A forward-viewing radial-array echoendoscope is useful for diagnosing the depth of colorectal neoplasia invasion
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and Other Interventional Techniques
A forward‑viewing radial‑array echoendoscope is useful for diagnosing the depth of colorectal neoplasia invasion Takeshi Kuno1 · Takeshi Yamamura2 · Masanao Nakamura1 · Keiko Maeda2 · Tsunaki Sawada2 · Yasuyuki Mizutani1 · Masaya Esaki2 · Takuya Ishikawa1 · Kazuhiro Furukawa1 · Eizaburo Ohno1 · Hiroki Kawashima2 · Mitsuhiro Fujishiro1 Received: 2 March 2020 / Accepted: 25 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background It is important to accurately diagnose the depth of colorectal neoplasia invasion. We aimed to evaluate the usefulness of a new forward-viewing radial-array echoendoscope (FRE), relative to the pit pattern method. Methods In this prospective study, the invasion depth of suspected early-stage carcinoma was diagnosed using the pit pattern and FRE methods. The diagnoses were classified as T1a (submucosal invasion distance 36 mm) than for smaller lesions (≤ 36 mm). In contrast, the accuracy of the FRE method did not differ significantly with lesion size. When using the FRE method, no cases were unevaluable because of attenuation. The FRE method provided correct diagnoses in 2 of 3 cases that were unevaluable using the pit pattern method. Conclusions The pit pattern and FRE methods offered similar diagnostic performance for invasion depth. Furthermore, the FRE method may be used to correctly diagnose cases that are unevaluable using the pit pattern method. Keywords Pit pattern method · Forward-facing radial-array echoendoscope · Colorectal neoplasia · Invasion depth Endoscopic treatments for early colorectal cancer have recently improved after the application of endoscopic submucosal dissection (ESD) in the colorectum [1–6]. These improvements have allowed more lesions to be treated endoscopically, although more precise pre-treatment diagnosis of invasion depth is needed to select the treatment strategy for colorectal neoplasia. For example, endoscopic treatment is used for adenoma and intramucosal cancers, which have no possibility of metastasis, while the treatment strategies * Takeshi Yamamura [email protected]‑u.ac.jp 1
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Department of Endoscopy, Nagoya University Hospital, 65 Tsuruma‑cho, Showa‑ku, Nagoya 466‑8550, Japan
2
for T1 cancer are determined based on the submucosal (SM) invasion distance. In T1a cases (SM invasion distance of 20 years, (2) suspected early-stage carcinoma (intramucosal cancer and T1) based on conventional endoscopic observation using whitelight imaging (WLI), (3) planned treatment using endoscopy or surgery, and (4) written informed consent. Patients were excluded when they had (1) a history of chemotherapy or radiation therapy; (2) an inappropriate lesion for study entry
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Surgical Endoscopy
as judged by the investigators, such as a pedunculated lesion, a scaring lesion, or a lesion in ulcerative colitis; or (3) no final histology results for the lesion becaus
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