Su1164 PREDICTIVE MODEL FOR ENDOSCOPIC ULTRASONOGRAPHY ACCURACY OF INVASION DEPTH IN EARLY GASTRIC CANCER
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Endoscopic ultrasonography
Endoscopic submucosal dissection
Endoscopic ultrasonography
Endoscopic submucosal dissection
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Accuracy of ultrasonography for the diagnosis of hepatocellular carcinoma (HCC) was examined. The subjects were 5339 patients who underwent ultrasonography of the upper abdomen, during the year 1980 at our hospital. Out of 5339, 113 cases were found to be hepatocellular carcinoma by a 3-year follow-up study, checking against the records of regional cancer registry. Diagnostic accuracy based on 6 months of follow-up was as follows: for identification of liver tumors, sensitivity, specificity, and overall accuracy were 94.9%, 98.7%, and 98.9% respectively; for diagnosis of HCC, sensitivity, specificity, and overall accuracy were 58.9%, 99.9%, and 99.3% respectively. In conclusion, the ability of ultrasonography to detect hepatocellular carcinoma is adequately high, and thus, ultrasonography can be employed as a diagnostic procedure for mass screening.
Liver Cancer
Abdominal ultrasonography
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Increasing research related to endoscopic ultrasonography is published every year. A welcome trend towards outcomes-oriented research, evaluating the impact of endoscopic ultrasonography on patient management, is continuing. As experience regarding the safety and efficacy of endosonography-guided fine-needle aspiration in different clinical settings accumulates, this procedure is rapidly becoming a key component of endoscopic ultrasonography. Although promising developments in the fields of guided tissue sampling and image acquisition and analysis are being reported, innovative technical ideas need to be incorporated into the existing endoscopic ultrasound technology to take it to the next level of applications, such as endosurgery.
Endoscopic ultrasonography
Endoscopic Ultrasound
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Backgroud/Aims: Endoscopic ultrasonography (EUS) has been used in assessing the depth of cancer invasion of the stomach. The aim of this study was to compare the factors which were likely to affect the diagnostic accuracy of EUS for the depth of invasion in early gastric cancer (EGC). Methods: Seventy eight EGC patients were pre-operatively examined by EUS. The depth of invasion by EUS was compared with the histopathologic finding of the resected specimen. The diagnostic accuracy of EUS was analyzed according to the factors which were likely to affect the accuracy. Results: The diagnostic accuracy of EUS for the depth of invasion was 78% (46/49) in mucosal cancer, 68.4% (13/19) in submucosal cancer (p＜0.05). Overall diagnostic accuracy of EUS in EGC was 75.6%. The diagnostic accuracy of the flat submucosal cancer was 55.6% and was significantly lower than other types of mucosal or submucosal cancers in endoscopic morphology (p＜0.05). Conclusions: The depth of invasion per se with respective endoscopic findings affected the diagnostic accuracy of EUS for the depth of invasion in EGC. Other factors did not affect the diagnostic accuracy of EUS for the depth of invasion in EGC.
Endoscopic ultrasonography
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Endoscopic ultrasonography
Clinical Practice
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Endoscopic ultrasonography (EUS) has become a reliable method for predicting the invasion depth of early gastric cancer (EGC). However, diagnostic accuracy of EUS is affected by several factors. In particular, it is difficult to differentiate between T1a and T1b EGC through EUS.To confirm whether submucosal saline injection (SSI) could improve the accuracy of EUS in distinguishing T1a and T1b lesions in EGC.Twenty-four patients with EGC were examined by EUS and subsequently by SSI combined EUS to compare the degree of tumor invasion. Then, they underwent endoscopic or surgical resection within 7 d. The diagnostic accuracy of EUS and SSI combined EUS was evaluated based on the final pathological findings postoperatively. Saline injected into the submucosa acted as an echoic contrast enhancing agent and had the effect of distinguishing the mucosal and submucosal layers clearly.Of total 24 patients, 23 were diagnosed with EGC (T1 cancer: 13 as T1a, and 10 as T1b). Standard EUS identified 6 of 13 T1a cancer patients and 3 of 10 T1b cancer patients. Whereas, EUS-SSI identified 12 of 13 T1a cancer patients and 6 of 10 T1b cancer patients. In this study, SSI combined EUS was more accurate than EUS alone in diagnosing T1a and T1b lesions of EGC (75.0% and 37.5%, respectively).SSI improved the diagnostic accuracy of EUS in distinguishing between the T1a and T1b stages in EGC.
