Pilot study on confocal endomicroscopy for determination of the depth of squamous cell esophageal cancer in vivo

Youichi Iguchi, Yasumasa Niwa, Ryoji Miyahara, Masanao Nakamura, Kakunori Banno, Toshihiko Nagaya, Tetsuro Nagasaka, Osamu Watanabe, Takafumi Ando, Hiroki Kawashima, Naoki Omiya, Akihiro Itoh, Yoshiki Hirooka, Hidemi Goto

Research output: Contribution to journalArticle

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Abstract

Background and Aim: Confocal endomicroscopy is ultra-high-magnification endoscopy with histological observation during ongoing endoscopy. We planned a pilot study of the diagnosis of the depth of esophageal cancer using confocal endomicroscopy for treatment strategies. Methods: Patients had 14 superficial esophageal cancers and one dysplasia. The depth of neoplasms in 15 lesions was confirmed by endoscopic mucosal resection or surgery. We examined the rate of delineation and compared results of confocal imaging with histological findings. We classified two cellular and three microvascular patterns on confocal endomicroscopic images: CP-N for normal squamous mucosa and CP-Ca for cancerous lesion; VP-type A for normal squamous mucosa; VP-type B for T1a-EP and T1a-LPM cancers; and VP-type C for T1a-MM or a more invasive cancer pattern. We measured diameters of microvessels for the three patterns of confocal endomicroscopic images and histological specimens. Results: The rate of delineation was 73.3% (11/15) for esophageal cancer. The results of confocal imaging coincided well with microvessel distribution on horizontal histology. Two endoscopists blindly diagnosed the two types by cellular pattern and the three types by vascular pattern: their overall accuracies were 96% and 89% for the cellular pattern and 85% and 85% for the vascular pattern, respectively. The k value of the cellular pattern and the vascular pattern diagnosis was 0.84 and 0.75, respectively. Conclusion: Scoring and quantification of confocal endomicroscopic images may be useful for the differential diagnosis and diagnosis of superficial invasion by squamous cell carcinoma.

Original languageEnglish
Pages (from-to)1733-1739
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume24
Issue number11
DOIs
Publication statusPublished - 01-01-2009
Externally publishedYes

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Squamous Cell Neoplasms
Esophageal Neoplasms
Blood Vessels
Microvessels
Endoscopy
Mucous Membrane
Neoplasms
Squamous Cell Carcinoma
Histology
Differential Diagnosis
Observation
Therapeutics

All Science Journal Classification (ASJC) codes

  • Gastroenterology
  • Hepatology

Cite this

Iguchi, Youichi ; Niwa, Yasumasa ; Miyahara, Ryoji ; Nakamura, Masanao ; Banno, Kakunori ; Nagaya, Toshihiko ; Nagasaka, Tetsuro ; Watanabe, Osamu ; Ando, Takafumi ; Kawashima, Hiroki ; Omiya, Naoki ; Itoh, Akihiro ; Hirooka, Yoshiki ; Goto, Hidemi. / Pilot study on confocal endomicroscopy for determination of the depth of squamous cell esophageal cancer in vivo. In: Journal of Gastroenterology and Hepatology (Australia). 2009 ; Vol. 24, No. 11. pp. 1733-1739.
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abstract = "Background and Aim: Confocal endomicroscopy is ultra-high-magnification endoscopy with histological observation during ongoing endoscopy. We planned a pilot study of the diagnosis of the depth of esophageal cancer using confocal endomicroscopy for treatment strategies. Methods: Patients had 14 superficial esophageal cancers and one dysplasia. The depth of neoplasms in 15 lesions was confirmed by endoscopic mucosal resection or surgery. We examined the rate of delineation and compared results of confocal imaging with histological findings. We classified two cellular and three microvascular patterns on confocal endomicroscopic images: CP-N for normal squamous mucosa and CP-Ca for cancerous lesion; VP-type A for normal squamous mucosa; VP-type B for T1a-EP and T1a-LPM cancers; and VP-type C for T1a-MM or a more invasive cancer pattern. We measured diameters of microvessels for the three patterns of confocal endomicroscopic images and histological specimens. Results: The rate of delineation was 73.3{\%} (11/15) for esophageal cancer. The results of confocal imaging coincided well with microvessel distribution on horizontal histology. Two endoscopists blindly diagnosed the two types by cellular pattern and the three types by vascular pattern: their overall accuracies were 96{\%} and 89{\%} for the cellular pattern and 85{\%} and 85{\%} for the vascular pattern, respectively. The k value of the cellular pattern and the vascular pattern diagnosis was 0.84 and 0.75, respectively. Conclusion: Scoring and quantification of confocal endomicroscopic images may be useful for the differential diagnosis and diagnosis of superficial invasion by squamous cell carcinoma.",
author = "Youichi Iguchi and Yasumasa Niwa and Ryoji Miyahara and Masanao Nakamura and Kakunori Banno and Toshihiko Nagaya and Tetsuro Nagasaka and Osamu Watanabe and Takafumi Ando and Hiroki Kawashima and Naoki Omiya and Akihiro Itoh and Yoshiki Hirooka and Hidemi Goto",
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Iguchi, Y, Niwa, Y, Miyahara, R, Nakamura, M, Banno, K, Nagaya, T, Nagasaka, T, Watanabe, O, Ando, T, Kawashima, H, Omiya, N, Itoh, A, Hirooka, Y & Goto, H 2009, 'Pilot study on confocal endomicroscopy for determination of the depth of squamous cell esophageal cancer in vivo', Journal of Gastroenterology and Hepatology (Australia), vol. 24, no. 11, pp. 1733-1739. https://doi.org/10.1111/j.1440-1746.2009.05892.x

