Subscribe to RSS
DOI: 10.1055/a-2037-5802
Novel low echo reduction function reduces artifacts in endoscopic ultrasound observation of the gallbladder
Endoscopic ultrasonography (EUS), with its high spatial resolution, is indispensable for diagnosing the nature and invasiveness of gallbladder lesions [1] [2] [3]. The gallbladder and bile ducts are hollow organs that do not originally have internal echo sources and are susceptible to multiple reflections and other artifacts. Recently, a new endoscopic ultrasound (EUS) processor (EVIS EUS EU-ME3; Olympus, Tokyo, Japan) was launched that is equipped with a novel anti-artifact function called low echo reduction (LER). LER suppresses low echo areas while maintaining high echo areas, thereby improving contrast without whiteout. LER is usually set at Lv.3 and ranges from 1 (lowest) to 20 (highest). The tissue harmonic echo (THE) mode can reduce artifacts in B-mode images, but LER can provide further artifact reduction, in addition to THE. The LER level can be changed both when the EUS screen is live or paused.
We usually evaluate the gallbladder using a radial-type scope (GF-UE290; Olympus) with THE mode, setting at gain Lv.10 and contrast at Lv.4. LER was able to suppress multiple reflection artifacts, making it easy to recognize the boundaries of the gallbladder wall and lesions ([Fig. 1]; [Video 1]). It should be noted that LER suppresses even minute signal changes, and there is a risk of missing small findings or lesions; however, small polyps were not obscured ([Fig. 2]). LER also suppressed artifacts and made it easier to see lesions in cases where they were covered by artifacts ([Fig. 3]).
Video 1 Low echo reduction, a novel endoscopic ultrasound function, is used to suppress multiple reflection artifacts during gallbladder observation, making it easy to recognize the gallbladder wall and lesions.
Quality:
In situations where artifacts prevent close evaluation of the interior of hollow organs with EUS, LER may reduce artifacts and improve visibility.
Endoscopy_UCTN_Code_CCL_1AF_2AF
Endoscopy E-Videos is an open access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online. Processing charges apply, discounts and wavers acc. to HINARI are available.
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos
Publication History
Article published online:
09 March 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Tanaka K, Katanuma A, Hayashi T. et al. Role of endoscopic ultrasound for gallbladder disease. J Med Ultrason (2001) 2021; 48: 187-198
- 2 Hashimoto S, Nakaoka K, Kawabe N. et al. The role of endoscopic ultrasound in the diagnosis of gallbladder lesions. Diagnostics (Basel) 2021; 11: 1789
- 3 Toyonaga H, Hayashi T, Ueki H. et al. An intact boundary between the tumor and inner hypoechoic layer discriminates T1 lesions among sessile elevated gallbladder cancers. J Hepatobiliary Pancreat Sci 2021; 28: 1121-1129