scholarly journals Reliability of Endoscopic Ultrasound Using Miniprobes and Grayscale Histogram Analysis in Diagnosing Upper Gastrointestinal Subepithelial Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Samiullah Khan ◽  
Rui Zhang ◽  
Weili Fang ◽  
Tao Wang ◽  
Shu Li ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Endoscopic Ultrasound ◽  
Muscularis Propria ◽  
Histogram Analysis ◽  
Muscularis Mucosa ◽  
Stromal Tumors ◽  
Subepithelial Lesions ◽  
Upper Gastrointestinal ◽  
Diagnostic Consistency

Background. To assess the role of endoscopic ultrasound (EUS) in the diagnosis of upper gastrointestinal subepithelial lesions (SELs) and to investigate EUS combined with a grayscale histogram analysis for the differentiation of leiomyomas and gastrointestinal stromal tumors (GISTs). Methods. A retrospective study of 709 patients with upper gastrointestinal SELs was conducted by EUS before endoscopic resection. The EUS findings of SELs and pathological results after endoscopic resection were compared. The EUS images of SELs, particularly, leiomyoma and GIST, were further analyzed via a grayscale histogram to differentiate between the two tumors. Results. Of the 709 patients, 47 cases were pathologically undetermined. The diagnostic consistency of EUS with endoscopic resection was 88.2% (584/662), including 185 muscularis mucosa, 61 submucosa, and 338 muscularis propria, respectively. The diagnostic consistency of EUS with pathology was 80.1% (530/662). The gray value of GISTs was significantly higher than that of leiomyomas (58.9±8.3 vs. 39.5±5.9, t=57.0, P<0.0001). The standard deviation of leiomyomas was significantly lower than that of GISTs (20.6±7.0 vs. 39.8±9.3, t=23.7, P<0.0001). The grayscale histogram analysis of GISTs showed higher echo ultrasound, and the echo of leiomyoma was more uniform. Conclusion. EUS is the preferred procedure for the evaluation of upper gastrointestinal SELs. EUS combined with a grayscale histogram analysis is an effective method for the differentiation of leiomyomas and GISTs.

Endoscopic ultrasound to support the diagnosis of submucosal tumors in the upper gastrointestinal tract

2019 ◽  
pp. 14-20
Author(s):  
Thanh Long Nguyen ◽  
Van Huy Tran
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Ultrasound ◽  
Epigastric Pain ◽  
Submucosal Tumor ◽  
Muscularis Propria ◽  
Doppler Signal ◽  
Upper Gastrointestinal Tract ◽  
Muscularis Mucosa ◽  
Submucosal Tumors ◽  
Upper Gastrointestinal

Background and Objectives: Submucosal tumors are generally discovered accidentally. Endoscopic ultrasound is a valuable technique in the diagonsis and management of submucosal tumors, however, there is still little research about the role of endoscopic ultrasound in diagnosing this pathology in Viet Nam. The purpose of this study was to research about endoscopic ultrasound to support the diagnosis of submucosal tumors in the upper gastrointestinal tract. Subjects and methods: This is a cross sectional study on 76 patients were diagnosed submucosal tumors of the upper gastrointestinal tract by endoscopic ultrasound at the Gastrointestinal Endoscopy Center, Hue University of Medicine and Pharmacy Hospital from May 2017 to July 2019. Results: In 76 patients, epigastric pain was most common (57.9%), followed by nausea or vomiting (15.8%); and asymptomatic (39.5%). Submucosal tumors located in the stomach (44.7%), esophagus (40.8%) and duodenum (14.5%). The overlying mucosa: 88.2% with the smooth mucosa, 9.2% with the umbilication (9.2%) and 2.6% with the mucosal ulceration. Mean size was 14.6 ± 9.1 mm. The muscularis mucosa was 47.4%, the submucosa was 13.2%, the muscularis propria was 32.9%. 61.8% with hypoechoic; 5.3% with hyperechoic; 22.4% with anechoic and 10.5% with mixed echoic. 82.9% with homogeneous tumor and 17.1% with heterogeneous tumor. All tumors have a smooth margin. 5.3% with positive Doppler signal and 94.7% with negative Doppler signal. Conclusion: Endoscopic ultrasound can provide information about size, location, structure, margin, Doppler signal and this is a highly valuable technique in the diagnosis of submucosal tumors of the upper gastrointestinal tract. Key words: Submucosal Tumor (SMT), Endoscopic Ultrasound, GastroIntestinal Stromal Tumor

