Autofluorescence imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia: A phase II study

Ryu Ishihara, Takuya Inoue, Noboru Hanaoka, Yoji Takeuchi, Yoshiki Tsujii, Hiromitsu Kanzaki, Takashi Oota, Masao Hanafusa, Sachiko Yamamoto, Kengo Nagai, Fumi Matsui, Natsuko Kawada, Koji Higashino, Noriya Uedo, Hiroyasu Iishi

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and Aim: Few prospective studies examining the efficacy of autofluorescence imaging (AFI) screening for esophageal cancer have been reported. This study aimed to investigate the diagnostic value of AFI endoscopy for the screening of squamous mucosal high-grade neoplasia of the esophagus, performed by experienced and less-experienced endoscopists. Methods: Patients with a history of esophageal neoplasia or head and neck cancer underwent AFI endoscopic screening, followed by chromoendoscopy using iodine staining as the reference standard. The primary outcome was the sensitivity of AFI for detecting new squamous mucosal high-grade neoplasias. The secondary outcome was the positive predictive value (PPV) of AFI. Results: Of a total 364 patients who underwent endoscopic examination, 43 new mucosal high-grade neoplasias were detected. The sensitivities of AFI in the experienced and less-experienced endoscopist groups were 71% (95% confidence interval [CI]: 55-87%) and 50% (95% CI: 32-68%), respectively. The PPV of AFI in the experienced and the less-experienced endoscopist groups were 25% (95% CI: 16-34%) and 26% (95% CI: 15-37%), respectively. The sensitivity of AFI in lesions ≤10mm (31%, 5/16 lesions) was significantly lower than that in lesions >10mm (78%, 21/27 lesions) (P=0.003). Conclusions: The sensitivity of AFI for the detection of new squamous mucosal high-grade neoplasias, and its PPV, were both low. Based on these results, a randomized study to compare AFI with standard techniques is not justified.

Original languageEnglish
Pages (from-to)86-90
Number of pages5
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume27
Issue number1
DOIs
Publication statusPublished - 2012
Externally publishedYes

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Optical Imaging
Endoscopy
Neoplasms
Confidence Intervals
Esophageal Neoplasms
Head and Neck Neoplasms
Iodine
Esophagus
Prospective Studies
Staining and Labeling

Keywords

  • Autofluorescence imaging endoscopy
  • Carcinoma
  • Endoscopy
  • Esophageal cancer
  • Squamous cell

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Autofluorescence imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia : A phase II study. / Ishihara, Ryu; Inoue, Takuya; Hanaoka, Noboru; Takeuchi, Yoji; Tsujii, Yoshiki; Kanzaki, Hiromitsu; Oota, Takashi; Hanafusa, Masao; Yamamoto, Sachiko; Nagai, Kengo; Matsui, Fumi; Kawada, Natsuko; Higashino, Koji; Uedo, Noriya; Iishi, Hiroyasu.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 27, No. 1, 2012, p. 86-90.

Research output: Contribution to journalArticle

Ishihara, R, Inoue, T, Hanaoka, N, Takeuchi, Y, Tsujii, Y, Kanzaki, H, Oota, T, Hanafusa, M, Yamamoto, S, Nagai, K, Matsui, F, Kawada, N, Higashino, K, Uedo, N & Iishi, H 2012, 'Autofluorescence imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia: A phase II study', Journal of Gastroenterology and Hepatology (Australia), vol. 27, no. 1, pp. 86-90. https://doi.org/10.1111/j.1440-1746.2011.06850.x
Ishihara, Ryu ; Inoue, Takuya ; Hanaoka, Noboru ; Takeuchi, Yoji ; Tsujii, Yoshiki ; Kanzaki, Hiromitsu ; Oota, Takashi ; Hanafusa, Masao ; Yamamoto, Sachiko ; Nagai, Kengo ; Matsui, Fumi ; Kawada, Natsuko ; Higashino, Koji ; Uedo, Noriya ; Iishi, Hiroyasu. / Autofluorescence imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia : A phase II study. In: Journal of Gastroenterology and Hepatology (Australia). 2012 ; Vol. 27, No. 1. pp. 86-90.
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abstract = "Background and Aim: Few prospective studies examining the efficacy of autofluorescence imaging (AFI) screening for esophageal cancer have been reported. This study aimed to investigate the diagnostic value of AFI endoscopy for the screening of squamous mucosal high-grade neoplasia of the esophagus, performed by experienced and less-experienced endoscopists. Methods: Patients with a history of esophageal neoplasia or head and neck cancer underwent AFI endoscopic screening, followed by chromoendoscopy using iodine staining as the reference standard. The primary outcome was the sensitivity of AFI for detecting new squamous mucosal high-grade neoplasias. The secondary outcome was the positive predictive value (PPV) of AFI. Results: Of a total 364 patients who underwent endoscopic examination, 43 new mucosal high-grade neoplasias were detected. The sensitivities of AFI in the experienced and less-experienced endoscopist groups were 71{\%} (95{\%} confidence interval [CI]: 55-87{\%}) and 50{\%} (95{\%} CI: 32-68{\%}), respectively. The PPV of AFI in the experienced and the less-experienced endoscopist groups were 25{\%} (95{\%} CI: 16-34{\%}) and 26{\%} (95{\%} CI: 15-37{\%}), respectively. The sensitivity of AFI in lesions ≤10mm (31{\%}, 5/16 lesions) was significantly lower than that in lesions >10mm (78{\%}, 21/27 lesions) (P=0.003). Conclusions: The sensitivity of AFI for the detection of new squamous mucosal high-grade neoplasias, and its PPV, were both low. Based on these results, a randomized study to compare AFI with standard techniques is not justified.",
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T1 - Autofluorescence imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia

