Endoscopic Ultrasonography, an Accurate Imaging Technique for the Diagnosis of Early Colorectal Cancer Kiyonori Kobayashi 1 , Mitsuhiro Kida 1 , Miyuki Mukae 1 , Hitomi Fukushima 1 , Kaoru Yokoyama 1 , Miwa Sada 1 , Wasaburo Koizumi 1 1Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan Keyword: 早期大腸癌 , 超音波内視鏡 , 3次元超音波内視鏡 , 深達度診断 , 治療方針 pp.811-821
Published Date 2010/4/30
DOI https://doi.org/10.11477/mf.1403101937
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 EUS(endoscopic ultrasonography), an accurate imaging technique for the diagnosis of early colorectal cancer, can provide vertical cross-sectional images and allows the depth of tumor invasion to be objectively evaluated. Among early colorectal cancers, endoscopic resection is indicated for the treatment of cancers confined to the mucosa(pM)or slightly invading the submucosa(pSM)on histopathological examination. However, colorectal cancer with massive invasion in the submucosa(pSM-massive)requires surgery with lymph-node dissection. Among 579 lesions that we studied by EUS, the rate of correct differential diagnosis was as high as 90%. In particular, when the depth of tumor invasion cannot be readily determined by conventional endoscopy, EUS should be concurrently performed. However, imaging of tumors was sometimes difficult with conventional EUS equipment, depending on location and other factors. Therefore, three-dimensional EUS has been developed, contributing not only to improved diagnostic accuracy, but also to overcoming the difficult-to-image lesions. Many problems remain in the diagnosis of early colorectal cancer by EUS. However, EUS plays an important role in assessing the depth of tumor invasion.

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