Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth

We evaluated whether endoscopic ultrasonography (EUS) image quality affects the accuracy of diagnosing the vertical invasion depth of early gastric cancer (EGC). A total of 75 lesions in 75 patients suspected of having EGC were enrolled. All patients underwent EUS examination. Findings of EUS were c...

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Main Authors: Shunsuke Yamamoto, Tsutomu Nishida, Motohiko Kato, Takuya Inoue, Yoshito Hayashi, Jumpei Kondo, Tomofumi Akasaka, Takuya Yamada, Shinichiro Shinzaki, Hideki Iijima, Masahiko Tsujii, Tetsuo Takehara
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/194530
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author Shunsuke Yamamoto
Tsutomu Nishida
Motohiko Kato
Takuya Inoue
Yoshito Hayashi
Jumpei Kondo
Tomofumi Akasaka
Takuya Yamada
Shinichiro Shinzaki
Hideki Iijima
Masahiko Tsujii
Tetsuo Takehara
author_facet Shunsuke Yamamoto
Tsutomu Nishida
Motohiko Kato
Takuya Inoue
Yoshito Hayashi
Jumpei Kondo
Tomofumi Akasaka
Takuya Yamada
Shinichiro Shinzaki
Hideki Iijima
Masahiko Tsujii
Tetsuo Takehara
author_sort Shunsuke Yamamoto
collection DOAJ
description We evaluated whether endoscopic ultrasonography (EUS) image quality affects the accuracy of diagnosing the vertical invasion depth of early gastric cancer (EGC). A total of 75 lesions in 75 patients suspected of having EGC were enrolled. All patients underwent EUS examination. Findings of EUS were compared with histopathologic results. We evaluated the effect of the following clinicopathologic factors: location, diameter, surface pattern, concomitant ulceration, histology type, and EUS image quality score. EUS image quality was scored based on detection repeatability, appropriate probe placement, and clarity of the five gastric wall layers including the lesion. Sixty-three lesions (84%) were pathologically mucosal and 12 lesions (16%) were submucosal cancer. Overall accuracy was 82.7%. Significantly more lesions in the upper and middle portions of the stomach were incorrectly diagnosed than in the lower portion (𝑃=0.0019). Lesion diameter was significantly larger among incorrectly diagnosed lesions (𝑃=0.0257). Low-quality images were significantly more often associated with incorrectly diagnosed lesions than with correctly diagnosed lesions (𝑃=0.0001). Multivariate analysis revealed that EUS image quality was associated with EUS staging accuracy (odds ratio, 21.8; 95% confidence interval, 4.5–137.6). Low-quality EUS images led to an incorrect diagnosis of invasion depth of EGC, independent of tumor location or size.
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spelling doaj-art-b22f862aaf41423cbe5ce4bf887be63e2025-02-03T01:31:04ZengWileyGastroenterology Research and Practice1687-61211687-630X2012-01-01201210.1155/2012/194530194530Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion DepthShunsuke Yamamoto0Tsutomu Nishida1Motohiko Kato2Takuya Inoue3Yoshito Hayashi4Jumpei Kondo5Tomofumi Akasaka6Takuya Yamada7Shinichiro Shinzaki8Hideki Iijima9Masahiko Tsujii10Tetsuo Takehara11Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 5650871, JapanWe evaluated whether endoscopic ultrasonography (EUS) image quality affects the accuracy of diagnosing the vertical invasion depth of early gastric cancer (EGC). A total of 75 lesions in 75 patients suspected of having EGC were enrolled. All patients underwent EUS examination. Findings of EUS were compared with histopathologic results. We evaluated the effect of the following clinicopathologic factors: location, diameter, surface pattern, concomitant ulceration, histology type, and EUS image quality score. EUS image quality was scored based on detection repeatability, appropriate probe placement, and clarity of the five gastric wall layers including the lesion. Sixty-three lesions (84%) were pathologically mucosal and 12 lesions (16%) were submucosal cancer. Overall accuracy was 82.7%. Significantly more lesions in the upper and middle portions of the stomach were incorrectly diagnosed than in the lower portion (𝑃=0.0019). Lesion diameter was significantly larger among incorrectly diagnosed lesions (𝑃=0.0257). Low-quality images were significantly more often associated with incorrectly diagnosed lesions than with correctly diagnosed lesions (𝑃=0.0001). Multivariate analysis revealed that EUS image quality was associated with EUS staging accuracy (odds ratio, 21.8; 95% confidence interval, 4.5–137.6). Low-quality EUS images led to an incorrect diagnosis of invasion depth of EGC, independent of tumor location or size.http://dx.doi.org/10.1155/2012/194530
spellingShingle Shunsuke Yamamoto
Tsutomu Nishida
Motohiko Kato
Takuya Inoue
Yoshito Hayashi
Jumpei Kondo
Tomofumi Akasaka
Takuya Yamada
Shinichiro Shinzaki
Hideki Iijima
Masahiko Tsujii
Tetsuo Takehara
Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth
Gastroenterology Research and Practice
title Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth
title_full Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth
title_fullStr Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth
title_full_unstemmed Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth
title_short Evaluation of Endoscopic Ultrasound Image Quality Is Necessary in Endosonographic Assessment of Early Gastric Cancer Invasion Depth
title_sort evaluation of endoscopic ultrasound image quality is necessary in endosonographic assessment of early gastric cancer invasion depth
url http://dx.doi.org/10.1155/2012/194530
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