Endoscopic ultrasonography
Submucosa
Endoscopic Ultrasound
Endoscopic mucosal resection
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The objectives of this study were to evaluate the accuracy of endoscopic ultrasonography (EUS) in local and regional staging of early gastric cancer, to analyze the factors influencing the accuracy of EUS, and to reveal the usefulness and problems of EUS in pre-treatment staging of gastric cancer. We examined 105 lesions in 104 patients with histologically confirmed gastric cancer and retrospectively evaluated them with EUS. The diagnostic accuracy, sensitivity, and specificity of EUS were determined by comparing the pre-treatment EUS with the postoperative histopathological findings. The overall diagnostic accuracy of EUS for the depth of cancer invasion was 86%. The overall sensitivity and specificity were 60% and 96%, respectively. The accuracy significantly declined in lesions located in the upper-third of the stomach (70%). Type 0-I lesions tended to be over-staged (12&), and the upper-third lesions tended to be under-staged (23%). The accuracy significantly declined in differentiated adenocarcinoma with massive submucosal invasion (56.5%). EUS is useful for evaluating the depth of gastric cancer invasion which determines the feasibility of endoscopic treatment. However, it is noteworthy that the diagnostic accuracy of the invasion depth diminished for lesions in the upper third of the stomach.
Endoscopic ultrasonography
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Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal diseases, especially malignancies. EUS is like other similar endoscopy techniques, based on high frequency ultrasonography. This high level technology allows examination of tissue to almost microscopic level, not only in digestive system but its surrounding structures.The aim of this study was to determine the contribution of endoscopic experience, based on the number of endosopic ultrasonography examination performed in the three years period, to obtain 80% diagnostic accuracy with staging of the disease in order to achieve a 30-60% change rate in treatment decisions which is accepted standard.First group with 210 patients was examined in the first year of work; 325 examined in the second year of work and 295 in the third year.Accuracy in the first year of work, were 45% (p<0.001 for the choledocholithiasis; p=0.197 for the pancreatic cancer; p=0.195 for LN detection in the gastric cancer). In the second year of work diagnostic accuracy were 78%/p=0.550 for the choledocholithiasis; p=0.228 for the pancreatic cancer; p=0.503 for LN detection in the gastric cancer/. Diagnostic accuracy in the third year of work were 81%/p<0.001 for the choledocholithiasis; p=0.018 for the pancreatic carcinoma; p=0.042 LN detection in the gastric cancer/.Application of Endoscopic ultrasonography in diagnostics, based on number of EUS examination performed, after three years of work, achieved 80% diagnostic accuracy, compared to standard imaging methods and results of surgery in staging of the disease. EUS results made a change in treatment decisions in 30-60% of patients which is world standard and completely justify use of endoscopic ultrasonography in clinical practice.
Endoscopic ultrasonography
Work-up
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OBJECTIVE:To evaluate the diagnostic value of ultrasonography and mammography for plasma cell mastitis. METHODS:The ultrasonographic and mammographic images of 111 women with histopathologically confirmed plasma cell mastitis were retrospectively analyzed. The diagnostic accuracy of the two imaging methods was compared. RESULTS:Ultrasonography identified 91 out of 111 (82.0%) patients with plasma cell mastitis, while the other twenty (18.0%) patients were misdiagnosed. Mammography identified 83 (74.8%) out of 111 patients with plasma cell mastitis. Nineteen (17.1%) patients were misdiagnosed. There was no significant difference between the diagnostic accuracy of using two imaging tests (P = 0.127). Mammography clouds identified 11 out of 20 patients who were not diagnosed by ultrasonography. Meanwhile, 19 of the 28 cases misdiagnosed with mammography were correctly identified by ultrasonography. Overall, 91.9% (102/111) of the patients were identified by the combination of ultrasonography and mammography, which yielded statistically significant higher accuracy than using each single test only (P < 0.05). CONCLUSIONS:In diagnosis of plasma cell mastitis, high-frequency ultrasonography and mammography should be combined to improve the diagnostic accuracy.
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