Dr Irving Waxman and colleagues from Texas prospectively evaluated the accuracy of preoperative high-frequency probe ultrasonography.
The team of doctors assessed whether the high frequency probe detects invasive cancer in patients referred for esophagectomy.
Patients were referred because of an endoscopic biopsy diagnosis of high-grade dysplasia or intramucosal carcinoma in Barrett's esophagus.
The team evaluated 9 consecutive male patients with a mean age of 69 years.
The doctors performed conventional upper gastrointestinal endoscopy followed by high-frequency probe ultrasonography.
A through-the-scope ultrasound probe of 20 MHz was used.
| High-frequency probe ultrasonography resulted in 2 false-negative diagnoses|
|American Journal of Gastroenterology|
The team then compared the preoperative findings with the pathologist's findings in the resected esophageal specimens.
The doctors found complete agreement between the postoperative pathological findings and the ultrasonography findings in only 4 of the 9 patients.
High-frequency probe ultrasonography resulted in 2 false-negative diagnoses of esophageal cancer.
The doctors observed 1 false-positive diagnosis of esophageal cancer, and 2 errors in tumor staging.
Dr Waxman's team concludes, “High-frequency probe ultrasonography has limited accuracy for identifying invasive cancer in patients found to have high-grade dysplasia or intramucosal carcinoma in Barrett's esophagus.”
“Pending further refinements in technology, clinical management decisions in such patients should not be based solely on the results of high-frequency probe ultrasonography.”