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Diagnostics
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Clinical Impact of Endoscopy for the Diagnosis and Therapy of...
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Clinical Impact of Endoscopy for the Diagnosis and Therapy of Oncological Patients

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 14504

Special Issue Editors

Prof. Dr. Adrian Saftoiu

E-Mail Website
Guest Editor
Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, Universitatea de Medicina si Farmacie Craiova, Craova, Romania
Interests: gastroenterology; chronic pancreatitis; elastography; EUS; liver cirrhosis; pancreatic cancer; endoscopic retrograde cholangiopancreatography; pancreatic diseases; hepatocellular carcinoma; gastric cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Bogdan Silviu Ungureanu

E-Mail Website
Co-Guest Editor
Center for Research in Gastroenterology and Hepatology, Universitatea de Medicina si Farmacie Craiova, Craova, Romania
Interests: endoscopy; gastrointestinal diseases; endoscopic retrograde cholangiopancreatography; hepatocellular carcinoma; liver diseases and immunology; EUS; pancreas; biliary tract diseases; pancreatic cancer; surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Irina M. Cazacu

E-Mail Website
Co-Guest Editor
1. Department of Oncology, Fundeni Clinical Institute, 022328 Bucharest, Romania
2. Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: digestive oncology; cancer biomarkers; cancer screening; pancreatic cancer; clonal hematopoiesis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endoscopy is gaining an increasingly important role in the management of gastrointestinal (GI) tumors. Recent endoscopic advances have offered novel perspectives in gastrointestinal oncology, from imaging, sampling, and staging of the tumors to advanced therapeutic and enhanced imaging techniques. New uses of endoscopy also include early diagnosis and high-risk screening.

Endoscopic ultrasound (EUS) represents a valuable addition to endoscopic procedures, with a wide range of diagnostic and therapeutic applications for GI malignancies. The interventional capacity of EUS continues to progress considerably, with the advent of new imaging techniques, including elastography, contrast enhancement, image fusion, and artificial intelligence.

Confocal laser endomicroscopy (CLE) has allowed the introduction of molecular imaging, which greatly changed the pattern for detection and characterization of gastrointestinal lesions. It enables microscopic examination of the gastrointestinal mucosa with endoscopy using molecular probes. In recent years, major advancements in endoscopic instruments and specific molecular probes have been achieved, thus providing a gateway toward application of precision medicine.

The aim of this Special Issue is to acquire new evidence regarding the clinical impact of recent endoscopic techniques on patients with GI malignancies.

Prof. Dr. Adrian Saftoiu
Guest Editor
Dr. Bogdan Silviu Ungureanu
Dr. Irina M. Cazacu
Co-Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Endoscopic ultrasound (EUS)
  • Confocal laser endomicroscopy
  • Molecular imaging
  • Angiogenesis
  • Precision medicine
  • Esophageal cancer
  • Gastric cancer
  • Pancreatic cancer
  • Colorectal cancer

Published Papers (5 papers)

