Mucosal Incision and Forceps Biopsy for Reliable Tissue Sampling of Gastric Subepithelial Tumors

Shin, Sa Young; Lee, Sang Jin; Jun, Joong-Hwan; Park, Jong Kyu; Seo, Hye-Jin; Han, Koon Hee; Kim, Young Don; Jeong, Woo Jin; Cheon, Gab Jin

doi:10.5946/ce.2015.094

Cited by 9 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even when the size was >5 cm, a leiomyoma located in the cardia was often mistakenly assumed to be a GIST. Predicting the possibility of malignancy and making a clinical decision of whether to observe the progress of the lesion, to perform EUS-guided biopsy, or to choose resection are important [16,28]. In particular, laparoscopic wedge resection cannot be easily applied to gastric SETs located in the cardia because of the technical complexities of the procedure [29].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors

et al. 2019

View full text Add to dashboard Cite

Background/AimsEndoscopic ultrasonography (EUS) is the most efficient imaging modality for gastric subepithelial tumors (SETs). However, abdominopelvic computed tomography (APCT) has other advantages in evaluating the characteristics, local extension, or invasion of SETs to adjacent organs. This study aimed to compare the diagnostic ability of EUS and APCT based on surgical histopathology results. MethodsWe retrospectively reviewed data from 53 patients who underwent both EUS and APCT before laparoscopic wedge resection for gastric SETs from January 2010 to December 2017 at a single institution. On the basis of histopathology results, we assessed the diagnostic ability of the 2 tests. ResultsThe overall accuracy of EUS and APCT was 64.2% and 50.9%, respectively. In particular, the accuracy of EUS vs. APCT for the diagnosis of gastrointestinal stromal tumors (GISTs), leiomyomas, and ectopic pancreas was 83.9% vs. 74.2%, 37.5% vs. 0.0%, and 57.1% vs. 14.3%, respectively. Most of the incorrect diagnoses with EUS involved hypoechoic lesions originating in the fourth echolayer, with the most common misdiagnosed lesions being GISTs mistaken for leiomyomas and vice versa. ConclusionsAPCT showed a lower overall accuracy than EUS; however, APCT remains a useful modality for malignant/potentially malignant gastric SETs.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors

et al. 2019

View full text Add to dashboard Cite

show abstract

“…3). The usefulness of this technique, termed mucosal cutting biopsy (MCB) or mucosal incision-assisted biopsy (MIAB), has been reported in several articles (Table 1), [59][60][61][62][63][64][65][66][67][68][69] many of which are retrospective, single-arm analyses with a relatively small number of cases. In approximately 20 mm in size, the diagnostic yield of MCB/MIAB for gastric SETs shows 86.9% in 314 lesions, ranging from 60% to 100% among the articles.…”

Section: Mucosal Cutting Biopsy/mucosal Incision-assisted Biopsymentioning

confidence: 99%

Advancements in the Diagnosis of Gastric Subepithelial Tumors

2022

View full text Add to dashboard Cite

A diagnosis of subepithelial tumors (SETs) is sometimes difficult due to the existence of overlying mucosa on the lesions, which hampers optical diagnosis by conventional endoscopy and tissue sampling with standard biopsy forceps. Imaging modalities, by using computed tomography and endoscopic ultrasonography (EUS) are mandatory to noninvasively collect the target's information and to opt candidates for further evaluation. Particularly, EUS is an indispensable diagnostic modality for assessing the lesions precisely and evaluating the possibility of malignancy. The diagnostic ability of EUS appears increased by the combined use of contrast-enhancement or elastography. Histology is the gold standard for obtaining the final diagnosis. Tissue sampling requires special techniques to break the mucosal barrier. Although EUS-guided fine-needle aspiration (EUS-FNA) is commonly applied, mucosal cutting biopsy and mucosal incision-assisted biopsy are comparable methods to definitively obtain tissues from the exposed surface of lesions and seem more useful than EUS-FNA for small SETs. Recent advancements in artificial intelligence (AI) have a potential to drastically change the diagnostic strategy for SETs. Development and establishment of noninvasive methods including AI-assisted diagnosis are expected to provide an alternative to invasive, histological diagnosis.

show abstract

“…It is less expensive than an EUS-FNA, able to maneuver into locations that can be challenging with an EUS-FNA, and does not require advanced endoscopic training [8]. No instances of perforation have been reported thus far [5,8,[10][11][12][13][14][15]. Many are unaware of this technique or have not been exposed to it in a meaningful way.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy and safety of mucosal incision-assisted biopsy for the diagnosis of upper gastrointestinal subepithelial tumors: A systematic review and meta-analysis

Dhaliwal

Kolli

Dhindsa

et al. 2020

aog

View full text Add to dashboard Cite

Background Endoscopic ultrasound-guided fine-needle aspiration and biopsy (EUS-FNA/FNB) has been traditionally used for making a tissue diagnosis. Several newer techniques are emerging as a viable alternative to EUS-FNA/FNB, including mucosal incision-assisted biopsy (MIAB), with a view to increasing the diagnostic yield for upper gastrointestinal (GI) subepithelial tumors (SETs). We conducted a systematic review and meta-analysis to describe the overall diagnostic yield of MIAB for upper GI SETs.Methods Multiple electronic databases (MEDLINE, EMBASE and Google Scholar) and conference abstracts were comprehensively searched. The primary outcome of our meta-analysis was the overall diagnostic yield of the MIAB. The secondary outcome was to study complications in terms of perforation and clinically significant bleeding. The meta-analysis was performed using a DerSimonian and Laird random-effect model. ResultsSeven studies were included in the final meta-analysis, reporting a total of 159 patients (male 86, female 73) with a mean age of 58 years. The overall pooled diagnostic yield of MIAB was 89% (95% confidence interval [CI] 82.65-93.51, I 2 =0.00). Histologically, GI stromal tumor was the reported diagnosis in 38.62% (95%CI 22.29-56.24, I 2 =77.51%) of tumors, followed by leiomyoma 25% (95%CI 18.02-32.62, I 2 =4.42%). The overall rate of clinically significant bleeding following the procedure was 5.03% (95%CI 0.36-12.86, I 2 =57.43%) and no perforations were reported.Conclusions MIAB is a safe and effective technique for the diagnosis of upper GI SETs and can be considered as a viable alternative to EUS-FNA/FNB. MIAB can be performed during routine endoscopy and no advanced equipment is required.

show abstract

Mucosal Incision and Forceps Biopsy for Reliable Tissue Sampling of Gastric Subepithelial Tumors

Cited by 9 publications

References 12 publications

Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors

Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors

Advancements in the Diagnosis of Gastric Subepithelial Tumors

Clinical efficacy and safety of mucosal incision-assisted biopsy for the diagnosis of upper gastrointestinal subepithelial tumors: A systematic review and meta-analysis

Contact Info

Product

Resources

About