scholarly journals Role of endoscopic ultrasonography for differential diagnosis of upper gastrointestinal submucosal lesions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qian Su ◽  
Jin Peng ◽  
Xiong Chen ◽  
Zhiming Xiao ◽  
Rui Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasonography ◽  
Muscularis Propria ◽  
Risk Groups ◽  
Low Risk ◽  
Muscularis Mucosa ◽  
Stromal Tumors ◽  
Submucosal Lesions ◽  
Upper Gastrointestinal

Abstract Objective To determine the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of upper gastrointestinal submucosal lesions (SMLs). Methods This was a retrospective study involving patients diagnosed with SMLs using EUS and confirmed by histopathology from November 2014 to December 2020 at The Third Xiangya Hospital of Central South University. Results A total of 231 patients with SMLs were examined by EUS. Histologically, 107 lesions were stromal tumors, and 75 lesions were leiomyomas. Stromal tumors were mainly located in the stomach (89.7%), and leiomyomas were predominantly seen in the esophagus (69.3%). The diagnostic accuracy of EUS for stromal tumors and leiomyomas was 80.4% and 68.0%, respectively. The diagnostic accuracy was highest for lesions located in the muscularis mucosa. The mean diameter of stromal tumors measured using EUS was significantly larger than that of leiomyomas (21.89 mm vs. 12.35 mm, p < 0.001). Stromal tumors and leiomyomas originated mainly from the muscularis propria (94.4%) and the muscularis mucosa (56.0%), respectively. Compared with the very low-risk and low-risk groups of stromal tumors according to the National Institute of Health guidelines, the intermediate-risk and high-risk groups were more likely to have a lesion > 3 cm (p < 0.001) and a surface ulcer (p < 0.01) identified by EUS. Conclusions EUS has good diagnostic value for the diagnosis of upper gastrointestinal SMLs based on the lesion size and the muscle layer of origin. The diagnostic accuracy of EUS lesions is related to the origin, and the diagnostic accuracy is greatest in the mucosal muscularis layer. Stromal tumors > 3 cm and a surface ulcer on EUS are likely to be intermediate or high risk for invasion.

scholarly journals Clinical Overview of GIST and Its Latest Management by Endoscopic Resection in Upper GI: A Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Cicilia Marcella ◽  
Rui Hua Shi ◽  
Shakeel Sarwar
Keyword(s):  
Endoscopic Resection ◽  
Gastrointestinal Stromal Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Endoscopic Techniques ◽  
Stromal Tumors ◽  
Upper Gi ◽  
Risk Of Malignancy

Aims. To review the clinical presentation, diagnosis, assessment of risk of malignancy, and recent advances in management (mainly focusing on the role of endoscopic resection) of gastrointestinal stromal tumors (GISTs) in upper GI.Method. We searched Embase, Web of science, and PubMed databases from 1993 to 2018 by using the following keywords: “gastrointestinal stromal tumors,” “GIST,” “treatment,” and “diagnosis.” Additional papers were searched manually from references of the related articles.Findings. The improvement of endoscopic techniques in treating upper gastrointestinal subepithelial tumors especially gastrointestinal tumors has reduced the need for invasive surgery in patients unfit for surgery. Many studies have concluded that modified endoscopic treatments are effective and safe. These treatments permit minimal tissue resection, better dissection control, and high rates of en bloc resection with an acceptable rate of complications.

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