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Zhong Y, Xiao YY, Ye JY, Jian GL, Huang WJ. Diagnostic efficacy of contrast-enhanced gastric ultrasonography in staging gastric cancer: a meta-analysis. BMC Cancer 2024; 24:422. [PMID: 38580944 PMCID: PMC10998428 DOI: 10.1186/s12885-024-12210-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/01/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND As comprehensive surgical management for gastric cancer becomes increasingly specialized and standardized, the precise differentiation between ≤T1 and ≥T2 gastric cancer before endoscopic intervention holds paramount clinical significance. OBJECTIVE To evaluate the diagnostic efficacy of contrast-enhanced gastric ultrasonography in differentiating ≤T1 and ≥T2 gastric cancer. METHODS PubMed, Web of Science, and Medline were searched to collect studies published from January 1, 2000 to March 16, 2023 on the efficacy of either double contrast-enhanced gastric ultrasonography (D-CEGUS) or oral contrast-enhanced gastric ultrasonography (O-CEGUS) in determining T-stage in gastric cancer. The articles were selected according to specified inclusion and exclusion criteria, and the quality of the included literature was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 scale. Meta-analysis was performed using Stata 12 software with data from the 2 × 2 crosslinked tables in the included literature. RESULTS In total, 11 papers with 1124 patients were included in the O-CEGUS analysis, which revealed a combined sensitivity of 0.822 (95% confidence interval [CI] = 0.753-0.875), combined specificity of 0.964 (95% CI = 0.925-0.983), and area under the summary receiver operating characteristic (sROC) curve (AUC) of 0.92 (95% CI = 0.89-0.94). In addition, five studies involving 536 patients were included in the D-CEGUS analysis, which gave a combined sensitivity of 0.733 (95% CI = 0.550-0.860), combined specificity of 0.982 (95% CI = 0.936-0.995), and AUC of 0.93 (95% CI = 0.91-0.95). According to the I2 and P values of the forest plot, there was obvious heterogeneity in the combined specificities of the included papers. Therefore, the two studies with the lowest specificities were excluded from the O-CEGUS and D-CEGUS analyses, which eliminated the heterogeneity among the remaining literature. Consequently, the combined sensitivity and specificity of the remaining studies were 0.794 (95% CI = 0.710-0.859) and 0.976 (95% CI = 0.962-0.985), respectively, for the O-CEDUS studies and 0.765 (95% CI = 0.543-0.899) and 0.986 (95% CI = 0.967-0.994), respectively, for the D-CEGUS studies. The AUCs were 0.98 and 0.99 for O-CEGUS and D-CEGUS studies, respectively. CONCLUSION Both O-CEGUS and D-CEGUS can differentiate ≤T1 gastric cancer from ≥T2 gastric cancer, thus assisting the formulation of clinical treatment strategies for patients with very early gastric cancer. Given its simplicity and cost-effectiveness, O-CEGUS is often favored as a staging method for gastric cancer prior to endoscopic intervention.
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Affiliation(s)
- Yuan Zhong
- Department of Medical Ultrasound, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan, 528010, China
| | - Yan-Yan Xiao
- Department of Medical Ultrasound, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan, 528010, China
| | - Jie-Yi Ye
- Department of Medical Ultrasound, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan, 528010, China
| | - Guo-Liang Jian
- Department of Medical Ultrasound, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan, 528010, China
| | - Wei-Jun Huang
- Department of Medical Ultrasound, The First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Foshan, 528010, China.
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Wang N, Yan X, Zhang Z, Liu L, Zhu J, Huang X, Nie F. Whether the use of intravenous contrast-enhanced ultrasound can improve the accuracy of T stage diagnosis of gastric cancer? Clin Hemorheol Microcirc 2024; 86:433-440. [PMID: 37980652 DOI: 10.3233/ch-231949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
OBJECTIVE To explore whether the use of intravenous contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of T stage of gastric cancer on the basis of oral contrast-enhanced ultrasound (OCEUS). METHODS Eighty-one patients with gastric cancer who underwent preoperative CEUS. Criteria for T staging was AJCC Stage 8th Edition. To compare the diagnostic accuracy, sensitivity and specificity of OCEUS and CEUS for T staging of gastric cancer using pathological results as the gold standard. RESULTS There were differences in the diagnostic accuracy of T2 (P = 0.048), T3(P = 0.002) and T4 (P = 0.000) between OCEUS and CEUS. And there was no difference in diagnostic accuracy for T1 (P = 0.118). CEUS significantly improved diagnostic sensitivity and specificity in T3 (42.86% to 61.90% for sensitivity, 86.96% to 93.75% for specificity), and T4 (64.71% to 76.47% for sensitivity, 78.33% to 95.74% for specificity). CONCLUSION Compared with OCEUS, CEUS did improve the diagnostic accuracy of T2, T3, and T4 stages of gastric cancer.
