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Yamamoto A, Kessoku T, Ogata T, Jono T, Takahashi K, Tanaka K, Suzuki K, Takeda Y, Ozaki A, Kasai Y, Okubo N, Iwaki M, Kobayashi T, Misawa N, Yoshihara T, Suzuki A, Fuyuki A, Hasegawa S, Imajo K, Kobayashi N, Matsumoto M, Tamai N, Sanada H, Oyamada S, Ichikawa Y, Nakajima A. A Handheld Ultrasound Device Can Predict Constipation with Rectal Fecal Retention in a Palliative Care Setting. Diagnostics (Basel) 2024; 14:1626. [PMID: 39125503 PMCID: PMC11311552 DOI: 10.3390/diagnostics14151626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/14/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Although handheld ultrasound devices (HUDs) are commonplace, their ability to diagnose fecal retention (FR) remains unclear. This prospective observational study examined HUDs' usefulness in diagnosing FR in patients with constipation in a palliative care setting. Between 10 December 2020 and 30 June 2022, we compared rectal ultrasonographic findings obtained using HUDs with clinical manifestations in 64 males and 70 females (48%, 52%, 68 ± 11 years old) with constipation who had undergone computed tomography (CT). FR was diagnosed using a HUD and compared with CT and digital rectal examination (DRE) results. In total, 42 (31%), 42 (31%), and 41 (31%) patients were diagnosed using HUDs, CT, and DRE, respectively. Thirty-nine (93%) patients in the CT group were also diagnosed with FR using HUDs. A total of 89 of 92 patients with a negative CT diagnosis also had a negative HUD diagnosis. Among the 41 patients in the DRE group, 37 were also diagnosed with FR using HUDs. Among 93 patients with a negative DRE diagnosis, 86 had a negative HUD diagnosis. The sensitivity, specificity, positive predictive value, and negative predictive value of HUDs for CT were 93%, 97%, 93%, and 97%, respectively. Those of HUDs for DRE were 88%, 94%, 86%, and 95%, respectively. The concordance rates for FR diagnosis were 128/134 for CT and HUDs and 123/134 for DRE and HUDs. HUD was useful for diagnosing FR in this setting. HUDs could provide valuable support for appropriate treatment selection. Developing a constipation treatment algorithm based on rectal ultrasonographic findings is warranted in the future.
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Affiliation(s)
- Atsushi Yamamoto
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Gastroenterology, Fujisawa Syonandai Hospital, Fujisawa 252-0802, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Palliative Medicine, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan
- Department of Gastroenterology, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan
| | - Tomoki Ogata
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Tsumugi Jono
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Kota Takahashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Gastroenterology, Yokosuka General Hospital Uwamachi, Yokosuka 238-0017, Japan
| | - Kosuke Tanaka
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Palliative Medicine, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan
- Department of Gastroenterology, International University Health and Welfare, Narita Hospital, Narita 286-8520, Japan
| | - Ko Suzuki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Yuma Takeda
- Department of Palliative Medicine, Yokohama City University, Yokohama 236-0004, Japan; (Y.T.); (Y.I.)
| | - Anna Ozaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Yuki Kasai
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Naoki Okubo
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
| | - Michihiro Iwaki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Noboru Misawa
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Tsutomu Yoshihara
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Akihiro Suzuki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
| | - Akiko Fuyuki
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Palliative Care, Shin-Yurigaoka General Hospital, Kawasaki 215-0026, Japan
| | - Sho Hasegawa
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
| | - Kento Imajo
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
- Department of Gastroenterology, Shin-Yurigaoka General Hospital, Kawasaki 215-0026, Japan
| | | | - Masaru Matsumoto
- School of Nursing, Ishikawa Prefectural Nursing University, Kahoku 929-1210, Japan; (M.M.); (H.S.)
| | - Nao Tamai
- Department of Nursing, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan;
| | - Hiromi Sanada
- School of Nursing, Ishikawa Prefectural Nursing University, Kahoku 929-1210, Japan; (M.M.); (H.S.)
| | - Shunsuke Oyamada
- Department of Biostatistics, JORTC Data Center, Tokyo 116-0013, Japan;
| | - Yasushi Ichikawa
- Department of Palliative Medicine, Yokohama City University, Yokohama 236-0004, Japan; (Y.T.); (Y.I.)
- Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan;
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (A.Y.); (T.O.); (T.J.); (K.T.); (K.T.); (K.S.); (A.O.); (Y.K.); (N.O.); (M.I.); (T.K.); (N.M.); (T.Y.); (A.S.); (A.F.); (S.H.); (K.I.); (A.N.)
