Highly accurate artificial intelligence systems to predict the invasion depth of gastric cancer: efficacy of conventional white-light imaging, nonmagnifying narrow-band imaging, and indigo-carmine dye contrast imaging

287 Background: As recent advances in chemotherapy improved prognosis of gastric cancer (GC) patients with peritoneal metastasis (PM), accurate diagnosis of PM has become more important. However, the sensitivity of conventional imaging modalities such as CT or PET is not satisfactory. Staging laparoscopy (SL) is often used to diagnose PM in advanced GC patients, but accurate detection of PM can be difficult. In this study, we evaluate the usefulness of laparoscopic narrow-band imaging (NBI) versus conventional laparoscopic white-light imaging (WLI) for the diagnosis of PM and for the evaluation of therapeutic effect of chemotherapy. Methods: We excised 54 white nodules from the parietal peritoneum of 40 GC patients. Among them, 9 patients received chemotherapy for advanced or recurrent GC before SL, and 31 did not receive chemotherapy except for adjuvant chemotherapy with S-1. The WLI and NBI findings were compared with the pathological findings. Results: Intranodular vessels were evaluated by WLI and NBI for dilatation, tortuousness, heterogeneity, and brown spots. Detection of any one abnormal finding on NBI plus clear demarcation of the peritoneal nodules on WLI more properly diagnosed 42 peritoneal nodules of 31 patients who did not receive chemotherapy (sensitivity, 100%; specificity, 88.9%; accuracy, 95.2%). In contrast, diagnosis ability was poor for 12 peritoneal nodules of 9 patients who received chemotherapy before SL (sensitivity, 66.7%; specificity, 33.3%; accuracy, 58.3%). Conclusions: Laparoscopic NBI is a useful tool for the diagnosis of PM in advanced GC before chemotherapy, and disappearance of dilated vessels on laparoscopic NBI could be useful to evaluate the therapeutic effect.

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473 Predicting the Invasion Depth of Differentiated Early Gastric Cancer: Comparison of Narrow-Band Imaging Magnification and Endoscopic Ultrasonography

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.100 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB149

Author(s):

Shuo Zhang ◽

Bin Lv ◽

Ting-Yuan Li

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Ultrasonography ◽

Narrow Band ◽

Narrow Band Imaging ◽

Invasion Depth

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Differences in the Microsurface and Microvascular Features between Early Gastric Cancer of Corpus and Antrum under Narrow Band Imaging Magnifying Endoscopy

10.21203/rs.2.13670/v1 ◽

2019 ◽

Author(s):

Qian Zhuang ◽

Jing Wang ◽

Shengzheng Luo ◽

Xiaowan Wu ◽

Jinnian Cheng ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Narrow Band ◽

Narrow Band Imaging ◽

Tumor Location ◽

Magnifying Endoscopy ◽

Histologic Type ◽

Invasion Depth ◽

Macroscopic Shape ◽

Microvascular Pattern

Abstract Objectives Microsurface structure (MS) and microvascular features (MV) of early gastric cancer (EGC) are associated with the histologic type, invasion depth and macroscopic shape of lesions. However, no studies have reported the differences in the MS and MV features between EGCs of antrum and corpus under magnifying endoscopy with narrow band imaging (ME-NBI).Methods This is a retrospective study including 116 patients with EGC. The characteristics of MS and MV pattern of EGC were evaluated in 2 group, antrum type and corpus type.Results According to the Sakaki’s classification, the MS of EGCs presented as IV, V1 or VI typein in sequence, one level higher than the previous type in the degree of atypia. Tumor location and differentiated degree were identified as independent predictors for MS pattern. For the probability of at least one level higher, in the MS pattern, the corporal EGCs was 5.84 times as high as that of antral EGCs ( χ 2 =9.42, P=0.002, 95%CI 1.89-18.05), and undifferentiated-type lesions was 8.82 times as high as that of the differentiated-type lesions ( χ 2 =11.67, P=0.001, 95%CI 2.53-30.76). No difference in the MV pattern was observed between antral EGCs and corporal EGCs (P=0.7), while the microvascular pattern and microsurface pattern (VS pattern, FNP, ILL-1, ILL-2 and CSP) were significantly different between those 2 groups (P=0.001).Conclusions There are significant differences in the MS and VS pattern of EGC between antrum and corpus types. The antral EGC is less obvious than the corporal EGC, therefore, it is more likely to be missed in clinical gastroscopy.