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Affiliation(s)
- Nan Wang
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Xueliang Yan
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhiqi Zhang
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
| | - Luping Liu
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Ju Zhu
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Xiao Huang
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Fang Nie
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
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He H, Tang T, Wang X, Zhou L, Wang L. Comparing endoscopic ultrasonography and double contrast-enhanced ultrasonography in the preoperative diagnosis of gastric stromal tumor. Cancer Imaging 2023; 23:122. [PMID: 38102702 PMCID: PMC10724945 DOI: 10.1186/s40644-023-00646-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND This study was designed to perform a comparative analysis between endoscopic ultrasonography (EUS) and double contrast-enhanced ultrasonography (DCEUS) for the preoperative diagnosis of gastric stromal tumors (GSTs). METHODS A retrospective study was conducted involving 139 patients with histologically confirmed GSTs. All patients preoperatively underwent DCEUS and EUS. The pathology reports were treated as the baseline and were retrospectively compared with the findings of EUS and DCEUS. RESULTS Of the 139 lesions, 120 and 113 were correctly identified by DCEUS and EUS, respectively, with an accuracy of 86.3% and 81.3%. The results revealed an insignificant difference between these two methods (p = 0.189). CONCLUSIONS DCEUS can display not only the locations, sizes, shapes, borders, internal echoes, but also show the blood perfusion patterns of GSTs. It is a highly accurate, noninvasive, and convenient method to be used at the pre-treatment stage.
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Affiliation(s)
- Huiliao He
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Tingting Tang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Xiaohua Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Lingling Zhou
- Department of Pathology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Liang Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
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Guan S, Yan R, Chen X, Chen W, Zhou X, Zhou M, Xie Z, Tan W, He Y, Fu J, Yuan F, Xu E. Risk stratification of gastric cancer screening in community population based on oral contrast-enhanced ultrasonography examination: A 3-year follow-up analysis report. Front Oncol 2023; 13:1218800. [PMID: 38023168 PMCID: PMC10643155 DOI: 10.3389/fonc.2023.1218800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Objective This study aimed to retrospectively investigate the use of oral contrast-enhanced ultrasonography (O-CEUS) in assessing the thickness of the gastric wall for gastric cancer (GC) screening and to establish screening strategies for GC with different risk stratifications based on the gastric wall thickness. Methods From January 2015 to March 2020, people who underwent O-CEUS at the Physical Examination Center of our hospital with at least three years of follow-up were included in this study. The thickness of the gastric wall measured by O-CEUS was divided into three groups using 6 mm and 9 mm as cutoff values. The occurrence of GC in each group was observed. The imaging and clinical information of these populations were recorded and analyzed. Kaplan-Meier survival analysis and Cox's proportional hazards regression were performed to calculate the risk of GC occurrence. Results A total of 4,047 people were finally included in this study. During the follow-up period, GC occurred in 7 individuals (incidence rate 0.17%). Among them, according to the thickness of the gastric wall, one case occurred in Group A (< 6 mm), two cases occurred in Group B (6-9 mm), and four cases occurred in Group C (>9mm). Based on Kaplan-Meier survival analysis, the curves of the three groups were significantly different (P < 0.01). The risk of GC occurrence in Group C and Group B were higher than that in Group A (4.76E+2-fold and 1.50E+2-fold). Conclusion O-CEUS is a convenient, economical, safe, and noninvasive screening method for GC. Measuring the thickness of the gastric wall is helpful to predict the risk of GC occurrence according to our stratification screening system.
