Diagnostic performance of EUS for evaluating the invasion depth of early colorectal cancers

Mukae, Miyuki; Kobayashi, Kiyonori; Sada, Miwa; Yokoyama, Keitaro; Koizumi, Wasaburo; Saegusa, Makoto

doi:10.1016/j.gie.2014.10.027

Cited by 38 publications

(17 citation statements)

References 25 publications

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“…For Type 2B-high lesions, because they alone cannot be identified with SM-d carcinoma, further examination is necessary to differentiate HGD and SM-s carcinoma from SM-d carcinoma, thereby avoiding unnecessary surgery. To determine the appropriate treatment method (endoscopic resection or surgery) for Type 2B-high lesions, pit pattern diagnosis using chromoagents 45,46 or endoscopic ultrasonography 47,48 is necessary to diagnose the correct invasion depth. However, no additional examination is necessary for Type 2B-low lesions because most of these are appropriate for endoscopic resection (Fig.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team

Sumimoto

Tanaka

Shigita

et al. 2017

Gastrointestinal Endoscopy

132

102

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Section: Discussionmentioning

confidence: 99%

Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team

Sumimoto

Tanaka

Shigita

et al. 2017

Gastrointestinal Endoscopy

132

102

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“…For colorectal LSTs associated with findings suggesting submucosal or deeper invasion on colonoscopic examination, including chromoendoscopy, the pit pattern of the lesions was diagnosed on magnifying endoscopy, and the depth of invasion was additionally evaluated on endoscopic ultrasonography [9][10][11] . Lesions that were considered to locally invade the mucosa or slightly invade the submucosa on the basis of the colonoscopic findings and were evaluated to be resectable endoscopically were resected by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD).…”

Section: Endoscopic Examinationmentioning

confidence: 99%

Comparison of the histopathological characteristics of large colorectal laterally spreading tumors according to growth pattern

Saito

Kobayashi

Sada

et al. 2019

J Anus Rectum Colon

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Objectives: Colorectal laterally spreading tumors (LSTs) are widely recognized owing to their structural characteristics. This study aims to clarify the histopathological characteristics of large colorectal LSTs according to growth pattern. Methods: We studied 297 colorectal LSTs measuring ≥20 mm in diameter. The LSTs were classified into four types: granular homogenous type (LST-G-H), granular nodular mixed type (LST-G-M), non-granular flat elevated type (LST-NG-F), and non-granular pseudo-depressed type (LST-NG-PD). Retrospectively collected data were examined to compare the histopathological characteristics of LSTs according to the growth pattern. Results: LST-G-M lesions (142 lesions) were most common, followed by LST-NG-F (74 lesions), LST-G-H (61 lesions), and LST-NG-PD (20 lesions). The mean tumor diameter of LST-G lesions (38.5 ± 17.2 mm) was significantly greater than that of LST-NG lesions (26.3 ± 7.0 mm, P < 0.001). In particular, 45% of LST-G-M lesions were ≥40 mm in diameter. Adenomas accounted for 54% of LST-G-H lesions compared with only 10% of LST-NG-PD lesions. Pathological T1 carcinomas accounted for 55% of LST-NG-PD lesions and were not found among LST-G-H lesions. Conclusions: The biological malignancy of colorectal LSTs differs considerably depending on the growth pattern even among large lesions and therefore should be considered when selecting treatment regimens.

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“…Endoscopic ultrasound or magnification colonoscopy have been used to differentiate T1b from Tis/T1a stage CRC. A miniprobe ultrasound had high accuracy (88 %) in discriminating Tis from T1 CRC [8]. Pit pattern assessment using magnification colonoscopy has also resulted in a high sensitivity (85.6 %) and high specificity (99.4 %) [9,10].…”

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confidence: 99%

Diagnostic performance of artificial intelligence to identify deeply invasive colorectal cancer on non-magnified plain endoscopic images

et al. 2020

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Background and study aims Colorectal cancers (CRC) with deep submucosal invasion (T1b) could be metastatic lesions. However, endoscopic images of T1b CRC resemble those of mucosal CRCs (Tis) or with superficial invasion (T1a). The aim of this study was to develop an automatic computer-aided diagnosis (CAD) system to identify T1b CRC based on plain endoscopic images. Patients and methods In two hospitals, 1839 non-magnified plain endoscopic images from 313 CRCs (Tis 134, T1a 46, T1b 56, beyond T1b 37) with sessile morphology were extracted for training. A CAD system was trained with the data augmented by rotation, saturation, resizing and exposure adjustment. Diagnostic performance was assessed using another dataset including 44 CRCs (Tis 23, T1b 21) from a third hospital. CAD generated a probability level for T1b diagnosis for each image, and > 95 % of probability level was defined as T1b. Lesions with at least one image with a probability level > 0.95 were regarded as T1b. Primary outcome is specificity. Six physicians separately read the same testing dataset. Results Specificity was 87 % (95 % confidence interval: 66–97) for CAD, 100 % (85–100) for Expert 1, 96 % (78–100) for Expert 2, 61 % (39–80) for both gastroenterology trainees, 48 % (27–69) for Novice 1 and 22 % (7–44) for Novice 2. Significant differences were observed between CAD and both novices (P = 0.013, P = 0.0003). Other diagnostic values of CAD were slightly lower than of the two experts. Conclusions Specificity of CAD was superior to novices and possibly to gastroenterology trainees but slightly inferior to experts.

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Diagnostic performance of EUS for evaluating the invasion depth of early colorectal cancers

Cited by 38 publications

References 25 publications

Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team

Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team

Comparison of the histopathological characteristics of large colorectal laterally spreading tumors according to growth pattern

Diagnostic performance of artificial intelligence to identify deeply invasive colorectal cancer on non-magnified plain endoscopic images

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