ultrasonography has limitations in determining the T stage in early colorectal cancer. Gut Liver. 2013;7:163–8.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Arima M, et al. Diagnostic accuracy of tumor staging and treatment outcomes in patients with superficial esophageal cancer. Esophagus. 2007;4:145–53.CrossRefGoogle Scholar
  24. 24.
    Choi J, et al. Comparison of endoscopic ultrasonography and conventional endoscopy for prediction of depth of tumor invasion in early gastric cancer. Endoscopy. 2010;42:705–13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Yuichiro Kuroki
    • 1
  • Toshio Uraoka
    • 2
  • Gernot W. Wolkersdörfer
    • 3
    Email author
  1. 1.Department of Gastroenterology and Endoscopy UnitToranomon HospitalMinato-kuJapan
  2. 2.Department of GastroenterologyTokyo Medical CenterMeguro-kuJapan
  3. 3.Department of Internal Medicine IParacelsus Medical University/Salzburger LandesklinikenSalzburgAustria

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