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Affiliation(s)
- Sainan Guan
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Ronghua Yan
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xiaomin Chen
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Weiqiang Chen
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Xi Zhou
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Minghui Zhou
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Zhengneng Xie
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Wen Tan
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yongyan He
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Juan Fu
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Fan Yuan
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Erjiao Xu
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
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Gao Z, Yu Z, Zhang X, Chen C, Pan Z, Chen X, Lin W, Chen J, Zhuge Q, Shen X. Development of a deep learning model for early gastric cancer diagnosis using preoperative computed tomography images. Front Oncol 2023; 13:1265366. [PMID: 37869090 PMCID: PMC10587601 DOI: 10.3389/fonc.2023.1265366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023] Open
Abstract
Background Gastric cancer is a highly prevalent and fatal disease. Accurate differentiation between early gastric cancer (EGC) and advanced gastric cancer (AGC) is essential for personalized treatment. Currently, the diagnostic accuracy of computerized tomography (CT) for gastric cancer staging is insufficient to meet clinical requirements. Many studies rely on manual marking of lesion areas, which is not suitable for clinical diagnosis. Methods In this study, we retrospectively collected data from 341 patients with gastric cancer at the First Affiliated Hospital of Wenzhou Medical University. The dataset was randomly divided into a training set (n=273) and a validation set (n=68) using an 8:2 ratio. We developed a two-stage deep learning model that enables fully automated EGC screening based on CT images. In the first stage, an unsupervised domain adaptive segmentation model was employed to automatically segment the stomach on unlabeled portal phase CT images. Subsequently, based on the results of the stomach segmentation model, the image was cropped out of the stomach area and scaled to a uniform size, and then the EGC and AGC classification models were built based on these images. The segmentation accuracy of the model was evaluated using the dice index, while the classification performance was assessed using metrics such as the area under the curve (AUC) of the receiver operating characteristic (ROC), accuracy, sensitivity, specificity, and F1 score. Results The segmentation model achieved an average dice accuracy of 0.94 on the hand-segmented validation set. On the training set, the EGC screening model demonstrated an AUC, accuracy, sensitivity, specificity, and F1 score of 0.98, 0.93, 0.92, 0.92, and 0.93, respectively. On the validation set, these metrics were 0.96, 0.92, 0.90, 0.89, and 0.93, respectively. After three rounds of data regrouping, the model consistently achieved an AUC above 0.9 on both the validation set and the validation set. Conclusion The results of this study demonstrate that the proposed method can effectively screen for EGC in portal venous CT images. Furthermore, the model exhibits stability and holds promise for future clinical applications.
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Affiliation(s)
- Zhihong Gao
- Zhejiang Engineering Research Center of Intelligent Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhuo Yu
- School of Information and Safety Engineering, Zhongnan University of Economics and Law, Wuhan, China
| | - Xiang Zhang
- Wenzhou Data Management and Development Group Co., Ltd., Wenzhou, Zhejiang, China
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhifang Pan
- Zhejiang Engineering Research Center of Intelligent Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaodong Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Weihong Lin
- Zhejiang Engineering Research Center of Intelligent Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jun Chen
- Zhejiang Engineering Research Center of Intelligent Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qichuan Zhuge
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xian Shen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Wu LL, Xin JY, Wang JJ, Feng QQ, Xu XL, Li KY. Prospective Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Contrast-Enhanced Computed Tomography in Pre-operative Tumor Staging of Gastric Cancer. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:569-577. [PMID: 36369213 DOI: 10.1016/j.ultrasmedbio.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/22/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The aim of this prospective study was to compare the diagnostic accuracy of oral contrast-enhanced transabdominal ultrasound imaging (OCTU) with that of contrast-enhanced computed tomography (CT) for the pre-operative tumor staging of gastric cancer, with post-operative pathology as the standard. We included 108 cases of gastric cancer with simultaneous OCTU and enhanced CT pre-operative tumor staging diagnoses. Results were compared with post-operative pathology based on the eighth edition of the American Joint Committee on Cancer tumor-node-metastasis staging guidelines for gastric cancer. The accuracy of each tumor stage was obtained by comparing OCTU and enhanced CT diagnoses with post-operative pathology. The McNemar test was used to compare the overall accuracy of the two methods. There was no statistical difference in accuracy between OCTU (72.2%) and enhanced CT (75.9%, p = 0.644) for overall pre-operative tumor staging diagnosis. For stages T1 to T4, the accuracy rates of OCTU were 84.2%, 81.8%, 69.4% and 65.5%, respectively, and those for enhanced CT were 52.6%, 72.7%, 87.8% and 72.4%, respectively. OCTU is comparable to enhanced CT in the preoperative overall T-stage diagnosis of gastric cancer.
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Affiliation(s)
- Ling-Ling Wu
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun-Yi Xin
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing-Jing Wang
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qun-Qun Feng
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiao-Li Xu
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kai-Yan Li
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Urakawa S, Michiura T, Tokuyama S, Fukuda Y, Miyazaki Y, Hayashi N, Yamabe K. Preoperative diagnosis of tumor depth in gastric cancer using transabdominal ultrasonography compared to using endoscopy and computed tomography. Surg Endosc 2023; 37:3807-3813. [PMID: 36690895 DOI: 10.1007/s00464-023-09883-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/08/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND An accurate evaluation method for preoperative diagnosis has not yet been established in patients with gastric cancer (GC), though it is essential for optimal treatment. Current standard modalities are endoscopy and contrast computed tomography (CT). In this study, we investigated the efficacy and limitations of transabdominal ultrasonography (TUS) for the assessment of tumor invasion. METHODS We enrolled 178 consecutive patients with GC evaluated by TUS, endoscopy, and contrast CT before gastrectomy. For the TUS examination, patients ingested water to fill their stomachs. The clinical staging determined using these modalities was compared to the pathological staging. RESULTS The overall accuracy of clinical T staging using TUS was 47.8% (pT1a: 5.8% (2/35); pT1b: 58.8% (20/35); pT2: 69.6% (16/23); pT3: 66.7% (22/33); pT4a: 46% (23/50); pT4b: 100% (2/2)). Using endoscopy, contrast CT, and TUS, the overall accuracy was 60.7%. The accuracy of TUS was associated with the tumor region (U region: 50% (14/28); M: 31.8% (14/44); L: 53.7% (57/106); P = 0.048), but not with the cross-sectional parts (P = 0.49). Multivariate analysis identified inaccurate TUS as independently correlating with tumor region (M vs. U/L, odds ratio (OR) = 3.11, 95% confidence interval (CI) 1.41-6.87; P = 0.005) and pT (pT1 vs. pT2-4, OR = 3.00, 95%CI 1.31-6.87; P = 0.009). CONCLUSIONS The present study demonstrated the importance of TUS in evaluating GC. Thus, TUS may be useful for clinical T staging in certain circumstances, leading to treatment optimization.
