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High-frequency catheter endoscopic ultrasonography

Maurits J Wiersema, MD
Section Editor
Douglas A Howell, MD, FASGE, FACG
Deputy Editor
Kristen M Robson, MD, MBA, FACG


Endoscopic ultrasound (EUS) has an important role in the evaluation of benign and malignant gastrointestinal diseases [1-8]. Echoendoscopes operate from 5 to 20 MHz, permitting a spectrum of depth of penetration and image resolution. Higher frequencies provide higher resolution but less penetration, while lower frequencies provide higher penetration but lower resolution.

Advancements in ultrasound technology have led to the development of small caliber ultrasound catheters (maximum diameter 2.6 mm) that can be passed through the biopsy channel of a standard endoscope [9]. These miniprobes operate across a range of frequencies (12 to 30 MHz), providing a greater image resolution (0.07 to 0.18 mm) than standard EUS scopes as well as improved accuracy for studying small or superficial lesions of the gastrointestinal tract [9,10].

This topic review describes the technical characteristics of the commercially available high-frequency ultrasound (HFUS) catheters and the experience with their use in a variety of conditions.


HFUS catheters can be broadly classified by their working mechanism into mechanical and electronic catheters.

Mechanical catheters — Mechanical catheters have a single ultrasound transducer located at the tip of the catheter, which is rotated by a cable and transmits the signal from the transducer to the ultrasound processor. A flexible housing protects the cable and the transducer from damage. When rotating, the ultrasound transducer produces a 360-degree image, perpendicular to the longitudinal axis of the HFUS catheter. Certain models of HFUS mechanical catheters can be inserted over a guidewire, facilitating examination of the bile and pancreas ducts. These probes have been modified so that linear imaging is also possible with subsequent three-dimensional reconstruction.

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Literature review current through: Nov 2017. | This topic last updated: Nov 05, 2015.
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  1. Rösch T, Lorenz R, Braig C, et al. Endoscopic ultrasound in pancreatic tumor diagnosis. Gastrointest Endosc 1991; 37:347.
  2. Dancygier H, Nattermann C. The role of endoscopic ultrasonography in biliary tract disease: obstructive jaundice. Endoscopy 1994; 26:800.
  3. Rösch T, Lightdale CJ, Botet JF, et al. Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med 1992; 326:1721.
  4. Rösch T, Braig C, Gain T, et al. Staging of pancreatic and ampullary carcinoma by endoscopic ultrasonography. Comparison with conventional sonography, computed tomography, and angiography. Gastroenterology 1992; 102:188.
  5. Amouyal P, Amouyal G, Lévy P, et al. Diagnosis of choledocholithiasis by endoscopic ultrasonography. Gastroenterology 1994; 106:1062.
  6. Burtin P, Palazzo L, Canard JM, et al. Diagnostic strategies for extrahepatic cholestasis of indefinite origin: endoscopic ultrasonography or retrograde cholangiography? Results of a prospective study. Endoscopy 1997; 29:349.
  7. Giovannini M, Seitz JF, Thomas P, et al. Endoscopic ultrasonography for assessment of the response to combined radiation therapy and chemotherapy in patients with esophageal cancer. Endoscopy 1997; 29:4.
  8. Brugge WR. Endoscopic ultrasonography: the current status. Gastroenterology 1998; 115:1577.
  9. Menzel J, Domschke W. Gastrointestinal miniprobe sonography: the current status. Am J Gastroenterol 2000; 95:605.
  10. Kawano T, Oshima M, Endo M. Endoscopic ultrasonographic diagnosis. Stomach Intestine 1995; 30:365.
  11. Norton ID, Bruce CJ, Seward JB, et al. Initial experience with a steerable, phased vector array ultrasound catheter in the GI tract. Gastrointest Endosc 2001; 53:496.
  12. Shamoun DK, Norton ID, Levy MJ, et al. Use of a phased vector array US catheter for EUS. Gastrointest Endosc 2002; 56:430.
  13. Inoue H, Kawano T, Takeshita K, Iwai T. Modified soft-balloon methods during ultrasonic probe examination for superficial esophageal cancer. Endoscopy 1998; 30 Suppl 1:A41.
  14. Wallace MB, Hoffman BJ, Sahai AS, et al. Imaging of esophageal tumors with a water-filled condom and a catheter US probe. Gastrointest Endosc 2000; 51:597.
  15. Fockens P, van Dullemen HM, Tytgat GN. Endosonography of stenotic esophageal carcinomas: preliminary experience with an ultra-thin, balloon-fitted ultrasound probe in four patients. Gastrointest Endosc 1994; 40:226.
  16. Vazquez-Sequeiros E, Wiersema MJ. High-frequency US catheter-based staging of early esophageal tumors. Gastrointest Endosc 2002; 55:95.
  17. Kimmey MB, Martin RW, Haggitt RC, et al. Histologic correlates of gastrointestinal ultrasound images. Gastroenterology 1989; 96:433.
  18. Hasegawa N, Niwa Y, Arisawa T, et al. Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoscopic ultrasonography. Gastrointest Endosc 1996; 44:388.
  19. Tajima Y, Nakanishi Y, Ochiai A, et al. Histopathologic findings predicting lymph node metastasis and prognosis of patients with superficial esophageal carcinoma: analysis of 240 surgically resected tumors. Cancer 2000; 88:1285.
  20. Murata Y, Suzuki S, Ohta M, et al. Small ultrasonic probes for determination of the depth of superficial esophageal cancer. Gastrointest Endosc 1996; 44:23.
  21. Konishi H, Murata Y, Kishino M, et al. A study of the layer structure of the gastric wall and diagnosis of cancer invasion by using 30 MHz ultrasonographic probe (Abstract). Endoscopy 2000; 32:A18.
  22. Chak A, Canto M, Stevens PD, et al. Clinical applications of a new through-the-scope ultrasound probe: prospective comparison with an ultrasound endoscope. Gastrointest Endosc 1997; 45:291.
  23. Van Dam J, Rice TW, Catalano MF, et al. High-grade malignant stricture is predictive of esophageal tumor stage. Risks of endosonographic evaluation. Cancer 1993; 71:2910.
  24. Waxman I, Raju GS, Critchlow J, et al. High-frequency probe ultrasonography has limited accuracy for detecting invasive adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia or intramucosal carcinoma: a case series. Am J Gastroenterol 2006; 101:1773.
  25. Yanai H, Fujimura H, Suzumi M, et al. Delineation of the gastric muscularis mucosae and assessment of depth of invasion of early gastric cancer using a 20-megahertz endoscopic ultrasound probe. Gastrointest Endosc 1993; 39:505.
  26. Saitoh Y, Obara T, Einami K, 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.
  27. Sabet EA, Okai T, Minamoto T, et al. Three-dimensional endoscopic ultrasonography in gastric carcinoma (Abstract). Endoscopy 2000; 32:A6.
  28. Yoshida M, Tsukamoto Y, Niwa Y, et al. Endoscopic assessment of invasion of colorectal tumors with a new high-frequency ultrasound probe. Gastrointest Endosc 1995; 41:587.
  29. Hurlstone DP, Brown S, Cross SS, et al. High magnification chromoscopic colonoscopy or high frequency 20 MHz mini probe endoscopic ultrasound staging for early colorectal neoplasia: a comparative prospective analysis. Gut 2005; 54:1585.
  30. Koch J, Halvorsen RA Jr, Levenson SD, Cello JP. Prospective comparison of catheter-based endoscopic sonography versus standard endoscopic sonography: evaluation of gastrointestinal-wall abnormalities and staging of gastrointestinal malignancies. J Clin Ultrasound 2001; 29:117.