Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Diagnostic Ability of High-definition Imaging Using Ultraslim Endoscopes in Early Gastric Cancer

  • Sugita, Tomomi (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine) ;
  • Suzuki, Sho (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine) ;
  • Ichijima, Ryoji (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine) ;
  • Ogura, Kanako (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine) ;
  • Kusano, Chika (Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine) ;
  • Ikehara, Hisatomo (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine) ;
  • Gotoda, Takuji (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine) ;
  • Moriyama, Mitsuhiko (Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine)
  • Received : 2021.06.02
  • Accepted : 2021.07.27
  • Published : 2021.09.30
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Abstract

Purpose: It is unclear whether high-definition (HD) imaging improves visibility and diagnostic ability in early gastric cancer (EGC) compared with standard-definition (SD) imaging. We aimed to compare the diagnostic performance and visibility scores of HD and SD ultraslim endoscopes in EGC. Materials and Methods: We used HD and SD ultraslim endoscopes to obtain 60 images with similar compositions of gastric environments. Of the 60 images, 30 showed EGC (15 images for each modality) and 30 showed no EGC (15 images for each modality). Seventeen endoscopists evaluated the presence and location of the lesions in each image. Diagnostic ability was compared between modalities. The color difference between a lesion and the surrounding mucosa (ΔE) was measured and compared between the modalities. Results: The ability of HD to detect EGC was significantly higher than that of SD (accuracy: 80.8% vs. 71.6%, P=0.017; sensitivity: 94.9% vs. 76.5%, P<0.001; positive predictive value, 76.2% vs. 55.3%, P<0.001; and negative predictive value (NPV), 94.1% vs. 73.5%, P<0.001). The ability of HD to determine the horizontal extent of EGC was significantly higher than that of SD (accuracy: 71.0% vs. 57.8%, P=0.004; sensitivity: 75.3% vs. 49.0%, P<0.001; NPV, 72.9% vs. 55.9%, P<0.001; and area under the curve: 0.891 vs. 0.631, P=0.038). The mean ΔE was significantly higher for HD than for SD (10.3 vs. 5.9, P=0.011). Conclusions: The HD ultraslim endoscope showed a higher diagnostic performance in EGC than the SD endoscope because it provided good color contrast.

Keywords

Acknowledgement

This study received technical assistance from Olympus Corporation. Olympus Corporation did not influence the data analysis and was not involved in this study.

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