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Mathias RM, Chu MKW, Edwards S, Day AS, Ma C, Jairath V, Bryant RV. Meta-analysis: Intestinal ultrasound to evaluate colonic contents and constipation. Aliment Pharmacol Ther 2024; 60:6-16. [PMID: 38745540 DOI: 10.1111/apt.18029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/02/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Constipation can be diagnosed clinically using the Rome criteria. Ultrasound (US), which lacks the radiation exposure of conventional X-ray, holds promise as a non-invasive tool to evaluate colonic contents and constipation. AIM To examine the role of US in the assessment of constipation. METHODS We performed a systematic search of Embase (OVID, 1984), Medline (Ovid, 1946), Cochrane Central, ClinicalTrials.gov and Australia New Zealand Clinical Trials Registry from database inception to 26 January 2024 according to PRISMA guidelines and prospectively registered with PROSPERO. All studies using US to assess constipation or colonic contents in either adults or children were included. Rectal diameter measurements were pooled in meta-analysis. Risk of bias was assessed using the Newcastle Ottawa Scales and Joanna Briggs Institute checklists. RESULTS Of 12,232 studies screened, 51 articles (6084 patients; 3422 children) describing US to assess symptoms in patients with constipation were included. Most studies used Rome criteria to diagnose constipation. Rectal diameter was associated with clinical constipation in 29 paediatric studies (3331 patients). Meta-analysis showed the mean rectal diameter of constipated patients was significantly higher than controls (mean difference 12 mm, 95% confidence intervals (CI): 6.48, 17.93, p < 0.0001, n = 16 studies). Other features of constipation on US included posterior acoustic shadowing and echogenicity of luminal contents. CONCLUSION US is an appealing imaging modality to assess luminal contents and constipation. Further well-designed studies are required to validate US metrics that accurately identify constipation.
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Affiliation(s)
- R M Mathias
- Inflammatory Bowel Disease Service, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Inflammatory Bowel Disease Research Group, The Basil Hetzel Institute for Translational Health Research, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - M K W Chu
- Inflammatory Bowel Disease Service, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Inflammatory Bowel Disease Research Group, The Basil Hetzel Institute for Translational Health Research, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - S Edwards
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - A S Day
- Inflammatory Bowel Disease Service, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Inflammatory Bowel Disease Research Group, The Basil Hetzel Institute for Translational Health Research, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - C Ma
- Division of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Alimentiv Inc., London, Ontario, Canada
| | - V Jairath
- Alimentiv Inc., London, Ontario, Canada
- Division of Gastroenterology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - R V Bryant
- Inflammatory Bowel Disease Service, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Inflammatory Bowel Disease Research Group, The Basil Hetzel Institute for Translational Health Research, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Sano Y, Matsumoto M, Akiyama K, Urata K, Matsuzaka N, Tamai N, Miura Y, Sanada H. Evaluating Accuracy of Rectal Fecal Stool Assessment Using Transgluteal Cleft Approach Ultrasonography. Healthcare (Basel) 2024; 12:1251. [PMID: 38998786 PMCID: PMC11241498 DOI: 10.3390/healthcare12131251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/10/2024] [Accepted: 06/16/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Transabdominal ultrasound is used to detect fecal impaction, but the rectum is difficult to visualize without bladder urine or with gastrointestinal gas. OBJECTIVE We developed a transgluteal cleft approach that is unaffected by these factors and sought to determine if our ultrasound method could detect and classify fecal matter in the lower rectum using this approach. METHODS We classified ultrasound images from hospitalized patients into four groups: Group 1 (bowed and rock-like echogenic areas), Group 2 (irregular and cotton candy-like hyperechoic areas), Group 3 (flat and mousse-like hyperechoic areas), and Group 4 (linear echogenic areas in the lumen). Stool characteristics were classified as hard, normal, and muddy/watery. Sensitivity and specificity were determined based on fecal impaction and stool classification accuracy. RESULTS We obtained 129 ultrasound images of 23 patients. The sensitivity and specificity for fecal retention in the rectum were both 100.0%. The recall rates were 71.8% for Group 1, 93.1% for Group 2, 100.0% for Group 3, and 100.0% for Group 4. The precision rates were 96.6% for Group 1, 71.1% for Group 2, 88.9% for Group 3, and 100.0% for Group 4. Our method was 89.9% accurate overall. CONCLUSION Transgluteal cleft approach ultrasound scanning can detect and classify fecal properties with high accuracy.
