Pre-operative TN staging of gastric cancer using a 15 MHz ultrasound miniprobe.

Abstract

The aim of the study was to evaluate the usefulness of and problems associated with a new endoscopically guided ultrasound miniprobe, used for pre-operative staging of gastric cancers. 59 cases of gastric cancer were prospectively examined with a 15 MHz ultrasound miniprobe. The results of the ultrasound imaging were compared with the histological findings of the resected specimens. The accuracy of the miniprobe for depth of invasion (T category) was 61% for all tumours, and 72% and 40%, respectively, for T1 and T2 to T4 lesions. If indeterminate cases due to ultrasound attenuation were excluded, the accuracy was improved to 82% for T1 and 57% for T2 to T4 tumours, respectively. The accuracy of the miniprobe for nodal staging (N category) was 69% overall, and 86%, 25% and 14% for stages N0, N1 and N2, respectively. In tumours classified on the basis of endoscopic types, the miniprobe staged early type gastric cancers (T category = 73%, N category = 80%) significantly (p < 0.01) more accurately than advanced ones (T category = 21%, N category = 36%). This study suggests that the miniprobe is indicated for pre-operative TN staging when endoscopy reveals an early gastric cancer.

Laparoscopically assisted distal gastrectomy for early gastric cancer

“…In addition to conventional radiologic gastrography and endoscopy, EUS recently has emerged as the most accurate method for staging gastric cancer. The overall accuracy rate of EUS was reported to be 61% to 65% [1,27]. Findings show that EUS staged early gastric cancers (73%) more accurately than advanced ones (21%) (p < 0.01) [ 1 ].…”

“…The overall accuracy rate of EUS was reported to be 61% to 65% [1,27]. Findings show that EUS staged early gastric cancers (73%) more accurately than advanced ones (21%) (p < 0.01) [ 1 ]. Additionally, a combination of conventional endoscopy and EUS improved accuracy in evaluating mucosal invasion of early gastric cancer to 92.2% [27].…”

Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer

“…The reported predictive value for EGC with EGD, MDCT, and EUS were 67.3-92.4% [5,15], 76.5-100.0% [12,13,[16][17][18], 57.1-100.0% [13,[19][20][21][22][23], respectively in various studies. The overall accuracy for EGC of EGD, MDCT and EUS were 83.6-96.8% [5,6,15,24], 77.8-94.1% [12,13,[16][17][18]25], 76.2-95.6% [7,13,[19][20][21][22]26,27], respectively. The values in this study were relatively higher than the results from other studies.…”

“…Furthermore high performance of CT for T stage may be caused by high-end CT scanner like MDCT and meticulous method for vigorous gastric distension with gas and water [16,28]. With respect to the N stage, the reported predictive value for N(À) of MDCT and EUS were 66.7-85.7% [11,13,16,18] and 54.8-95.0% [11,13,[19][20][21][22][23]29], respectively, and the overall accuracy for N(À) were 68.9-85.5% [11,13,16,18] and 65.9-98.0% [7,11,13,[20][21][22][23]27], respectively, similar to those observed in this study. The relatively low predictive value of N(À) was due to the lack of reliable CT and EUS criteria for metastatic nodes.…”

Echoendoscopic characterization of the human colon

“…The number of layers may change according to the organ assessed (13,15), to the degree of wall distension and/or compression or to its functional status (16). Another reason is the inter-observer variability, as we are facing an operator-dependent diagnosis method.…”