Pilot study on confocal endomicroscopy for determination of the depth of squamous cell esophageal cancer in vivo. / Iguchi, Youichi; Niwa, Yasumasa; Miyahara, Ryoji; Nakamura, Masanao; Banno, Kakunori; Nagaya, Toshihiko; Nagasaka, Tetsuro; Watanabe, Osamu; Ando, Takafumi; Kawashima, Hiroki; Omiya, Naoki; Itoh, Akihiro; Hirooka, Yoshiki; Goto, Hidemi.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 24, No. 11, 01.01.2009, p. 1733-1739.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pilot study on confocal endomicroscopy for determination of the depth of squamous cell esophageal cancer in vivo

AU - Iguchi, Youichi

AU - Niwa, Yasumasa

AU - Miyahara, Ryoji

AU - Nakamura, Masanao

AU - Banno, Kakunori

AU - Nagaya, Toshihiko

AU - Nagasaka, Tetsuro

AU - Watanabe, Osamu

AU - Ando, Takafumi

AU - Kawashima, Hiroki

AU - Omiya, Naoki

AU - Itoh, Akihiro

AU - Hirooka, Yoshiki

AU - Goto, Hidemi

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Background and Aim: Confocal endomicroscopy is ultra-high-magnification endoscopy with histological observation during ongoing endoscopy. We planned a pilot study of the diagnosis of the depth of esophageal cancer using confocal endomicroscopy for treatment strategies. Methods: Patients had 14 superficial esophageal cancers and one dysplasia. The depth of neoplasms in 15 lesions was confirmed by endoscopic mucosal resection or surgery. We examined the rate of delineation and compared results of confocal imaging with histological findings. We classified two cellular and three microvascular patterns on confocal endomicroscopic images: CP-N for normal squamous mucosa and CP-Ca for cancerous lesion; VP-type A for normal squamous mucosa; VP-type B for T1a-EP and T1a-LPM cancers; and VP-type C for T1a-MM or a more invasive cancer pattern. We measured diameters of microvessels for the three patterns of confocal endomicroscopic images and histological specimens. Results: The rate of delineation was 73.3% (11/15) for esophageal cancer. The results of confocal imaging coincided well with microvessel distribution on horizontal histology. Two endoscopists blindly diagnosed the two types by cellular pattern and the three types by vascular pattern: their overall accuracies were 96% and 89% for the cellular pattern and 85% and 85% for the vascular pattern, respectively. The k value of the cellular pattern and the vascular pattern diagnosis was 0.84 and 0.75, respectively. Conclusion: Scoring and quantification of confocal endomicroscopic images may be useful for the differential diagnosis and diagnosis of superficial invasion by squamous cell carcinoma.

AB - Background and Aim: Confocal endomicroscopy is ultra-high-magnification endoscopy with histological observation during ongoing endoscopy. We planned a pilot study of the diagnosis of the depth of esophageal cancer using confocal endomicroscopy for treatment strategies. Methods: Patients had 14 superficial esophageal cancers and one dysplasia. The depth of neoplasms in 15 lesions was confirmed by endoscopic mucosal resection or surgery. We examined the rate of delineation and compared results of confocal imaging with histological findings. We classified two cellular and three microvascular patterns on confocal endomicroscopic images: CP-N for normal squamous mucosa and CP-Ca for cancerous lesion; VP-type A for normal squamous mucosa; VP-type B for T1a-EP and T1a-LPM cancers; and VP-type C for T1a-MM or a more invasive cancer pattern. We measured diameters of microvessels for the three patterns of confocal endomicroscopic images and histological specimens. Results: The rate of delineation was 73.3% (11/15) for esophageal cancer. The results of confocal imaging coincided well with microvessel distribution on horizontal histology. Two endoscopists blindly diagnosed the two types by cellular pattern and the three types by vascular pattern: their overall accuracies were 96% and 89% for the cellular pattern and 85% and 85% for the vascular pattern, respectively. The k value of the cellular pattern and the vascular pattern diagnosis was 0.84 and 0.75, respectively. Conclusion: Scoring and quantification of confocal endomicroscopic images may be useful for the differential diagnosis and diagnosis of superficial invasion by squamous cell carcinoma.

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DO - 10.1111/j.1440-1746.2009.05892.x

M3 - Article

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SP - 1733

EP - 1739

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

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