Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma

Graham, David Y.; Schwartz, Jim T.; Cain, George D.; Györkey, Ferenc

doi:10.1016/0016-5085(82)90009-9

Cited by 238 publications

(82 citation statements)

References 10 publications

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“…18 By using OCT to guide conventional biopsy, sampling errors can be reduced, and higher sensitivity may be achieved using fewer biopsies to identify areas of dysplasia, thus increasing the diagnostic yield of endoscopy and histology. 19 Furthermore, in analogy with endoscopic ultrasound, OCT could aid in identifying the invasion depth of early neoplasias and in monitoring response to therapy. Improvements in endoscope design, acquisition rates, and resolution are necessary to transform the current OCT system into a viable clinical device.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies

Pitris

Jesser

Boppart

et al. 2000

Journal of Gastroenterology

139

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Optical coherence tomography (OCT) is a new imaging technology which can perform high-resolution, cross-sectional imaging of the internal microstructure of biological tissues. OCT is analogous to ultrasound, except that it measures the intensity of back-reflected infrared light rather than sound waves. OCT performs two- and three-dimensional imaging of tissue microstructure in situ and in real time. It can achieve image resolutions approaching the cellular level over approximately the same imaging depths as a conventional biopsy. In this article we examine the feasibility of OCT for high-resolution imaging of gastrointestinal malignancies with ex-vivo imaging of normal and pathologic microstructures. Tissue, both normal and neoplastic, was obtained from patients undergoing surgical resection after an initial diagnosis of a gastrointestinal malignancy. The tissue samples were imaged prior to fixation using a laboratory OCT system. The OCT system consists of a fiber optic-based Michelson interferometer, a commercially available amplified superluminscent light source, and a computer for data acquisition. The images were subsequently compared with histological cross-sections corresponding to the imaged areas. The stratified squamous epithelium of the normal esophagus was clearly visible in the OCT images and contrasted to the disorganized and non-uniform nature of the mucosal layers of Barrett's esophagus and squamous carcinoma. The columnar epithelial morphology as well as other mucosal structures in normal colon were distinctly visible using OCT. In contrast, disorganization of the normal mucosal layers and ulcerative lesions were identified in tissues from ulcerative colitis and adenocarcinoma of the colon. The ability of OCT to image tissue microstructure at high resolutions makes it a potentially powerful technology for minimally invasive assessment of the gastrointestinal tract and the evaluation of early neoplastic changes.

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Section: Discussionmentioning

confidence: 99%

Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies

Pitris

Jesser

Boppart

et al. 2000

Journal of Gastroenterology

139

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“…In general at least seven biopsies are needed when the offered diagnostic accuracy is to approach 100% [17]. Tissue sample should be taken not only from the tumor itself, but from the junction between the grossly diseased and normal tissue, as well as from different parts of the stomach [18,26].…”

Section: Discussionmentioning

confidence: 99%

Is gastroscopy still a valid diagnostic tool in detecting gastric MALT lymphomas?

et al. 2003

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“…Any lesion suspicious for esophageal neoplasia should be adequately biopsied. Graham et al [10] suggest that seven biopsies should be taken to optimize sensitivity. If the histology is not diagnostic, then the specimen should be interpreted by another pathologist with expertise in the diagnosis of esophageal neoplasia.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity of Upper Endoscopy in Diagnosing Esophageal Cancer

2005

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Esophageal cancer is a common cause of dysphagia and upper endoscopy is the accepted standard for making the diagnosis; however, the accuracy of endoscopy is not known. The purpose of this study is to determine the sensitivity of upper endoscopy in making the diagnosis of esophageal cancer in clinical practice. All patients with a new diagnosis of esophageal cancer from 1997 to 2001 in the Tumor Registry of Wake Forest University Baptist Medical Center were identified. The medical records were reviewed to identify all patients who had undergone a previous endoscopy within two years that failed to diagnose esophageal cancer. The reason for failure was recorded. One hundred ten new cases of esophageal carcinoma were identified, and ten patients had had a previous false-negative endoscopy within two years for a sensitivity of 90.9% in clinical practice. The reasons for the failure of endoscopy were (1) lesion not seen in seven patients, (2) lesion seen and biopsied with benign histology in two patients, and (3) lesion seen but felt to be benign and not biopsied in one patient. Given the uncertain natural history of esophageal cancer, the data were also analyzed using a one-year window; this resulted in a sensitivity of 94.5%. The sensitivity of upper endoscopy in the diagnosis of esophageal cancer in general clinical practice is 90.9% using a two-year window and 94.5% using a one-year window. Understanding the reasons for the failure of endoscopy may allow us to improve the practice of endoscopy.

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Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma

Cited by 238 publications

References 10 publications

Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies

Feasibility of optical coherence tomography for high-resolution imaging of human gastrointestinal tract malignancies

Is gastroscopy still a valid diagnostic tool in detecting gastric MALT lymphomas?

Sensitivity of Upper Endoscopy in Diagnosing Esophageal Cancer

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