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Affiliation(s)
- Shinya Urakawa
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan.
- Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan.
| | - Toshiya Michiura
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan
| | - Shinji Tokuyama
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan
| | - Yasunari Fukuda
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan
| | - Yasuaki Miyazaki
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan
| | - Nobuyasu Hayashi
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan
| | - Kazuo Yamabe
- Department of Gastroenterological Surgery, Kinan Hospital, Wakayama, Japan
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Zeng Q, Feng Z, Zhu Y, Zhang Y, Shu X, Wu A, Luo L, Cao Y, Xiong J, Li H, Zhou F, Jie Z, Tu Y, Li Z. Deep learning model for diagnosing early gastric cancer using preoperative computed tomography images. Front Oncol 2022; 12:1065934. [PMID: 36531076 PMCID: PMC9748811 DOI: 10.3389/fonc.2022.1065934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/07/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Early gastric cancer (EGC) is defined as a lesion restricted to the mucosa or submucosa, independent of size or evidence of regional lymph node metastases. Although computed tomography (CT) is the main technique for determining the stage of gastric cancer (GC), the accuracy of CT for determining tumor invasion of EGC was still unsatisfactory by radiologists. In this research, we attempted to construct an AI model to discriminate EGC in portal venous phase CT images. METHODS We retrospectively collected 658 GC patients from the first affiliated hospital of Nanchang university, and divided them into training and internal validation cohorts with a ratio of 8:2. As the external validation cohort, 93 GC patients were recruited from the second affiliated hospital of Soochow university. We developed several prediction models based on various convolutional neural networks, and compared their predictive performance. RESULTS The deep learning model based on the ResNet101 neural network represented sufficient discrimination of EGC. In two validation cohorts, the areas under the curves (AUCs) for the receiver operating characteristic (ROC) curves were 0.993 (95% CI: 0.984-1.000) and 0.968 (95% CI: 0.935-1.000), respectively, and the accuracy was 0.946 and 0.914. Additionally, the deep learning model can also differentiate between mucosa and submucosa tumors of EGC. CONCLUSIONS These results suggested that deep learning classifiers have the potential to be used as a screening tool for EGC, which is crucial in the individualized treatment of EGC patients.
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Affiliation(s)
- Qingwen Zeng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Medical Innovation Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zongfeng Feng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanyan Zhu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Yang Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xufeng Shu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Ahao Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Lianghua Luo
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Yi Cao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Jianbo Xiong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Hong Li
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Zhigang Jie
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yi Tu
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhengrong Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Sacerdoțianu VM, Ungureanu BS, Iordache S, Cazacu SM, Pirici D, Liliac IM, Burtea DE, Șurlin V, Stroescu C, Gheonea DI, Săftoiu A. Gastric Cancer Angiogenesis Assessment by Dynamic Contrast Harmonic Imaging Endoscopic Ultrasound (CHI-EUS) and Immunohistochemical Analysis-A Feasibility Study. J Pers Med 2022; 12:jpm12071020. [PMID: 35887515 PMCID: PMC9324362 DOI: 10.3390/jpm12071020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 11/16/2022] Open
Abstract
Tumor vascular perfusion pattern in gastric cancer (GC) may be an important prognostic factor with therapeutic implications. Non-invasive methods such as dynamic contrast harmonic imaging endoscopic ultrasound (CHI-EUS) may provide details about tumor perfusion and could also lay out another perspective for angiogenesis assessment. Methods: We included 34 patients with GC, adenocarcinoma, with CHI-EUS examinations that were performed before any treatment decision. We analyzed eighty video sequences with a dedicated software for quantitative analysis of the vascular patterns of specific regions of interest (ROI). As a result, time-intensity curve (TIC) along with other derived parameters were automatically generated: peak enhancement (PE), rise time (RT), time to peak (TTP), wash-in perfusion index (WiPI), ROI area, and others. We performed CD105 and CD31 immunostaining to calculate the vascular diameter (vd) and the microvascular density (MVD), and the results were compared with CHI-EUS parameters. Results: High statistical correlations (p < 0.05) were observed between TIC analysis parameters MVD and vd CD31. Strong correlations were also found between tumor grade and 7 CHI-EUS parameters, p < 0.005. Conclusions: GC angiogenesis assessment by CHI-EUS is feasible and may be considered for future studies based on TIC analysis.
