Digital "medium format" in the 44 x 33 sensor size needs to be renamed something other than medium format, which has long been 6 x 6 cm (58mm x 58mm is more accurate), or 6x7 cm, or 6x8 or 6x9, or even 6x17cm in the case of a wide-format rollfilm back or camera or two here and there. Even the smallest medium format film size was 6 x 4.5 cm. Ken Rockwell's recent arrempt to rename these new "medium format" cameras as mezzo format makes sense. This is a new format size, and it is not the 135 format, and it is MUCH smaller than 645 format.
Do the area calculations of 24x36mm, 44x33mm, 58x40mm, and 58x58, and so on and you'll see that these new "medium format" digital cameras are really not that much larger than the area of a 24 x 36mm or so-called full frame format digital camera.
I read the dPreview article yesterday; reaction to it on the Fuji GFX 50 Facebook page has been swift and filled with hue and cry from the folks who've convinced themselves that it is the next best thing since sliced bread. And there is a positive side to the GFX: super-fast compatibility with multiple lens adapters that have already hit the stores and the web vendors. I have **never** seen adapters for a new camera created as rapidly as for this new Fuji. And the performance of the camera with adapted lenses from Nikon, Zeiss,Mamiya, Canon, etc. has been very,very good. A wide range of 35mm system lenses are offering full coverage with the lens. The fact that lenses designed for 24 x 36mm film cameras (the 135 format as it has been known for decades) can cover this new Fuji's sensor area is an indicator that it's not true "medium format" at all.
A typical 24 x 36mm sensor needs about a 43mm diameter image circle from the lens; an APS-C sensor requires a 29mm image circle diameter. So, there are plenty of legacy 35mm system (Nikon,Canon,Leica M and R, etc.) lenses in existence that can cover the new Fuji GFX 50's image sensor. And I think that is one factor Fuji was aware of, and planned for, and cooperated with adapter developers and makers during the run-up to the release of the GFX 50; the adpaters are already available for purchase, for multiple lens mounts: Mamiya, Leica-M, Leica-R, Hasselblad, Nikon F, Canon EF, and more!
The image quality of the Fuji GFX is very, very nice--as is the image quality of 36- and 42-, and 50-MP FX cameras from Nikon, Sony, and Canon. Make no mistake about it: this is a bigger sensor than 24x36mm, and the detail it can show is very high. But as Ysarex mentioned, the article dPreview released tries to shed some light on the Giant-killer type claims that have been floated about mezzo format digital as it relates to 24x36 format digital.