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Multicenter, prospective trial of white-light imaging alone versus white-light imaging followed by magnifying endoscopy with narrow-band imaging for the real-time imaging and diagnosis of invasion depth in superficial esophageal squamous cell carcinoma

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.11.015 ◽

2015 ◽

Vol 81 (6) ◽

pp. 1355-1361.e2 ◽

Cited By ~ 27

Author(s):

Masahide Ebi ◽

Takaya Shimura ◽

Tomonori Yamada ◽

Takashi Mizushima ◽

Keisuke Itoh ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

White Light ◽

Narrow Band ◽

Narrow Band Imaging ◽

Prospective Trial ◽

Magnifying Endoscopy ◽

Invasion Depth ◽

White Light Imaging

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Visualization of Laterally Spreading Colorectal Tumors by Using Image-Enhanced Endoscopy

Gastroenterology Research and Practice ◽

10.1155/2012/638391 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Naoto Tamai ◽

Yutaka Saito ◽

Taku Sakamoto ◽

Takeshi Nakajima ◽

Takahisa Matsuda ◽

...

Keyword(s):

White Light ◽

Narrow Band ◽

Narrow Band Imaging ◽

Indigo Carmine ◽

Autofluorescence Imaging ◽

Colorectal Tumors ◽

White Light Imaging ◽

Experienced Endoscopists ◽

Laterally Spreading Tumors

Laterally spreading tumors may sometimes evade detection by colonoscopy. This study aimed to evaluate the use of image-enhanced endoscopy for visualizing laterally spreading tumors of the nongranular type. We reviewed consecutive patients with 47 non-granular-type laterally spreading tumors that had been examined using white-light imaging, autofluorescence imaging, narrow-band imaging, and chromoendoscopy with indigo carmine. The quality of visualization was evaluated using a 5-point scale by less- and more-experienced endoscopists. Autofluorescence imaging provided significantly better visualization than white-light imaging for both less-experienced and experienced endoscopists. On the other hand, no significant differences were observed between the quality of visualization provided by white-light imaging and narrow-band imaging for less-experienced endoscopists. Autofluorescence imaging provides high-quality visualization of non-granular-type laterally spreading tumors on still images. Multicenter trials should be conducted to confirm the usefulness of autofluorescence imaging in detecting laterally spreading colorectal tumors.

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Delineation of the extent of early gastric cancer by magnifying narrow-band imaging and chromoendoscopy: a multicenter randomized controlled trial

Endoscopy ◽

10.1055/s-0044-100790 ◽

2018 ◽

Vol 50 (06) ◽

pp. 566-576 ◽

Cited By ~ 18

Author(s):

Takashi Nagahama ◽

Kenshi Yao ◽

Noriya Uedo ◽

Hisashi Doyama ◽

Tetsuya Ueo ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Narrow Band ◽

Narrow Band Imaging ◽

Controlled Trial ◽

Indigo Carmine ◽

Controlled Study ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial ◽

The Difference

Abstract Background Accurate delineation of tumor margins is necessary for curative resection of early gastric cancer (EGC). The objective of this multicenter, randomized, controlled study was to compare the accuracy with which magnifying narrow-band imaging (M-NBI) and indigo carmine chromoendoscopy delineate EGC margins. Methods Patients with EGC ≥ 10 mm undergoing endoscopic or surgical resection were enrolled. The oral-side margins of the lesions were first evaluated with conventional white-light endoscopy in both groups and then delineated by either chromoendoscopy or M-NBI. Biopsies were taken from noncancerous and cancerous mucosa, each at 5 mm from the margin. Accurate delineation was judged to have been achieved when the histological findings in all biopsy samples were consistent with endoscopic diagnoses. The primary end point was the difference in rate of accurate delineation between the two techniques. Results Data on 343 patients were analyzed. The accurate delineation rate (95 % confidence interval) was 85.7 % (80.4 – 91.0) in the chromoendoscopy group (n = 168), and 88.0 % (83.2 – 92.8) in the M-NBI group (n = 175; P = 0.63). Lower third tumor location (odds ratio [OR] 2.9; P = 0.01), nonflat macroscopic type (OR 4.4; P < 0.01), and high diagnostic confidence (OR 3.6; P < 0.001) were associated with accurate delineation, whereas use of M-NBI was not (OR 1.2; P = 0.39). Even after adjustment for identified confounders, the difference in accurate delineation between the groups was not significant (OR 1.0; P = 0.82). Conclusions M-NBI does not offer superior delineation of EGC margins compared with chromoendoscopy; the two methods appear to be clinically equivalent.

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