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Affiliation(s)
- Victor Mihai Sacerdoțianu
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
| | - Bogdan Silviu Ungureanu
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
- Correspondence: ; Tel.: +40-723-178-763
| | - Sevastiţa Iordache
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
| | - Sergiu Marian Cazacu
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
| | - Daniel Pirici
- Histology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.P.); (I.M.L.)
| | - Ilona Mihaela Liliac
- Histology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.P.); (I.M.L.)
| | - Daniela Elena Burtea
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
| | - Valeriu Șurlin
- Surgical Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Cezar Stroescu
- Surgical Department II, St. Mary Hospital Bucharest, 011172 București, Romania;
| | - Dan Ionuț Gheonea
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
| | - Adrian Săftoiu
- Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (V.M.S.); (S.I.); (S.M.C.); (D.E.B.); (D.I.G.); (A.S.)
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10
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Zhang M, Lin H, Hu J, Jing XX, Qin LL. The value of colorectal filling contrast ultrasonography in diagnosing pediatric juvenile polyps. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:564-572. [PMID: 35318682 DOI: 10.1002/jcu.23198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To describe a facilitated procedure of colorectal filling contrast ultrasonography (CFCUS) and explore its value in the diagnosis of pediatric juvenile polyps. METHODS One hundred and eleven children with clinical signs of colorectal polyps admitted to our hospital between May 2018 and May 2021 were retrospectively reviewed. All children underwent conventional transabdominal ultrasonography (CTUS) and CFCUS prior to undergoing colonoscopy. Pathologic findings were used as the gold standard. Chi-squared tests and Mann-Whitney U tests were used for the statistical analysis. RESULTS Forty-five children with fifty-two colorectal polyps were confirmed via pathological examination. The sensitivity, specificity, positive predictive value, and negative predictive value of CFCUS vs. CTUS were 92.3% versus 80.7%, 100% versus 100%, 100% versus 100%, and 93.3% versus 84.8%, respectively. The missed polyps were significantly smaller than the polyps detected in diameter (7.50 ± 2.12 mm vs. 19.62 ± 7.89 mm, p < 0.0001) by CTUS. A significant difference between CTUS and CFCUS was observed in the detection rate of polyps with a diameter < 1 cm (p = 0.031) and pedicles (p < 0.001). The kappa values for the assessment of Yamada's classification between CTUS and colonoscopy and CFCUS and colonoscopy were 0.51 and 0.84, respectively. Moreover, CFCUS incidentally revealed a punctate hyperechoic area on the surface of colonic polyps in six cases, which may be suggestive of a correlation with erosion and bleeding findings. CONCLUSION CFCUS can increase the detection rate of polyps and pedicles, especially polyps with diameters <1 cm, and accurately evaluate Yamada's classification, providing useful preoperative information for colonoscopy.
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Affiliation(s)
- Min Zhang
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Hai Lin
- Department of Pediatric Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Jie Hu
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Xiang Xiang Jing
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Ling Ling Qin
- Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
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Adoption of Two-Dimensional Ultrasound Gastrointestinal Filling Contrast on Artificial Intelligence Algorithm in Clinical Diagnosis of Gastric Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7385344. [PMID: 35535230 PMCID: PMC9078808 DOI: 10.1155/2022/7385344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 11/29/2022]
Abstract
This research was aimed to explore the value of gastrointestinal filling contrast-enhanced ultrasound (CEUS) and computed tomography (CT-)-enhanced scanning based on artificial intelligence (AI) algorithm in the evaluation of gastric cancer staging. 102 patients with gastric cancer were selected as the research objects. All of them underwent CEUS of gastrointestinal filling and 64-slice spiral CT before surgery. In addition, an improved mean shift algorithm was proposed based on differential optical flow and deep convolutional neural network (D-CNN), which was applied in image processing. The predicted positive rate (PPR), sensitivity, specificity, and accuracy of gastric cancer in different stages by CEUS and CT were calculated using pathological diagnosis results as the gold standard. 17 patients with T1 stage, 41 patients with T2-T3 stage, and 35 patients with T4 stage were detected by CEUS. 13 patients with T1 stage, 34 patients with T2-T3 stage, and 30 patients with T4 stage were detected by CT enhanced examination. The PPRs of CEUS for T1, T2-T3, and T4 stages of gastric cancer were higher than those of CT enhanced (P < 0.05). The PPR of CEUS for N0 staging of gastric cancer was higher than that of CT enhanced (P < 0.05), and it for N3 staging of gastric cancer was lower than that of CT enhanced (P < 0.05). From the analysis of M staging of gastric cancer, the PPRs of CEUS for M0 and M1 staging of gastric cancer were not statistically different from the PPRs of CT enhanced (P > 0.05). The sensitivity (95.6%), specificity (81.82%), and accuracy (94.12%) of CEUS in assessing resectability were significantly higher than those of CT enhancement (89.01%, 63.67%, and 86.27%, respectively), and the differences were statistically significant (P < 0.05). In summary, CEUS gastrointestinal filling based on the D-CNN algorithm could better improve the display rate of the tissue lesions around the stomach. It also helped to judge the lesion progress, the depth of infiltration, and lymph node metastasis of the lesion. In addition, it had excellent performance in evaluating the resectability of gastric cancer before surgery and had clinical promotion value.
