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By Kelly Davis Independent-Mail

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get staging and biopsies with­ out surgical procedures," said Jessie Ivey, AnMed Health's director of oncology services. Staging refers to classifying a cancer's level of growth. "Sometimes there are so many complications from the surgery itself in these patients," she said. Together with computer­ ized tomography (CT) and positron emission tomogra­ phy (PET) scanning, endo­ scopic ultrasound provides a near-complete diagnosis without surgery, she said. Dr. Wallace is nationally renowned in the field and has come to Anderson twice, once in June and Tuesday, to watch over Dr. Veera as he used the equipment on patients. Dr. Veera has completed more than 100 d iagnostic endoscopic ultrasounds. and Dr. Wallace is training him to use ultrasound-guided instru­ ments to retrieve tissue sam­ ples and inject pain medica­ tion. This is the "fine-needle

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aspiration" that is now avail­ able only in Charleston and Florence. Dr. Shahzd Sheikh, another Anderson gastroenterologist, also is using AnMed Health's ultrasound endoscopy equip­ ment for diagnostic proce­ dures, and said he probably will pursue similar training in the therapeutic uses of the device. New York-based Olympus America Inc., the camera manufacturer, supplies most of the ultrasound endoscopy equipment in U. S. medical centers, South Carolina sales representative John Wolfe said. The technology is about 15 years old and there are approximately 500 systems nationwide, he said. The equipment at AnMed Health cost about $200.000, including the scopes and an ultrasound signal processor, he said. It is one of seven systems in use in the state, four of which are at the Medical University in Charleston.

Using ultrasound to peer into the womb has become commonplace in most places in the United States, but a specialized type of ultra­ sound that aids the detection and treatment of hard-to­ reach cancers is harder to find but about to become available in Anderson. Dr. M.P. Veerabagu is in training to be just the third private physician in the state to offer so-called fine-needle aspiration endoscopic ultra­ sound. meaning he will soon be qualified to use an ultra­ sound-fitted endoscope to obtain tissue samples and provide certain types of treatment. " You get more information without doing a big opera­ tion," said Dr. Veerabagu, bet­ ter known as Dr. Veera. " It's technically a very advanced procedure not widely avail­ able even in big medical cen­ ters;" Endoscopy uses camera-

''This procedure is can get staging and

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iopsies without surgical many

procedures� Sometimes there are patients. "

complications from the surgery itself in these
Jessie Jvey

director ofoncology services at AnMed
and instrument-equ ipped probes to examine or treat internal body parts yia the mouth or rectum_ This avoids the need to make new open­ ings with surgery. Ultrasound uses high-fre­ quency sound waves to create images of body structures, but has limitations, said Dr. Mike Wallace, a national leader in endoscopic ultra­ sound at the Iv�edical University of South Carolina and Dr. Veera's trainer. Ultrasound produces clear­ er images at higher frequencies, but as the frequency goes up, penetration of the sound waves decreases. Therefore, ultrasound cannot create good images of cen­ tralized or deep organs such as the pancreas, lungs, stom­ ach and rectum, Dr. Wallace said.

Pairing ultrasound with endoscopy allows high-fre­ high-resolution quency, images to be made of these hard-to-reach places on an outpatient basis. "This procedure is so encouraging because we can

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