In the Manual for Abdominal Ultrasound in Cancer Screening and Health Checkups, diffuse and localized lesions of the liver are specified in detail, and bile duct lesions are also described, but vascular lesions are simply classified as hepatic vascular abnormalities (category 2, judgment category D2). Although it is unavoidable because the manual is intended for cancer screening and summarizes B-mode findings, Doppler is actually very useful for making a definitive diagnosis in diseases such as focal nodular hyperplasia and portal vein shunts, and for detecting unnoticed abnormalities such as portal vein collateral vascular pathways.

As with B-mode, Doppler is not simply a matter of pressing a button; it can only be evaluated after appropriate adjustments such as setting the region of interest and optimal sensitivity, selecting various modes, and understanding conditions that are difficult to measure (deep area or the left lobe of the liver). In addition, it is necessary to understand conditions that are difficult to measure (e.g., deep area or the lateral left lobe of the liver).

In this article, I will go one step further than the manual for screening judgment and explain the method for evaluating blood flow in vascular lesions and mass lesions of the liver. Since the information herein is intended to be used in medical examinations, it will focus on Doppler examinations.

Objective: The study aimed to delineate clinical distinctions between fatty liver disease and suspected chronic liver disease, as classified based on the 2021 updated edition of the Manual for Abdominal Ultrasound in Cancer Screenings and Health Checkups, and to devise a management approach for the early detection of liver neoplasia.

Methods: We enrolled 1,187 patients with fatty liver who had been diagnosed using the previous version of the Manual for Abdominal Ultrasound in Cancer Screenings and Health Checkups between April 2021 and March 2022. Video images of abdominal ultrasound were used to retrospectively distinguish between fatty liver (2C) and suspected chronic liver disease (3C), followed by the updated version of the manual. Serum test levels, body mass index (BMI), body fat percentage (BFP), and Fib-4 index were compared between the two groups.

Results: Out of the 1,187 patients, 1,027 were classified as 2C patients, while 159 were classified as 3C patients. The levels of serum AST, ALT, γ-GT, triglyceride, and fasting plasma glucose as well as BMI and BFP in the 3C patients were significantly higher than those in the 2C patients, while no significant difference was observed in FIB-4 index. One out of two hepatocellular carcinoma cases was classified as 2C and the elevated ALT and AST levels were observed.

Conclusion: Even if patients are initially categorized as fatty liver disease through ultrasound screening, it is crucial to perform blood tests to assess for potential liver damage.

Objective: An increased adenoma detection rate (ADR) is believed to contribute to decreased colorectal cancer mortality. We investigated the usefulness of CADEYE^TM (CAD), an artificial intelligence (AI) lesion detection support function that is expected to improve ADR, by looking at changes in ADR before and after the introduction of CAD.

Subjects and Methods: First-time total colonoscopy patients were divided into 3,207 patients in the post-CAD group (Group C) and 1,572 patients in the pre-CAD group (Group non-C), and the ADR for each group was calculated for lesions larger than 6 mm by sex and age.

Results: ADRs by male and female age (<40/40s/50s/60s/70s/80+/all ages) were 7.0%/21.2%/32.3%/32.9%/37.7%/39.5%/23.3% for males in Group C , 4.3%/20.1%/31.3%/41.0%/42.2%/40%/24.2%/42.3% for males in Group non-C, 4.9%/12.5%/16.7%/22.5%/30.9%/36.7%/17.1% for females in Group C, and 5.2%/8.4%/15.8%/18.9%/25%/30.8%/14.5% for females in Group non-C. No statistically significant differences were found.

Discussion/Conclusion: There was no significant difference in ADR before and after the introduction of CAD, but this may be due to the fact that lesions larger than 6 mm were targeted and that the lesions were observed by a skilled endoscopist in a high-volume center. As colorectal cancer screening via colonoscopy becomes more widespread in the future, AI technology is expected to be more useful in equalizing the quality of examinations.

In Japan, two statistical surveys on gastric cancer screening have been published. One survey is an annual report on gastrointestinal cancer screening (hereinafter, “annual report”) that includes population-based screening and opportunistic screening (partially covered); the other is a prefecture cancer screening assessment (hereinafter, “prefecture assessment”) of population-based screening.

Analyzing the changes in “process indicator” extracted from the annual reports (2015-2019) in the Kyushu region, the number of examinees who received cancer screening or a medical checkup, recall, and cancer detection tended to decline annually. According to the prefecture assessment in the Kyushu region, it is unlikely that “Guideline for Cancer Prevention Education and Cancer Screening (2023)” and “Cancer Screening Checklists for Prefectures (2020)” have been observed or carried out.

Increasing the proportion of examinees who undergo detailed examination should be promoted because this rate is associated with the cancer detection rate. Additionally, all data on opportunistic screening should be collected, in cooperation with institutions conducting cancer screening and medical checkups as well as municipal, prefectural, and national governments.

Tome City, Miyagi Prefecture, is located approximately 70 km north of Sendai City and has a high percentage of elderly people. It has implemented the use of fecal occult blood test (FOBT) for colorectal cancer screening at Tome Citizen Hospital, which is the only core hospital in the city. The hospital distributes stool collection kits to those who undergo the examination based on the patient registry compiled by Tome City, and the collected specimens are assessed at the hospital to determine the results. FOBT-positive patients are invited to the detailed examination sessions at a specified date, time, and location at the same time as the notification of results, while an appointment for total colonoscopy is made at the detailed examination sessions. The absentees are mailed a letter of introduction and a detailed examination report necessary for their visit to a medical institution, and they are individually advised to undergo a medical examination. The number of FOBT-positive patients in FY2021 was 784, with a positive rate of 5.3%, whereas the number of those who underwent the detailed examination was 666, indicating a participation rate of 84.9%. Moreover, the number of attendees at the detailed examination sessions was 551, with an attendance rate of 70.3%, whereas the participation rate of the detailed examination was 96.7%. Conversely, the participation rate of the attendees was significantly higher (p < 0.01) than that of the absentees (57.1%). In general, these findings revealed that implementing detailed examination sessions may improve its participation rate.