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12
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Zhang X, Yao J, Zhang Y, Huang X, Wang W, Huang H. Updated Evaluation of the Diagnostic Performance of Double Contrast-Enhanced Ultrasonography in the Preoperative T Staging of Gastric Cancer: A Meta-Analysis and Systematic Review. Front Oncol 2022; 12:844390. [PMID: 35356215 PMCID: PMC8959463 DOI: 10.3389/fonc.2022.844390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/08/2022] [Indexed: 01/30/2023] Open
Abstract
Objective This study aimed to systematically evaluate the diagnostic performance of double contrast-enhanced ultrasonography (DCEUS) in the preoperative T staging of gastric cancer (GC). Methods Literature searches for eligible studies were performed using MEDLINE, EMBASE, and Cochrane Library. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve of DCEUS in the diagnosis of each T stage tumor were calculated. Meta-analyses were performed to obtain the pooled effects of risk ratio (RR) with 95% confidence interval (CI) in the comparison of DCEUS with CT/endoscopic ultrasound (EUS). Results A total of 8 studies including 1,232 patients were identified for inclusion in this meta-analysis. The pooled sensitivity and specificity were 0.78 (95% CI = 0.64–0.88) and 0.98 (95% CI = 0.96–0.99) for T1, 0.81 (95% CI = 0.76–0.86) and 0.96 (95% CI = 0.91–0.98) for T2, 0.88 (95% CI = 0.84–0.91) and 0.85 (95% CI = 0.79–0.90) for T3, and 0.81 (95% CI = 0.69–0.89) and 0.96 (95% CI = 0.93–0.97) for T4. Moreover, DCEUS demonstrated significant superiority to CT in diagnosing T1 (RR = 1.57, 95% CI = 1.20–2.05, p = 0.001) and T2 (RR = 1.41, 95% CI = 1.16–1.71, p = 0.001) and to EUS in diagnosing T3 (RR = 1.24, 95% CI = 1.08–1.42, p = 0.003) and T4 (RR = 1.40, 95% CI = 1.09–1.79, p = 0.008). However, it showed a lower diagnostic accuracy than EUS in T1 tumors (RR = 0.77, 95% CI = 0.62–0.94, p = 0.013). Conclusions DCEUS is a feasible complementary diagnostic tool for clinical T staging of GC. However, it is still far from a definitive conclusion for DCEUS to be proposed for use in routine clinical practice.
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Affiliation(s)
- Xin Zhang
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jun Yao
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yu Zhang
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xin Huang
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Weijun Wang
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Hejing Huang
- Department of Ultrasound, Second Affiliated Hospital of Naval Medical University, Shanghai, China
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13
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Feng H, Zheng J, Zheng C, Deng Z, Liao Q, Wang J, Li Y. The probability of Lymph node metastasis with a tumor size larger than and smaller than 4 cm is different in stages T1-T3 of Siewert type II adenocarcinoma of esophagogastric junction: A Population-Based Study. J Cancer 2021; 12:6873-6882. [PMID: 34659575 PMCID: PMC8518009 DOI: 10.7150/jca.63392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background: In adenocarcinoma of esophagogastric junction (AEG), the relationship between tumor size (TS) and lymph node metastasis (LNM) is unclear. This study aimed to explore the relationship between TS and LNM, and to construct a prediction model for LNM. Materials and Methods: Data from 4649 Siewert type II AEG patients were retrospectively acquired from the Surveillance, Epidemiology, and End Result (SEER) database. TS data was analyzed as a continuous variable, but also divided into 1-cm-interval categorical groups for further analysis. The logistic regression model and restricted cubic spline (RCS) model was used to explore the relationship between TS and LNM, after adjusting for covariates. Internal validations as well as external validation (Single-Center data) were used to check our LNM prediction model. Results: TS and LNM showed a significant relationship in the logistic regression analysis, regardless of the TS data being entered as a continuous or a categorical variable, after adjusting for covariates. The logistic regression model and RCS consistently showed that larger TS resulted in larger Odds Ratio (OR) values. When tumors were larger than 4 cm, the OR value remained relatively constant. The receiver operator characteristic curve evaluated the nomogram by the area under the curve (AUC) (AUC=0.737, in internal validation; AUC=0.626, in external validation), and the calibration curve of the nomogram showed an improved prediction system. Conclusions: In Siewert type II T1-T3 stage AEG patients, we reported that LNM increased with TS up to 4-cm, and our nomogram provided a simple tool to predict LNM.
