Usefulness of detective flow imaging endoscopic ultrasound for the diagnosis of rectal wall thickening

Rectal linitis plastica (RLP) is a rare rectal neoplasia manifestation characterized by diffuse wall thickening. A superficial endoscopic biopsy sometimes is inconclusive due to the tendency of RLP to cause extensive submucosal infiltration. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is currently an alternative diagnostic modality when endoscopic biopsy fails to verify the diagnosis [1] [2]. Recently, detective flow imaging (DFI) has been developed as a new ultrasound imaging technology [3]. It uses a unique algorithm that allows the visualization of fine vessels with low velocities in the absence of motion artifacts, which were previously difficult to visualize. We present the first case in which the DFI for EUS (DFI-EUS) was useful for RLP diagnosis.