Abdominal ultrasonography is a noninvasive examination and is regarded as the first choice for gallbladder diseases. In order to obtain clear ultrasound images of the gallbladder, it is necessary to understand the its anatomy and surrounding organs to recognize artifacts, to adjust the ultrasound equipment to appropriate settings, and to know what to do if clear images are difficult to obtain. In order to make an accurate diagnosis, it is also necessary to be familiar with the ultrasonographic findings of typical gallbladder diseases. The key points in the diagnosis of gallbladder diseases will be discussed: abnormal morphology of the gallbladder, abnormal size, wall thickening, point hyperechogenicity and strong echogenicity, and elevated lesions or masses.
Objective: This study aimed to identify the quality indicators of examination associated with the detection of gastric cancer after Helicobacter pylori (H. pylori) eradication.
Subjects and Methods: A total of 22,978 screening endoscopies were performed between July 2020 and January 2022. We randomly selected endoscopic images from 25 uninfected and 25 eradicated cases examined by nine endoscopists who detected gastric cancer after H. pylori eradication and seven endoscopists who did not detect any during the study period. The former group was defined as the detection group (225 uninfected and 225 eradicated cases), and the latter as the non-detection group (175 uninfected and 175 eradicated cases). Cases with post-surgical stomach, chromoendoscopy, and biopsies were excluded. We evaluated the Kyoto classification of gastric cancer risk scores, intragastric observation time, upper-middle (UM) region observation time, lower (L) region observation time, narrow band imaging (NBI) usage rate in the L region, and the sites of imaging.
Results: In H. pylori-eradicated cases, the detection group had a significantly higher imaging rate of the posterior wall of the lower body. Only in the detection group were intragastric observation time, UM region observation time, L region observation time, and NBI usage rate significantly higher in eradicated cases compared to uninfected cases. In the non-detection group, intragastric observation time and UM region observation time were significantly higher in cases with a Kyoto classification gastric cancer risk score of 2 points or higher. Additionally, in the detection group, L region observation time and NBI usage rate were also significantly higher.
Conclusion: Careful observation using NBI in atrophic and intestinal metaplasia-associated regions contributes to the detection of gastric cancer after H. pylori eradication.
Objective: This study aimed to confirm the clinical and pathological characteristics of colorectal cancer cases detected by screening in Iwate Prefecture and verify their significance.
Subjects and methods: Among 1,900 colorectal cancer cases with complete records that were diagnosed based on colonoscopy (TCS) between 2011 and 2020 at this and related facilities, we investigated the number and population of early and advanced cancers regarding the following three factors: i) three background factors: medical history, gender, and age; ii) three characteristics of cancer: tumor site, diameter, and depth (early-stage cancers only). Furthermore, the number and proportion of early-stage cancers type 0-I and 0-II were investigated for the above-mentioned items.
Results: 1) The total number of cancers was the highest in both men and women aged 70 to 74 years (272 and 159 cases, respectively). 2) Advanced cancers showed statistically significant differences in all items of first time, female, elderly, right-sided colon, and tumor diameter of 21 mm or more. 3) The proportion of type 0-II showed statistically significant differences in items of elderly, right-sided colon, tumor diameter of 11 mm or more, and submucosal.
Conclusion: It is important to actively include women and elderly people aged 70 to 74 years as targets recommended for colorectal cancer screening.
Objective: We retrospectively verified the ability of artificial intelligence (AI)-assisted colonoscopy to detect colorectal tumors (adenomas and carcinomas) among Ningen dock participants and examined the usefulness of AI-assisted colonoscopy.
Subjects and Methods: The subjects were 365 first-time colonoscopy patients who underwent total colonoscopy for screening purposes between November 2021 to November 2022. They were divided into two groups: AI(+) group with AI-assisted colonoscopy and AI(-) group without AI-assisted colonoscopy. Observation time and colorectal adenoma detection rate (ADR) were recorded. The independent variables were <60 years of age and ≥60 years of age. Univariate logistic regression analysis was performed using age (≥60/<60 years), sex, AI status, and observation time as independent variables, and tumor detection as the dependent variable.
Results: Subjects were slightly more male in the AI(+) group and did not differ in mean age. ADR was 44.0% (131/298) for the AI(+) group and 37.3% (25/67) for the AI(-) group, which was not significantly different. Logistic regression analysis showed that the odds ratio for tumor detection was significantly higher in patients ≥60 years of age and with an observation time of 9 minutes or longer (odds ratio [95% confidence interval] = 2.24 [1.220-4.120], 3.98 [2.540-6.240]).
Conclusion: There was no increase in observation time with the use of AI-assisted colonoscopy. In experts, there was an additional but not significant improvement in ADR with AI-assisted colonoscopy.