Linear-array EUS improves the accuracy of predicting deep submucosal invasion in non-pedunculated rectal polyps compared with radial EUS: a prospective observational study
- 1 April 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 35 (4), 1734-1740
- https://doi.org/10.1007/s00464-020-07566-9
Abstract
Background Radial endoscopic ultrasound (EUS) is typically used to estimate the depth of rectal polyp invasion, however, there are no data on linear EUS in this setting and its relative accuracy compared to radial EUS. Methods In this prospective cohort study, 89 patients with non-pedunculated rectal polyp who underwent linear EUS or radial EUS were prospectively enrolled. The invasion depth was measured for each polyp and categorized as mucosal to shallow submucosal(SMs) or deep submucosal(SMd) invasion. Invasion measurements were compared with the final diagnosis on histopathology. Results A total of 58 patients underwent radial EUS and 31 patients underwent linear EUS examination. There were 38 lesions correctly diagnosed in the radial EUS group and 29 correctly diagnosed lesions in the linear EUS group. The diagnostic accuracy of SMd invasion for linear EUS was significantly higher than radial EUS (0.936 vs. 0.655, p = 0.003). A significant difference was also noted for specificity between the two groups (0.963 vs. 0.659, p = 0.003). Univariate analysis showed radial EUS type (OR 0.131, 95% CI 0.028-0.606, p = 0.009) to be an independent predictor for incorrect diagnosis. The area under the receiver operating curve (ROC) was 0.856 and 0.651 for linear EUS and radial EUS, respectively. It was noted that four patients underwent unnecessary surgery for radial EUS while there were no such patients in the linear EUS group. Conclusions Linear EUS was more accurate for determining SMd invasion and contributed to the selection of appropriate treatment modalities in patients with non-pedunculated rectal polyp.Keywords
This publication has 19 references indexed in Scilit:
- British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polypsGut, 2015
- Linear-array EUS improves detection of pancreatic lesions in high-risk individuals: a randomized tandem studyGastrointestinal Endoscopy, 2015
- Diagnostic performance of EUS for evaluating the invasion depth of early colorectal cancersGastrointestinal Endoscopy, 2015
- Prospective, randomized, comparative study of delineation capability of radial scanning and curved linear array endoscopic ultrasound for the pancreaticobiliary regionEndoscopy International Open, 2014
- Magnifying Chromoendoscopy and Endoscopic Ultrasonography Measure Invasion Depth of Early Stage Colorectal Cancer With Equal Accuracy on the Basis of a Prospective TrialClinical Gastroenterology and Hepatology, 2013
- Comparison of Diagnostic Accuracies of Various Endoscopic Examination Techniques for Evaluating the Invasion Depth of Colorectal TumorsGastroenterology Research and Practice, 2012
- Staging of Early Colorectal Cancers: Magnifying Colonoscopy versus Endoscopic Ultrasonography for Estimation of Depth of InvasionDigestive Diseases and Sciences, 2007
- High magnification chromoscopic colonoscopy or high frequency 20 MHz mini probe endoscopic ultrasound staging for early colorectal neoplasia: a comparative prospective analysisGut, 2005
- Comparison of EUS and magnifying colonoscopy for assessment of small colorectal cancersGastrointestinal Endoscopy, 2002
- Comparison of EUS and magnifying colonoscopy for assessment of small colorectal cancersPublished by Elsevier BV ,2002