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Le Fur M, Zhou IY, Catalano O, Caravan P. Toward Molecular Imaging of Intestinal Pathology. Inflamm Bowel Dis 2020; 26:1470-1484. [PMID: 32793946 PMCID: PMC7500524 DOI: 10.1093/ibd/izaa213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Indexed: 12/13/2022]
Abstract
Inflammatory bowel disease (IBD) is defined by a chronic relapsing and remitting inflammation of the gastrointestinal tract, with intestinal fibrosis being a major complication. The etiology of IBD remains unknown, but it is thought to arise from a dysregulated and excessive immune response to gut luminal microbes triggered by genetic and environmental factors. To date, IBD has no cure, and treatments are currently directed at relieving symptoms and treating inflammation. The current diagnostic of IBD relies on endoscopy, which is invasive and does not provide information on the presence of extraluminal complications and molecular aspect of the disease. Cross-sectional imaging modalities such as computed tomography enterography (CTE), magnetic resonance enterography (MRE), positron emission tomography (PET), single photon emission computed tomography (SPECT), and hybrid modalities have demonstrated high accuracy for the diagnosis of IBD and can provide both functional and morphological information when combined with the use of molecular imaging probes. This review presents the state-of-the-art imaging techniques and molecular imaging approaches in the field of IBD and points out future directions that could help improve our understanding of IBD pathological processes, along with the development of efficient treatments.
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Affiliation(s)
- Mariane Le Fur
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, The Institute for Innovation in Imaging, Massachusetts General Hospital and Harvard Medical School, MA, USA
| | - Iris Y Zhou
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, The Institute for Innovation in Imaging, Massachusetts General Hospital and Harvard Medical School, MA, USA
| | - Onofrio Catalano
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, The Institute for Innovation in Imaging, Massachusetts General Hospital and Harvard Medical School, MA, USA,The Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, MA, USA
| | - Peter Caravan
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, The Institute for Innovation in Imaging, Massachusetts General Hospital and Harvard Medical School, MA, USA,Address correspondence to: Peter Caravan, PhD, The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, The Institute for Innovation in Imaging, Massachusetts General Hospital and Harvard Medical School, 149 Thirteenth Street, Charlestown 02129, MA, USA. E-mail:
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Ding YE, Li Y, He XK, Sun LM. Impact of Barrett's esophagus surveillance on the prognosis of esophageal adenocarcinoma: A meta-analysis. J Dig Dis 2018; 19:737-744. [PMID: 30375167 DOI: 10.1111/1751-2980.12682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/21/2018] [Accepted: 10/26/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Whether endoscopic surveillance would improve the outcomes of esophageal adenocarcinoma in patients previously diagnosed with Barrett's esophagus remains unclear. This meta-analysis aimed to assess the survival advantages of endoscopic surveillance for patients with Barrett's esophagus. METHODS Databases including PubMed, the Web of Science, and the Cochrane Library were examined systematically from their inception to July 2017, for articles related to the survival outcomes of esophageal adenocarcinoma in patients with Barrett's esophagus under endoscopic surveillance. Adjusted hazard estimates were adopted to determine overall results with 95% confidence intervals (CIs), using the fixed-effect model. We conducted subgroup and sensitivity analyses using the "metan" command in Stata software to assess the stability of the overall results. Begg's test, Egger's test and the funnel plot were used to evaluate the presence of publication bias. RESULTS A total of eight studies (two case-control and six cohort studies) were finally included in our current study. Compared with patients with esophageal adenocarcinoma that was not detected by surveillance, a significant 29% reduction in mortality from esophageal adenocarcinoma was observed among patients under endoscopic surveillance (adjusted hazard ratio [HR] 0.71, 95% CI 0.66-0.77). This effect was presented in both the USA (adjusted HR 0.71, 95% CI 0.65-0.78) and Europe (adjusted HR 0.71, 95% CI 0.60-0.83). We found no evidence of publication bias. CONCLUSIONS Our meta-analysis supports the concept that endoscopic surveillance for patients with Barrett's esophagus could improve the prognosis of esophageal adenocarcinoma. More well-designed prospective studies are needed to confirm this association.
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Affiliation(s)
- Yu E Ding
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University Medical School, Hangzhou, Zhejiang Province, China.,Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yue Li
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University Medical School, Hangzhou, Zhejiang Province, China.,Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xing Kang He
- Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Lei Min Sun
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University Medical School, Hangzhou, Zhejiang Province, China.,Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China
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Abstract
Gastrointestinal (GI) tumors are the most commonly diagnosed cancers worldwide and the second leading cause of cancer-related death. Endoscopy is the gold standard for diagnosis of GI cancers. Early diagnosis of GI tumors by endoscopy at the precancerous or early stage may decrease the prevalence and mortality rate of GI cancers. The preventive role of endoscopic interventions and the limitations of conventional white-light endoscopy have given rise to myriad innovations. Chromoendoscopy with dye injection can be used to detect lesions at an early stage. However, the prolonged procedure duration and steep learning curve are disadvantages of chromoendoscopy. Recent technological advances in imaging enhancement have enabled detection of GI lesions without the need for dye injection, using digital chromoendoscopy systems, of which flexible spectral-imaging color enhancement, narrow-band imaging, and I-Scan are the most frequently used. The combination of endoscopic image magnification and high-definition optical systems using digital endoscopic methods has increased the diagnostic value of endoscopy. The development of confocal laser endomicroscopy has also improved in vivo endoscopic diagnosis. This review focuses on the latest technological innovations in endoscopy.