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Affiliation(s)
- Huolun Feng
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China
| | - Jiabin Zheng
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China
| | - Chengbin Zheng
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China
| | - Zhenru Deng
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China
| | - Qianchao Liao
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China
| | - Junjiang Wang
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China
| | - Yong Li
- Department of gastrointestinal surgery, Guangdong Provincial People's Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, P. R. China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China
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Liu Y, Liu G, Hou B, Shen B. Ultrasound intervention combined with multi-slice spiral CT has excellent diagnostic value in lymph node metastasis of gastric cancer. Am J Transl Res 2021; 13:11764-11770. [PMID: 34786105 PMCID: PMC8581938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with multi-slice helical CT (MSCT) for gastric carcinoma and its lymph node metastasis (LNM). METHODS 150 patients with gastric carcinoma diagnosed in our hospital from July 2017 to July 2020 were enrolled for this retrospective study. The patients were all confirmed with gastric carcinoma by biopsy pathology. CEUS and MSCT were performed within one week before surgery. Logistic regression analysis was conducted to analyze the risk factors for LNM of gastric carcinoma. The diagnostic efficiency of CEUS and MSCT in gastric carcinoma and the screening efficiency of LNM were compared, and the sensitivity and specificity were calculated with the postoperative pathologic finding as the gold standard. The scores of lymph node reinforcement were compared. RESULTS There were 115 cases diagnosed with LNM while 35 were diagnosed without it by CEUS. MSCT results confirmed that there were 112 cases with LNM while 38 without. CEUS combined with MSCT confirmed that there were 116 cases with LNM while 34 cases were without. The sensitivity, specificity, and diagnostic coincidence rate of CEUS for LNM of gastric carcinoma were 89.07%, 70.96% and 85.33%, respectively. Those of MSCT were 84.87%, 64.51% and 80.66%, respectively. Those of CEUS combined with MSCT were 94.11%, 87.10%, and 92.67%, respectively. The reinforcement of CEUS combined with MSCT was better than either alone. CONCLUSION CEUS combined with MSCT is more effective in the diagnosis of LNM in gastric carcinoma patients. Hence, the combination of the two is helpful to enhance the accuracy of LNM diagnosis before operation.
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Affiliation(s)
- Yanchao Liu
- Department of Ultrasound Medicine, Handan Central HospitalHandan 056001, Hebei Province, China
| | - Guokun Liu
- CT Room, Handan Central HospitalHandan 056001, Hebei Province, China
| | - Bo Hou
- CT Room, Handan Central HospitalHandan 056001, Hebei Province, China
| | - Bing Shen
- CT Room, Handan Central HospitalHandan 056001, Hebei Province, China
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15
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Xu L, Wang X, Wu W, Li Y. Diagnostic Accuracy of Double Contrast-Enhanced Ultrasonography in Clarifying Tumor Depth (T Stage) of Gastric Cancer: Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2483-2493. [PMID: 34172338 DOI: 10.1016/j.ultrasmedbio.2021.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to quantitatively analyze published data regarding the ability of double contrast-enhanced ultrasonography (DCEUS) to clarify tumor depth (T stage) in primary gastric carcinoma patients. We obtained six studies, including 926 gastric cancer (GC) patients who were diagnosed by DCEUS from the Cochrane Library "Cochrane Central Register of Controlled Trials (CENTRAL)," OVID MEDLINE, EMBASE, PUBMED and EBSCOhost, to 2019. Sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), forest plot analysis and summary receiver operating characteristic (SROC) curve analysis were used to evaluate the diagnostic accuracy of DCEUS. In our study, all the patients were examined by DCEUS. The quality of all included studies was good. The meta-analysis of six studies (n = 926) revealed that the summary sensitivity and specificity of DCEUS in discriminating T1-T2 versus T3-T4 gastric carcinomas were 0.94 and 0.91, respectively. The pooled sensitivity and specificity of DCEUS were 0.67 and 0.98 for T1 stage, 0.81 and 0.95 for T2 stage, 0.89 and 0.86 for T3 stage and 0.87 and 0.96 for T4 stage, respectively. The SROC curve revealed that the areas under the curve (AUC) of T1-T2 were 0.97 for each stage and 0.82 (T1), 0.84 (T2), 0.91 (T3) and 0.97 (T4). These results indicate that the accuracy of DCEUS in discriminating T1-T2 is higher than that in discriminating T3-T4, and the diagnostic value of DCEUS in discriminating the T3 stage requires further consideration. Finally, our analysis suggested that the diagnostic accuracy of DCEUS is available to guide surgeons in the pre-operative diagnosis of GC patients for more precise treatment.