T2 - A phase II study

AU - Ishihara, Ryu

AU - Inoue, Takuya

AU - Hanaoka, Noboru

AU - Takeuchi, Yoji

AU - Tsujii, Yoshiki

AU - Kanzaki, Hiromitsu

AU - Oota, Takashi

AU - Hanafusa, Masao

AU - Yamamoto, Sachiko

AU - Nagai, Kengo

AU - Matsui, Fumi

AU - Kawada, Natsuko

AU - Higashino, Koji

AU - Uedo, Noriya

AU - Iishi, Hiroyasu

PY - 2012

Y1 - 2012

N2 - Background and Aim: Few prospective studies examining the efficacy of autofluorescence imaging (AFI) screening for esophageal cancer have been reported. This study aimed to investigate the diagnostic value of AFI endoscopy for the screening of squamous mucosal high-grade neoplasia of the esophagus, performed by experienced and less-experienced endoscopists. Methods: Patients with a history of esophageal neoplasia or head and neck cancer underwent AFI endoscopic screening, followed by chromoendoscopy using iodine staining as the reference standard. The primary outcome was the sensitivity of AFI for detecting new squamous mucosal high-grade neoplasias. The secondary outcome was the positive predictive value (PPV) of AFI. Results: Of a total 364 patients who underwent endoscopic examination, 43 new mucosal high-grade neoplasias were detected. The sensitivities of AFI in the experienced and less-experienced endoscopist groups were 71% (95% confidence interval [CI]: 55-87%) and 50% (95% CI: 32-68%), respectively. The PPV of AFI in the experienced and the less-experienced endoscopist groups were 25% (95% CI: 16-34%) and 26% (95% CI: 15-37%), respectively. The sensitivity of AFI in lesions ≤10mm (31%, 5/16 lesions) was significantly lower than that in lesions >10mm (78%, 21/27 lesions) (P=0.003). Conclusions: The sensitivity of AFI for the detection of new squamous mucosal high-grade neoplasias, and its PPV, were both low. Based on these results, a randomized study to compare AFI with standard techniques is not justified.

AB - Background and Aim: Few prospective studies examining the efficacy of autofluorescence imaging (AFI) screening for esophageal cancer have been reported. This study aimed to investigate the diagnostic value of AFI endoscopy for the screening of squamous mucosal high-grade neoplasia of the esophagus, performed by experienced and less-experienced endoscopists. Methods: Patients with a history of esophageal neoplasia or head and neck cancer underwent AFI endoscopic screening, followed by chromoendoscopy using iodine staining as the reference standard. The primary outcome was the sensitivity of AFI for detecting new squamous mucosal high-grade neoplasias. The secondary outcome was the positive predictive value (PPV) of AFI. Results: Of a total 364 patients who underwent endoscopic examination, 43 new mucosal high-grade neoplasias were detected. The sensitivities of AFI in the experienced and less-experienced endoscopist groups were 71% (95% confidence interval [CI]: 55-87%) and 50% (95% CI: 32-68%), respectively. The PPV of AFI in the experienced and the less-experienced endoscopist groups were 25% (95% CI: 16-34%) and 26% (95% CI: 15-37%), respectively. The sensitivity of AFI in lesions ≤10mm (31%, 5/16 lesions) was significantly lower than that in lesions >10mm (78%, 21/27 lesions) (P=0.003). Conclusions: The sensitivity of AFI for the detection of new squamous mucosal high-grade neoplasias, and its PPV, were both low. Based on these results, a randomized study to compare AFI with standard techniques is not justified.

KW - Autofluorescence imaging endoscopy

KW - Carcinoma

KW - Endoscopy

KW - Esophageal cancer

KW - Squamous cell

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