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Affiliation(s)
- Murat Akarsu
- Department of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Cevher Akarsu
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istabbul, Turkey
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The Role of Chromoendoscopy and Enhanced Imaging Techniques in Inflammatory Bowel Disease Colorectal Cancer Colonoscopy Surveillance. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/978-3-319-62993-3_25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Skay A, Van Dam J. Advanced endoscopic imaging: Polyps and dysplasia detection. SEMINARS IN COLON AND RECTAL SURGERY 2017. [DOI: 10.1053/j.scrs.2016.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Akarsu C, Sahbaz NA, Dural AC, Unsal MG, Kones O, Kocatas A, Halicioglu I, Alis H. FICE vs Narrow Band Imaging for In Vivo Histologic Diagnosis of Polyps. JSLS 2016; 20:e2016.00084. [PMID: 28028382 PMCID: PMC5183649 DOI: 10.4293/jsls.2016.00084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Gastrointestinal cancers are the most frequently occurring cancers worldwide. Diagnosis and removal of polyps during screening endoscopy decreases the prevalence of colon cancer and cancer-related mortality, and it is considered to be the gold standard in gastrointestinal system cancer prevention. Technological innovations in endoscopy have led to revolutionary developments in many areas. Flexible spectral imaging color enhancement (FICE) and narrow-band imaging (NBI) are forms of digital chromoendoscopy and enhance the endoscopic images without the need for a dye. This study seeks to evaluate the efficacy of FICE and NBI on polyp screening and real-time histologic diagnosis with endoscopy and to compare them. METHODS A total of 134 patients (male/female = 72/62) and 161 polyps were evaluated with FICE or NBI, and real-time histologic diagnosis predictions were classified as neoplastic or nonneoplastic, according to Kudo's pit pattern classification. Pathological results and real-time endoscopic diagnoses were statistically interpreted for both FICE and NBI. Positive predictive value, negative predictive value, sensitivity, specificity, and accuracy rates were calculated and compared for both modalities. RESULTS When both systems were compared, the negative predictive value of NBI was found to be higher than that of FICE statistically (P < .001). Specificity and positive predictive value in the FICE group were higher than in the NBI group, but the difference was not statistically significant (P = .082 and P = .153, respectively). CONCLUSIONS Aside from being safe in polyp detection, digital chromoendoscopy also helps the endoscopist in selecting the type of simultaneous intervention (eg, polypectomy, endomucosal resection, or submucosal dissection) by enabling endoscopic histologic diagnosis.
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Affiliation(s)
- Cevher Akarsu
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nuri Alper Sahbaz
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Cem Dural
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Gokhan Unsal
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Osman Kones
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ali Kocatas
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ilkay Halicioglu
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Halil Alis
- General Surgery Department, University of Medical Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Rameshshanker R, Wilson A. Electronic Imaging in Colonoscopy: Clinical Applications and Future Prospects. ACTA ACUST UNITED AC 2016; 14:140-51. [PMID: 26923476 PMCID: PMC4783450 DOI: 10.1007/s11938-016-0075-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Electronic chromoendoscopy (EC) is an equipment-based technology which could be easily activated by push of a button. There are four EC techniques available for use at present: narrow band imaging (NBI), i-Scan, flexible spectral chromoendoscopy and blue laser imaging. Out of the four techniques, NBI has been extensively evaluated for the detection and characterization of dysplasia in colonic polyps and dysplasia associated with inflammatory bowel disease. In this review, we will focus on the new developments and applications of EC.
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Affiliation(s)
- R Rameshshanker
- Imperial College London, Wolfson Endoscopy Unit, St Mark's Hospital, Watford Road, Harrow, HA1 3UJ, UK.
| | - Ana Wilson
- Imperial College London, Wolfson Endoscopy Unit, St Mark's Hospital, Watford Road, Harrow, HA1 3UJ, UK.
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Benedict M, Neto AG, Zhang X. Interval colorectal carcinoma: An unsolved debate. World J Gastroenterol 2015; 21:12735-12741. [PMID: 26668498 PMCID: PMC4671029 DOI: 10.3748/wjg.v21.i45.12735] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/16/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
Colorectal carcinoma (CRC), as the third most common new cancer diagnosis, poses a significant health risk to the population. Interval CRCs are those that appear after a negative screening test or examination. The development of interval CRCs has been shown to be multifactorial: location of exam-academic institution versus community hospital, experience of the endoscopist, quality of the procedure, age of the patient, flat versus polypoid neoplasia, genetics, hereditary gastrointestinal neoplasia, and most significantly missed or incompletely excised lesions. The rate of interval CRCs has decreased in the last decade, which has been ascribed to an increased understanding of interval disease and technological advances in the screening of high risk individuals. In this article, we aim to review the literature with regard to the multifactorial nature of interval CRCs and provide the most recent developments regarding this important gastrointestinal entity.
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