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Research

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7 pages, 483 KiB  
Article
Opportunistic Colonoscopy Cancer Screening Pays off in Romania—A Single-Centre Study
by Iulia Rațiu, Raluca Lupușoru, Prateek Vora, Alina Popescu, Ioan Sporea, Adrian Goldiș, Mirela Dănilă, Bogdan Miuțescu, Andreea Barbulescu, Madalina Hnatiuc, Razvan Diaconescu, Sorina Tăban, Fulger Lazar and Roxana Șirli
Diagnostics 2021, 11(12), 2393; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122393 - 19 Dec 2021
Viewed by 2176
Abstract
Colorectal cancer (CRC) is the third most diagnosed cancer in men (after prostate and lung cancers) and in women (after breast and lung cancer). It is the second cause of cancer death in men (after lung cancer) and the third one in women [...] Read more.
Colorectal cancer (CRC) is the third most diagnosed cancer in men (after prostate and lung cancers) and in women (after breast and lung cancer). It is the second cause of cancer death in men (after lung cancer) and the third one in women (after breast and lung cancers). It is estimated that, in EU-27 countries in 2020, colorectal cancer accounted for 12.7% of all new cancer diagnoses and 12.4% of all deaths due to cancer. Our study aims to assess the opportunistic colorectal cancer screening by colonoscopy in a private hospital. A secondary objective of this study is to analyse the adenoma detection rate (ADR), polyp detection rate (PDR), and colorectal cancer (CRC) detection rate. We designed a retrospective single-centre study in the Gastroenterology Department of Saint Mary Hospital. The study population includes all individuals who performed colonoscopies in 2 years, January 2019–December 2020, addressed to our department by their family physician or came by themselves for a colonoscopy. One thousand seven hundred seventy-eight asymptomatic subjects underwent a colonoscopy for the first time. The mean age was 59.0 ± 10.9, 59.5% female. Eight hundred seventy-three polyps were found in 525 patients. Five hundred and twenty-five had at least one polyp, 185 patients had two polyps, 87 had three polyps, and 40 patients had more than three polyps. The PDR was 49.1%, ADR 39.0%, advanced adenomas in 7.9%, and carcinomas were found in 5.4% of patients. In a country without any colorectal cancer screening policy, polyps were found in almost half of the 1778 asymptomatic patients evaluated in a single private center, 39% of cases adenomas, and 5.4% colorectal cancer. Our study suggests starting screening colonoscopy at the age of 45. A poor bowel preparation significantly impacted the adenoma detection rate. Full article
(This article belongs to the Special Issue Clinical Impact of Endoscopy for the Diagnosis and Therapy of Oncological Patients)
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10 pages, 970 KiB  
Article
Endoscopic Ultrasound Elastography in the Assessment of Rectal Tumors: How Well Does It Work in Clinical Practice?
by Adrian Catinean, Gheorghe G. Balan, Anita Mezei, Emil-Claudiu Botan, Andrei-Otto Mitre, Radu Motocu, Florin Graur, Dan-Tudor Eniu and Maria-Adriana Neag
Diagnostics 2021, 11(7), 1180; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11071180 - 29 Jun 2021
Cited by 1 | Viewed by 1985
Abstract
Endorectal ultrasound applications in the evaluation of rectal tumors could be a useful tool in achieving proper staging of rectal cancer. The purpose of this study was to compare the efficacy of rectal tumor staging by flexible endoscopic ultrasound (EUS) with real-time elastography [...] Read more.
Endorectal ultrasound applications in the evaluation of rectal tumors could be a useful tool in achieving proper staging of rectal cancer. The purpose of this study was to compare the efficacy of rectal tumor staging by flexible endoscopic ultrasound (EUS) with real-time elastography (RTE) using the gold standard post-surgery histological analysis of the resected tissue as the control. The second aim of our research was to establish cutoff values for the EUS-RTE strain ratio corresponding to stages by independently comparing the stiffness values obtained with histology and EUS-RTE staging in order to minimize observation bias. We evaluated the records of 130 patients with a rectal tumor confirmed by biopsy. EUS was used in 70 patients, EUS-RTE—in the other 60. We found no statistically significant differences in staging accuracy when comparing EUS to EUS-RTE. Through a correspondence method between staging assessment and the EUS-RTE stain ratio, we identified cutoff intervals for T2, T3, and T4 staging that were nonoverlapping and proved to be statistically significant in terms of EUS-RTE values (significantly different ascending values from one interval to the other). We found that EUS-RTE offers slightly better, although not statistically significant sensitivity and specificity for T and N stage predictions compared to 2D EUS. Our results showed that EUS-RTE offers slightly higher sensitivity and specificity compared to EUS. Reliable cutoff intervals were found for strain rate elastography, previously available only for shear wave elastography (SWE) which is currently unavailable on any EUS system. Thus, these commonly available EUS-RTE systems can serve as a complementary tool in the staging of rectal tumors. Full article
(This article belongs to the Special Issue Clinical Impact of Endoscopy for the Diagnosis and Therapy of Oncological Patients)
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Review