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Affiliation(s)
- Yumi Sano
- Department of Clinical Laboratory, Tokatsu Clinic Hospital, 865-2 Hinokuchi, Matsudo 2710067, Chiba, Japan
| | - Masaru Matsumoto
- Department of Well-Being Nursing, Graduate School of Nursing, Ishikawa Prefectural Nursing University, 1-1 Gakuendai, Kahoku 9291210, Ishikawa, Japan
- Fomer Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan
| | - Kazuhiro Akiyama
- Department of Gastroenterological Surgery, Tokatsu Clinic Hospital, 865-2 Hinokuchi, Matsudo 2710067, Chiba, Japan
| | - Katsumi Urata
- Department of Nursing, Tokatsu Clinic Hospital, 865-2 Hinokuchi, Matsudo 2710067, Chiba, Japan
| | - Natsuki Matsuzaka
- Department of Pharmacy, Tokatsu Clinic Hospital, 865-2 Hinokuchi, Matsudo 2710067, Chiba, Japan
| | - Nao Tamai
- Fomer Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan
- Department of Nursing, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 2360014, Kanagawa, Japan
- Former Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan
| | - Yuka Miura
- Fomer Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan
- Research Center for Implementation Nursing Science Initiative, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 4701192, Aichi, Japan
| | - Hiromi Sanada
- Former Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan
- Former Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan
- Ishikawa Prefectural Nursing University, 1-1 Gakuendai, Kahoku 9291210, Ishikawa, Japan
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Matsumoto M, Yoshida M, Miura Y, Sato N, Okawa Y, Yamada M, Otaki J, Nakagami G, Sugama J, Okada S, Ohta H, Sanada H. Feasibility of the constipation point‐of‐care ultrasound educational program in observing fecal retention in the colorectum: A descriptive study. Jpn J Nurs Sci 2020; 18:e12385. [DOI: 10.1111/jjns.12385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/30/2020] [Accepted: 08/12/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Masaru Matsumoto
- Department of Imaging Nursing Science, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery Tohoku University Graduate School of Medicine Miyagi Japan
| | - Yuka Miura
- Department of Imaging Nursing Science, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Naoko Sato
- Department of Home Care Nursing St. Luke's International University Tokyo Japan
| | - Yohei Okawa
- Global Nursing Research Center, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Masako Yamada
- Department of Home Care Nursing St. Luke's International University Tokyo Japan
| | - Junji Otaki
- Department of Medical Education/General Medicine and Primary Care Tokyo Medical University Tokyo Japan
| | - Gojiro Nakagami
- Global Nursing Research Center, Graduate School of Medicine The University of Tokyo Tokyo Japan
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative Kanazawa University Ishikawa Japan
| | - Shingo Okada
- Department of Surgery Kitamihara Clinic Hokkaido Japan
| | - Hideki Ohta
- Medical Corporation Activities Supporting Medicine: Systematic Services (A.S.M.ss) Tochigi Japan
| | - Hiromi Sanada
- Department of Women's Health Nursing & Midwifery Tohoku University Graduate School of Medicine Miyagi Japan
- Institute for Frontier Science Initiative Kanazawa University Ishikawa Japan
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Matsumoto M, Tsutaoka T, Nakagami G, Tanaka S, Yoshida M, Miura Y, Sugama J, Okada S, Ohta H, Sanada H. Deep learning-based classification of rectal fecal retention and analysis of fecal properties using ultrasound images in older adult patients. Jpn J Nurs Sci 2020; 17:e12340. [PMID: 32394621 DOI: 10.1111/jjns.12340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/02/2020] [Accepted: 03/13/2020] [Indexed: 11/30/2022]
Abstract
AIM The present study aimed to analyze the use of machine learning in ultrasound (US)-based fecal retention assessment. METHODS The accuracy of deep learning techniques and conventional US methods for the evaluation of fecal properties was compared. The presence or absence of rectal feces was analyzed in 42 patients. Eleven patients without rectal fecal retention on US images were excluded from the analysis; thus, fecal properties were analyzed in 31 patients. Deep learning was used to classify the transverse US images into three types: absence of feces, hyperechoic area, and strong hyperechoic area in the rectum. RESULTS Of the 42 patients, 31 tested positive for the presence of rectal feces, zero were false positive, zero were false negative, and 11 were negative, indicating a sensitivity of 100% and a specificity of 100% for the detection of rectal feces in the rectum. Of the 31 positive patients, 14 had hard stools and 17 had other types. Hard stool was detected by US findings in 100% of the patients (14/14), whereas deep learning-based classification detected hard stool in 85.7% of the patients (12/14). Other stool types were detected by US findings in 88.2% of the patients (15/17), while deep learning-based classification also detected other stool types in 88.2% of the patients (15/17). CONCLUSIONS The results showed that US findings and deep learning-based classification can detect rectal fecal retention in older adult patients and distinguish between the types of fecal retention.
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Affiliation(s)
- Masaru Matsumoto
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takuya Tsutaoka
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gojiro Nakagami
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gerontological Nursing / Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shiho Tanaka
- Department of Gerontological Nursing / Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Yuka Miura
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative, Kanazawa University, Ishikawa, Japan
| | - Shingo Okada
- Department of Surgery, Kitamihara Clinic, Hokkaido, Japan
| | - Hideki Ohta
- Medical Corporation Activities Supporting Medicine: Systematic Services (A.S.M.ss), Tochigi, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gerontological Nursing / Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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