Endoscopic ultrasonography in the diagnosis of colorectal cancer invasion

Cho, Eisai; Nakajima, Masahiro; Yasuda, Kenjiro; Ashihara, Tooru; Kawai, Kensuke

doi:10.1016/s0016-5107(93)70163-7

Cited by 78 publications

(36 citation statements)

References 8 publications

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“…32 33 HFUS imaging (12.5 MHz, using the criteria of Cho and colleagues 23 ) to predict LNM in our series had a sensitivity of 0.8 with an NPV (lymph node negative prediction) of 0.88, data comparable with that of Tseng and colleagues, 22 Hamada and colleagues 34 and Hunerbein and colleagues. 35 However, Stergiou et al have reported lower sensitivity rates (56%) compared with other groups.…”

Section: Discussionsupporting

confidence: 83%

“…Of the remaining three lesions (6%), one caecal PT II lesion was under staged as sm2 (pT sm3+/T2) with two ascending colonic PT II lesions under staged as uT sm3 compared with the pT stage of T4 disease. Using the criteria of Cho and colleagues 23 at HFUS as predictive of LNM sensitivity, specificity, PPV, and NPV were 0.8, 0.88, 0.8, and 0.88, respectively. The kappa coefficient of agreement between HFUS anticipated LNM was 0.68 (95% CI 0.4-0.97).…”

Section: Hfus Phase 2 T/n Stagingmentioning

confidence: 93%

“…Acoustic coupling was achieved using the direct water immersion technique or by the distal balloon attachment method of Tseng and colleagues. 22 Radial images were then acquired with invasion depth and nodal status classified according to the criteria of Cho and colleagues 23 : Histopathology and resection practice All identified lesions were cold biopsied, removed by EMR, 2 or referred directly for surgical resection. Predicted T0/1/N0 lesions at HMCC or HFUS were resected using EMR (Roth net retrieval to minimise trauma and specimen fragmentation) with the remaining referred for surgical resection.…”

Section: Methodsmentioning

confidence: 99%

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High magnification chromoscopic colonoscopy or high frequency 20 MHz mini probe endoscopic ultrasound staging for early colorectal neoplasia: a comparative prospective analysis

Hurlstone

Brown²,

Cross³

et al. 2005

Gut

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Background: Successful endoscopic management of early colorectal cancer using endoscopic mucosal resection requires the mandatory prediction of invasive depth and lymph node metastasis. Previous data using the Nagata crypt types Vn(B)/(C) as clinical indicators of T2/N+ disease have shown low specificity (50%) with a tendency to over stage lesions. New mini probe ultrasound ''through the scope'' imaging permits staging of lesions proximal to the rectum using direct endoscopic visualisation. Aim: To compare the staging accuracy of the Nagata crypt type V with mini probe high frequency 20 MHz endoscopic ultrasound. Methods: Sixty two patients with a Paris type II flat cancer were imaged using magnification colonoscopy followed by 20/12.5 MHz ultrasound in a ''back to back'' design. Crystal violet staining (0.05%) at 1006 magnification permitted Nagata crypt criteria to be defined. Submucosal deep invasion (sm3+) was defined at ultrasound by the presence or absence of a disrupted third sonographic layer. Predicted T0/1: N0 lesions were resected using endoscopic mucosal resection with the remaining referred for surgery. Ultrasound and magnification staging were then compared with the resected histopathological specimens. Results: One patient was excluded from the study due to poor bowel preparation. Fifty two lesions from 52 patients therefore met inclusion criteria (12 sm1/13 sm2/27 sm3+). Ultrasound (20 MHz) was significantly more accurate for invasive depth staging compared with Nagata stage (p,0.0001) (overall accuracy 93% and 59%, respectively). The sensitivity for lymph node metastasis detection using ultrasound and magnification was 80% and 31%, respectively (p,0.001). The negative predictive value of ultrasound for invasive depth was better than that observed using magnification (88%/47%, respectively). The prevalence of nodal disease overall was 19% (10/52), with 80% (8/10) node positive lesions occurring in the sm3+ lesion group. Conclusions: High frequency 20 MHz ultrasound is superior to magnification alone when differentiating T1/2 disease with a high positive predictive value for sm3 differentiation. Sm3+ invasion was associated with nodal metastasis.

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Section: Discussionsupporting

confidence: 83%

Section: Hfus Phase 2 T/n Stagingmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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High magnification chromoscopic colonoscopy or high frequency 20 MHz mini probe endoscopic ultrasound staging for early colorectal neoplasia: a comparative prospective analysis

Hurlstone

Brown²,

Cross³

et al. 2005

Gut

View full text Add to dashboard Cite

show abstract

“…Type 0-II lesions included three distinct Following morphological classification, all patients underwent on-table staging using an Olympus UM-2R or UM-3R high-frequency ultrasound miniprobe (12·5 and 20 MHz respectively) with acoustic coupling achieved with a distally attached water inflatable Tseng balloon 12,13 . Cho criteria were used to differentiate tumour stage and nodal disease status 14 : ultrasound radiology (u)T0, lesions confined to the first hypoechoic layer; uT1, penetration to the third hypoechoic layer; uT2/3, penetration of the muscularis propria (outer hypoechoic layer) or serosa (most peripheral echogenic band); uT4, extension of the lesion through the serosa with or without infiltration of adjacent structures; and uN+, presence of pericolic, well demarcated, hypoechoic round or oval structures more than 10 mm in diameter.…”

Section: Assessment For Endoscopic Dissectionmentioning

confidence: 99%

Achieving R0 resection in the colorectum using endoscopic submucosal dissection

Hurlstone

Atkinson

Sanders

et al. 2007

British Journal of Surgery

132

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“…However, differential diagnosis from enlarged lymph nodes associated with inflammation is challenging. The rate of correctly diagnosing lymph node metastases has been reported to be 70% to 80% (Tio, 1991, Cho E, et al 1993. The diagnostic ability of EUS is thus not considered good.…”

Section: Diagnosis Of Lymph Node Metastasismentioning

confidence: 99%