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12 pages, 281 KiB  
Review
Efficacy and Safety of Deep Sedation and Anaesthesia for Complex Endoscopic Procedures—A Narrative Review
by Daniela Godoroja-Diarto, Alina Constantin, Cosmin Moldovan, Elena Rusu and Massimilliano Sorbello
Diagnostics 2022, 12(7), 1523; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071523 - 22 Jun 2022
Cited by 6 | Viewed by 2308
Abstract
Propofol sedation for advanced endoscopic procedures is a widespread technique at present, which generates controversy worldwide when anaesthetic or non-anaesthetic personnel administer this form of sedation. There is some evidence for safe administered propofol sedation by non-anaesthetic personnel in patients undergoing endoscopy procedures, [...] Read more.
Propofol sedation for advanced endoscopic procedures is a widespread technique at present, which generates controversy worldwide when anaesthetic or non-anaesthetic personnel administer this form of sedation. There is some evidence for safe administered propofol sedation by non-anaesthetic personnel in patients undergoing endoscopy procedures, but there are only few randomised trials addressing the safety and efficacy of propofol in patients undergoing advanced procedures. A serious possible consequence of propofol sedation is the rapid and unpredictable progression from deep sedation to general anaesthesia mostly when elderly and frail patients are involved in the diagnosis or treatment of various neoplasia. This situation requires rescue measures with skilled airway management. The aim of this paper is to review the safety and efficacy aspects of sedation techniques, with special reference to propofol administration covering the whole patient journey, including preassessment, sedation options and discharge when advanced endoscopic procedures are performed. Full article
(This article belongs to the Special Issue Clinical Impact of Endoscopy for the Diagnosis and Therapy of Oncological Patients)
13 pages, 4694 KiB  
Review
Diagnostic Value of Endoscopic Ultrasound after Neoadjuvant Chemotherapy for Gastric Cancer Restaging: A Meta-Analysis of Diagnostic Test
by Victor Mihai Sacerdotianu, Bogdan Silviu Ungureanu, Sevastita Iordache, Adina Turcu-Stiolica, Antonio Facciorusso, Stefano Francesco Crinò and Adrian Saftoiu
Diagnostics 2022, 12(1), 100; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010100 - 03 Jan 2022
Viewed by 1679
Abstract
This study aimed to evaluate the diagnostic value of endoscopic ultrasound (EUS) after neoadjuvant therapy (NT) for gastric cancer restaging by meta-analysis. We conducted a systematic search of studies published on PubMed and Web of Science up to 30th August 2021. Assessing the [...] Read more.
This study aimed to evaluate the diagnostic value of endoscopic ultrasound (EUS) after neoadjuvant therapy (NT) for gastric cancer restaging by meta-analysis. We conducted a systematic search of studies published on PubMed and Web of Science up to 30th August 2021. Assessing the risk of bias in the included studies was done with the QUADAS-2 tool. We used R and Review Manager 5.4.1 for calculations and statistical analysis. To evaluate the diagnostic value of EUS after NT for gastric cancer restaging, we performed a meta-analysis on six studies, with a total of 283 patients, including true-positive, true-negative, false-positive, and false-negative results for T1-T4, N0. EUS as a diagnostic test for GC patients after chemotherapy has a relatively low DOR for the T2 (3.96) and T4 stages (4.79) and a relatively high partial AUC for the T2 (0.85) and T4 (0.71) stages. Our results reveal that the pooled sensitivity for T stages after chemotherapy is rather low (29–56%), except for the T3 stage (71%). A potential limitation of our study was the small number of included studies, but no significant heterogeneity was found between them. Our meta-analysis concludes that EUS is not recommended or is still under debate for GC restaging after NT. Full article
(This article belongs to the Special Issue Clinical Impact of Endoscopy for the Diagnosis and Therapy of Oncological Patients)
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Other

Jump to: Research, Review

3 pages, 2728 KiB  
Interesting Images
A Differential Diagnosis of Unusual Gastric Ulcer
by Soo-Yoon Sung, Hyun Ho Choi and Kyung Jin Seo
Diagnostics 2022, 12(8), 1929; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12081929 - 10 Aug 2022
Cited by 1 | Viewed by 4811
Abstract
The endoscopic findings of diffuse large B cell lymphoma have various presentations. In our case, the patient had developed multiple elevated central ulceration lesions, and the peripheral elevated portion had a heaped-up margin. The margin had a sharp, smooth edge that was not [...] Read more.
The endoscopic findings of diffuse large B cell lymphoma have various presentations. In our case, the patient had developed multiple elevated central ulceration lesions, and the peripheral elevated portion had a heaped-up margin. The margin had a sharp, smooth edge that was not infiltrative and could be confused with a simple gastric ulcer. Endoscopists should be aware of the possibility of multiple lymphoma ulcers with heaped-up margins. We present some unusual endoscopic features of lymphoma, which are easily misdiagnosed as gastric ulcers. Full article
(This article belongs to the Special Issue Clinical Impact of Endoscopy for the Diagnosis and Therapy of Oncological Patients)
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