Preoperative Staging of Colorectal Cancer with a Balloon-Sheathed Miniprobe

Tseng, Li‐Jung; Jao, Yeun Tarl Fresner Ng; Mo, Li

doi:10.1055/s-2002-33218

Cited by 36 publications

(45 citation statements)

References 3 publications

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“…22 This may in part account for the improved scanning rates in our series. However, when comparing ''adjusted'' HFUS imaging (excluding failed acoustic coupling), the overall accuracy rate for invasive depth estimation in our cohort was similar to those of Saitoh and colleagues 20 and Tsuruta and colleagues 31 (94%, 88%, and 88.9%, respectively).…”

Section: Discussionmentioning

confidence: 82%

“…33 In this series, 4/9 pN1 lymph nodes were not detected using HFUS. 33 Many reasons may account for the disparity in these data, including recently improved acoustic coupling using the Tseng balloon technique, 22 operator dependent error, and the limited tissue penetration resultant from higher frequency imaging.…”

Section: Discussionmentioning

confidence: 99%

“…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: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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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“…The overall accuracy for the assessment of the infiltration depth in gastric and colonic tumors was 88% and for 87%, respectively. Other authors have reported comparable accuracy rates for the evaluation of gastric cancer (61-82%) and colorectal tumors (82-88%) with miniprobes [5,8,17,20]. However, it has also been suggested that the accuracy of miniprobes may decrease with increasing tumor size.…”

Section: Discussionmentioning

confidence: 97%

Impact of miniprobe ultrasonography on planning of minimally invasive surgery for gastric and colonic tumors

et al. 2004

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“…With regard to T2 staging, 3D was superior to mp-EUS, which tended to overstage tumors (12,16,17,(22)(23)(24). A very high accuracy for T3 staging was reported for 3D or mp-EUS (12,16,17,(23)(24)(25)(26), whereas mp-EUS had the lowest accuracy in relation to the higher ultrasound frequency for T4 staging, which is in line with current evidence (17,(24)(25)(26)(27). The use of 3D for T staging of rectal cancer had the best accuracy with mp and allowed the staging of stenosing tumors, although with some limitations for large masses (e.g., T4 staging).…”

Section: Discussionmentioning

confidence: 94%