Clinical efficacy of endoscopic ultrasonography for decision of treatment strategy of gastric cancer

Kim, Jung; Kim, Sang Gyun; Lee, Hyuk-Joon; Lim, Joo Hyun; Choi, Ji Min; Park, Jae Yong; Yang, Hyo Joon; Han, Sang Beom; Oh, Seok‐Young; Kim, Min Seong; Kim, Hyun Ju; Hong, Hyoungju; Lee, Hee Jong; Lee, Eunwoo; Jung, Hyun Chae

doi:10.1007/s00464-018-6104-5

Cited by 40 publications

(37 citation statements)

References 25 publications

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“…Several studies have mentioned the sensitivity for SM2 or deeper EGC by EUS ranging from 66.3% to 84.0%, 17 , 20 , 21 similar to the findings in our study.…”

Section: Discussionsupporting

confidence: 91%

“…A few number of EGCs with 0-IIb were included our study cohort, which was rarely seen in other studies, which might also affect the results. Several previous studies have reported ulceration as one of the risk factors for misdiagnosis, 4 , 13 , 14 , 19 , 20 while both endoscopic and histological ulceration did not reach statistical significance in our study. Because histological findings were not suitable for predictive factors prior to treatment, we used endoscopic ulceration in logistic regression analysis.…”

Section: Discussioncontrasting

confidence: 85%

“…Several previous reports have identified risk factors associated with diagnostic accuracy such as size of the lesion, protruded (0-I) type EGCs, location of the upper-third of the stomach (U), and ulceration for misdiagnosis by EUS. 15 , 16 , 19 , 20 , 22 - 25 One of the reasons why these findings were not significant in our study was partially due to the differences in our study subjects and EUS method. With regards to study subjects, we only included EGCs suspicious for SM invasion, while other studies have included a high number of muscularis propria gastric cancers.…”

Section: Discussioncontrasting

confidence: 59%

“…In some previous reports, EUS examinations were performed by conventional EUS or miniature probe. 20 , 21 , 23 This is one of the reasons that the upper-third stomach location was not a risk factor of misdiagnosis in our study, because it is often difficult to scan lesions located in the upper-third of the stomach using conventional EUS, while we have used only the miniature probe for EUS examination. The “0-I” macroscopic subtype has also been reported to be a factor for misdiagnosis, 13 , 15 however, macroscopic features had no relationship to misdiagnosis in our study.…”

Section: Discussionmentioning

confidence: 94%

“…With regards to study subjects, we only included EGCs suspicious for SM invasion, while other studies have included a high number of muscularis propria gastric cancers. 18 , 20 , 21 , 25 EUS examination is not necessary in practice for lesions in which the depth diagnosis is evident based on endoscopic evaluation because of time and procedure related costs. Our study analysis only focused on EGC suspicious of SM invasion.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion

et al. 2020

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Background/Aims: The accurate assessment of the depth of invasion of early gastric cancer (EGC) is critical to determine the most appropriate treatment option. However, it is difficult to distinguish shallow submucosal (SM1) invasion from deeper submucosal (SM2) invasion. We investigated the diagnostic performance of endoscopic ultrasonography (EUS) using a miniature probe for EGC with suspected SM invasion. Methods: From April 2008 to June 2018, EGCs with suspected SM invasion were analyzed retrospectively. The EGCs examined by a 20 MHz high-frequency miniature probe was included in our study. Esophago-gastric junction cancers and patients treated by chemotherapy before resection were excluded. The sensitivity and specificity for the detection of SM2 invasion by EUS were compared with those of white light imaging (WLI). Additionally, factors related to depth underestimation or overestimation were investigated using multivariate analysis. Results: A total of 278 EGCs in 259 patients were included in the final analysis. The sensitivity and specificity for SM2 or deeper by EUS were 73.7% (87/118) and 74.4% (119/160), respectively. The sensitivity and specificity by WLI were 47.5% (56/118) and 68.1% (109/160), respectively. The sensitivity of EUS was significantly superior to that of conventional endoscopy (p<0.01). Multivariate analysis revealed that an anterior location of the EGC was an independent risk factor for underestimation by EUS (odds ratio, 3.3; 95% confidence interval, 1.1 to 9.8; p=0.03). Conclusions: The depth diagnostic performance for EGCs with suspected SM invasion using EUS was satisfactory and superior to that of conventional endoscopy. Additionally, it is important to recognize factors that may lead to misdiagnosis in those lesions.

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“…Several studies have mentioned the sensitivity for SM2 or deeper EGC by EUS ranging from 66.3% to 84.0%, 17 , 20 , 21 similar to the findings in our study.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 85%

Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion

et al. 2020

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Photoacoustic imaging of fresh human surgically and endoscopically resected gastrointestinal specimens

et al. 2021

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Objective Photoacoustic (PA) imaging is a novel noninvasive technique that offers high‐contrast tomographic imaging with ultrasound‐like resolution at depths of centimeters, enabling visualization of deep small vessels. The aim of this pilot study was to survey the characteristics of deep vessel networks in the mucosa of neoplastic gastrointestinal (GI) lesions using PA imaging. Methods Specimens of patients who had undergone surgical and endoscopic resection for GI lesions were included in this study. The PA/ultrasound imaging system for clinical research is characterized by a technology that can superimpose a PA image over an ultrasound image. Three‐dimensional PA images were acquired for the resected specimen before fixation. The stomach and colon of live pigs were incised, and the walls were scanned from the mucosa. Results A total of 32 specimens (nine esophageal, 12 gastric, 11 colorectal) were scanned. The pathological diagnoses were adenomas ( n = 2), intramucosal cancers ( n = 14), and invasive cancers ( n = 16). The deep vessel networks of all lesions could be visualized. In the intramucosal lesions, the deep vessel network was similar to that of a normal tissue. In invasive cancers, the thick and prominent vessel network was visible in the surface layer of esophageal cancers, infiltrated area of gastric cancers, and surface layer and infiltrated area of colorectal cancers. In the images of living pigs, visualizing the vascular network deeper than the submucosa in both the stomach and large intestine was possible. Conclusion Our study confirmed that the deep vessel networks of neoplastic GI lesions were visible by PA imaging.

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Exploring the possibility of endoscopic submucosal dissection for clinical submucosal invasive early gastric cancers

Lee

Kim

et al. 2019

Surg Endosc

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Clinical efficacy of endoscopic ultrasonography for decision of treatment strategy of gastric cancer

Abstract: EUS showed the high accuracy of 84.6% for T1a in lesion ≤ 2 cm in miniprobe EUS and 83.2% for EGC in lesion > 2 cm in conventional EUS, respectively. EUS can be a complementary diagnostic method to determine endoscopic or surgical treatment modality.

Cited by 40 publications

References 25 publications

Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion

Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion

Photoacoustic imaging of fresh human surgically and endoscopically resected gastrointestinal specimens

Exploring the possibility of endoscopic submucosal dissection for clinical submucosal invasive early gastric cancers

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