Efficacy of a High-Frequency Ultrasound Probe for Determining the Therapeutic Strategy for Laterally Spreading Tumors Kentaro Moriichi 1 , Yusuke Saitoh 2 , Jiro Watari 1 , Mikihiro Fujiya 1 1Third Department of Internal Medicine, Asahikawa Medical College 2Center of Gastroenterology, Asahikawa City Hospital Keyword: 超音波内視鏡 , 高周波細径プローブ , 深達度診断 , 側方発育型大腸腫瘍 , LST pp.1770-1780
Published Date 2005/12/25
DOI https://doi.org/10.11477/mf.1403100180
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 We retrospectively studied the diagnostic accuracy of the high-frequency ultrasound probe (HFUP) for invasion depth of colorectal laterally spreading tumors (LSTs), used in 117 such tumors. The macroscopic type was classified into 4 types ; homogeneous type, nodular mixed type, flat elevated type and pseudo-depressed type. The diagnostic accuracy is higher in LSTs measured less than 30mm in diameter than in those measured more than 30mm in size. The diagnostic accuracy rate for the homogeneous type was highest among the four types. When investigating the accuracy rate of diagnosis of LSTs by the combination of tumor size and the macroscopic types, HFUP diagnosed 100% in the homogeneous type, 90.9% in the nodular mixed type less than 30mm in size, 88.9% in the pseudo-depressed type less than 20mm in size and 81.8% in the flat elevated type. The mean tumor size which was incorrectly diagnosed was significantly larger than that of correctly diagnosed cases. Incorrect diagnosis by HFUP was found in 27 cases (23.1%), mainly caused by insufficient visualization, when the lesions existed on the colonic folds in 10 cases, ultrasound attenuation in 7 cases, and fibrosis in the submucosal layer in 4 cases. These results suggest that diagnostic accuracy of HFUP in LST depends on both tumor size and macroscopic type. Although HFUP is a useful modality for invasion depth diagnosis of LSTs, insufficient visualization and ultrasound attenuation remain problems to be resolved.

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