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Affiliation(s)
- Lifeng Xu
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China; Department of General Surgery, Anhui Second Provincial People's Hospital, Hefei, Anhui, People's Republic of China
| | - Xiaodong Wang
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Wenzhou Wu
- Department of General Surgery, Anhui Second Provincial People's Hospital, Hefei, Anhui, People's Republic of China
| | - Yongxiang Li
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
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16
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Jin N, George TL, Otterson GA, Verschraegen C, Wen H, Carbone D, Herman J, Bertino EM, He K. Advances in epigenetic therapeutics with focus on solid tumors. Clin Epigenetics 2021; 13:83. [PMID: 33879235 PMCID: PMC8056722 DOI: 10.1186/s13148-021-01069-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/04/2021] [Indexed: 02/06/2023] Open
Abstract
Epigenetic (“above genetics”) modifications can alter the gene expression without altering the DNA sequence. Aberrant epigenetic regulations in cancer include DNA methylation, histone methylation, histone acetylation, non-coding RNA, and mRNA methylation. Epigenetic-targeted agents have demonstrated clinical activities in hematological malignancies and therapeutic potential in solid tumors. In this review, we describe mechanisms of various epigenetic modifications, discuss the Food and Drug Administration-approved epigenetic agents, and focus on the current clinical investigations of novel epigenetic monotherapies and combination therapies in solid tumors.
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Affiliation(s)
- Ning Jin
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - Tiffany L George
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - Gregory A Otterson
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - Claire Verschraegen
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - Haitao Wen
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA.,Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - David Carbone
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - James Herman
- Department of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Erin M Bertino
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA.
| | - Kai He
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA.
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Wang X, Kou H, He H, Lu M, Zhou L, Wang L. Difference in Perfusion Parameters Between Gastric Cancer and Gastric Stromal Tumors: Evaluation With Oral Contrast Plus Contrast-Enhanced Ultrasonography. Front Oncol 2020; 10:532. [PMID: 32432030 PMCID: PMC7214801 DOI: 10.3389/fonc.2020.00532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/25/2020] [Indexed: 12/31/2022] Open
Abstract
Objective: To explore the difference of perfusion parameters between gastric cancer (GC) and gastric stromal tumors (GSTs) by using oral contrast plus contrast-enhanced ultrasonography (OC+CEUS). Methods: We retrospectively reviewed 149 patients with histologically confirmed gastric lesions (80 patients with GC and 69 patients with GST). OC+CEUS was performed in all patients in the GC group and the GST group before surgery. The cine loops of OC+CEUS of all cases were analyzed. The perfusion parameters including arrival time (AT), time to peak (TTP), basal intensity (BI), and peak intensity (PI) were obtained via a program designed for autotracking contrast quantification (ACQ). The between-group differences in these parameters were compared. Results: According to time-intensity curve (TIC) analysis, high-risk GST had higher PI than low-risk GST (P < 0.05). GC had faster AT and higher PI than normal gastric wall (P < 0.05); GST had higher PI than normal gastric wall (P < 0.05). Furthermore, the GC group had faster AT and higher PI than the GST group (P < 0.05). In contrast, the difference in BI and peak time (TTP) between the groups was not significant (P > 0.05). Conclusion: AT and PI differ significantly between the GC group and the GST group. As a new method, OC+CEUS has value for the differential diagnosis of GC and GST.
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Affiliation(s)
- Xiaohua Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hongju Kou
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huiliao He
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mingdong Lu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lingling Zhou
- Department of Pathology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liang Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Tingting LMD, Xiaoyan LMD, Man LMD, Ji-Bin LMD, Wenming LMD, Lixue YMD, Changjun WMD, Zhiqing CMD, Guangxia WMD, Liying MMD, Jingyu WMD, Dong XMD, Jianqiang MMD, Jin YMD, Kang WMD, Zhi DMD, Ling GMD, Lina TMD, Shengjun MMD, Yinrong CMD, Kairong LMD, Yanfang ZMD, Xingxing DMD, Xuemei HMD, Xiaoxia DMD, Yuan LMD, Lu WMD. Chinese Expert Consensus and Guidelines on Oral Contrast Gastric Ultrasonography for Scanning Technique and Imaging Acquisition. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.200061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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