Surveillance using trimodal imaging endoscopy after endoscopic submucosal dissection for superficial gastric neoplasia

Hiroyuki Imaeda, Naoki Hosoe, Kazuhiro Kashiwagi, Yosuke Ida, Rieko Nakamura, Hidekazu Suzuki, Yoshimasa Saito, Naohisa Yahagi, Yasushi Iwao, Yuukou Kitagawa, Toshifumi Hibi, Haruhiko Ogata, Takanori Kanai

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

AIM: To evaluate the effectiveness of trimodal imaging endoscopy (TME) to detect another lesion after endoscopic submucosal dissection (ESD) for superficial gastric neoplasia (SGN).

METHODS: Surveillance esophagogastroduodenoscopy (EGD) using a TME was conducted in 182 patients that had undergone ESD for SGN. Autofluorescence imaging (AFI) was conducted after white-light imaging (WLI). When SGN was suspicious, magnifying endoscopy with narrow-band imaging (ME-NBI) was conducted. Final diagnoses were made by histopathologic findings of biopsy specimens. The detection rates of lesions in WLI, AFI, and NBI, and the characteristics of lesions detected by WLI and ones missed by WLI but detected by AFI were examined. The sensitivity, specificity, and accuracy of endoscopic diagnosis using WLI, AFI and ME-NBI were evaluated.

RESULTS: In 242 surveillance EGDs, 27 lesions were determined pathologically to be neoplasias. Sixteen early gastric cancers and 6 gastric adenomas could be detected by WLI. Sixteen lesions were reddish and 6 were whitish. Five gastric neoplasias were missed by WLI but were detected by AFI, and all were whitish and protruded gastric adenomas. There was a significant difference in color and pathology between the two groups (P = 0.006). Sensitivity, specificity and accuracy in MENBI were higher than those in both WLI and AFI. Specificity and accuracy in AFI were lower than those in WLI.

CONCLUSION: Surveillance using trimodal imaging endoscopy might be useful for detecting another lesion after endoscopic submucosal dissection for superficial gastric neoplasia.

Original languageEnglish
Pages (from-to)16311-16317
Number of pages7
JournalWorld Journal of Gastroenterology
Volume20
Issue number43
DOIs
Publication statusPublished - 2014 Nov 21

Fingerprint

Endoscopy
Optical Imaging
Stomach
Light
Neoplasms
Narrow Band Imaging
Adenoma
Stomach Neoplasms
Digestive System Endoscopy
Endoscopic Mucosal Resection
Sensitivity and Specificity
Color
Pathology
Biopsy

Keywords

  • Autofluorescence imaging
  • Endoscopic submucosal dissection
  • Superficial gastric neoplasia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Surveillance using trimodal imaging endoscopy after endoscopic submucosal dissection for superficial gastric neoplasia. / Imaeda, Hiroyuki; Hosoe, Naoki; Kashiwagi, Kazuhiro; Ida, Yosuke; Nakamura, Rieko; Suzuki, Hidekazu; Saito, Yoshimasa; Yahagi, Naohisa; Iwao, Yasushi; Kitagawa, Yuukou; Hibi, Toshifumi; Ogata, Haruhiko; Kanai, Takanori.

In: World Journal of Gastroenterology, Vol. 20, No. 43, 21.11.2014, p. 16311-16317.

Research output: Contribution to journalArticle

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AU - Imaeda, Hiroyuki

AU - Hosoe, Naoki

AU - Kashiwagi, Kazuhiro

AU - Ida, Yosuke

AU - Nakamura, Rieko

AU - Suzuki, Hidekazu

AU - Saito, Yoshimasa

AU - Yahagi, Naohisa

AU - Iwao, Yasushi

AU - Kitagawa, Yuukou

AU - Hibi, Toshifumi

AU - Ogata, Haruhiko

AU - Kanai, Takanori

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N2 - AIM: To evaluate the effectiveness of trimodal imaging endoscopy (TME) to detect another lesion after endoscopic submucosal dissection (ESD) for superficial gastric neoplasia (SGN).METHODS: Surveillance esophagogastroduodenoscopy (EGD) using a TME was conducted in 182 patients that had undergone ESD for SGN. Autofluorescence imaging (AFI) was conducted after white-light imaging (WLI). When SGN was suspicious, magnifying endoscopy with narrow-band imaging (ME-NBI) was conducted. Final diagnoses were made by histopathologic findings of biopsy specimens. The detection rates of lesions in WLI, AFI, and NBI, and the characteristics of lesions detected by WLI and ones missed by WLI but detected by AFI were examined. The sensitivity, specificity, and accuracy of endoscopic diagnosis using WLI, AFI and ME-NBI were evaluated.RESULTS: In 242 surveillance EGDs, 27 lesions were determined pathologically to be neoplasias. Sixteen early gastric cancers and 6 gastric adenomas could be detected by WLI. Sixteen lesions were reddish and 6 were whitish. Five gastric neoplasias were missed by WLI but were detected by AFI, and all were whitish and protruded gastric adenomas. There was a significant difference in color and pathology between the two groups (P = 0.006). Sensitivity, specificity and accuracy in MENBI were higher than those in both WLI and AFI. Specificity and accuracy in AFI were lower than those in WLI.CONCLUSION: Surveillance using trimodal imaging endoscopy might be useful for detecting another lesion after endoscopic submucosal dissection for superficial gastric neoplasia.

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KW - Autofluorescence imaging

KW - Endoscopic submucosal dissection

KW - Superficial gastric neoplasia

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