KMID : 1141820210210030246
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Journal of Gastric Cancer 2021 Volume.21 No. 3 p.246 ~ p.257
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Diagnostic Ability of High-definition Imaging Using Ultraslim Endoscopes in Early Gastric Cancer
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Sugita Tomomi
Suzuki Sho Ichijima Ryoji Ogura Kanako Kusano Chika Ikehara Hisatomo Gotoda Takuji Moriyama Mitsuhiko
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Abstract
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Purpose: It is unclear whether high-definition (HD) imaging improves visibility and diagnostic ability in early gastric cancer (EGC) compared with standard-definition (SD) imaging. We aimed to compare the diagnostic performance and visibility scores of HD and SD ultraslim endoscopes in EGC.
Materials and Methods: We used HD and SD ultraslim endoscopes to obtain 60 images with similar compositions of gastric environments. Of the 60 images, 30 showed EGC (15 images for each modality) and 30 showed no EGC (15 images for each modality). Seventeen endoscopists evaluated the presence and location of the lesions in each image. Diagnostic ability was compared between modalities. The color difference between a lesion and the surrounding mucosa (¥ÄE) was measured and compared between the modalities.
Results: The ability of HD to detect EGC was significantly higher than that of SD (accuracy: 80.8% vs. 71.6%, P=0.017; sensitivity: 94.9% vs. 76.5%, P<0.001; positive predictive value, 76.2% vs. 55.3%, P<0.001; and negative predictive value (NPV), 94.1% vs. 73.5%, P<0.001). The ability of HD to determine the horizontal extent of EGC was significantly higher than that of SD (accuracy: 71.0% vs. 57.8%, P=0.004; sensitivity: 75.3% vs. 49.0%, P<0.001; NPV, 72.9% vs. 55.9%, P<0.001; and area under the curve: 0.891 vs. 0.631, P=0.038). The mean ¥ÄE was significantly higher for HD than for SD (10.3 vs. 5.9, P=0.011).
Conclusions: The HD ultraslim endoscope showed a higher diagnostic performance in EGC than the SD endoscope because it provided good color contrast.
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KEYWORD
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Gastric cancer, Endoscopy, Screening, Diagnosis, Diagnostic imaging
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