1.Clinical Impact of Different Reconstruction Methods on Remnant Gastric Cancer at the Anastomotic Site after Distal Gastrectomy
Kei MATSUMOTO ; Shinwa TANAKA ; Takashi TOYONAGA ; Nobuaki IKEZAWA ; Mari NISHIO ; Masanao URAOKA ; Tomoatsu YOSHIHARA ; Hiroya SAKAGUCHI ; Hirofumi ABE ; Tetsuya YOSHIZAKI ; Madoka TAKAO ; Toshitatsu TAKAO ; Yoshinori MORITA ; Hiroshi YOKOZAKI ; Yuzo KODAMA
Clinical Endoscopy 2022;55(1):86-94
Background/Aims:
The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Different reconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomotic site. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastric cancers at the anastomotic site.
Methods:
We recruited 34 consecutive patients who underwent endoscopic submucosal dissection for remnant gastric cancer at the anastomotic site after distal gastrectomy. Clinicopathology and treatment outcomes were compared between the Billroth II and non-Billroth II groups.
Results:
The tumor size in the Billroth II group was significantly larger than that in the non-Billroth II group (22 vs. 19 mm; p=0.048). More severe gastritis was detected endoscopically in the Billroth II group (2 vs. 1.33; p=0.0075). Moreover, operation time was longer (238 vs. 121 min; p=0.004) and the frequency of bleeding episodes was higher (7.5 vs. 3.1; p=0.014) in the Billroth II group.
Conclusions
Compared to remnant gastric cancers in non-Billroth II patients, those in the Billroth II group had larger lesions with a background of severe remnant gastritis. Endoscopic submucosal dissection for remnant gastric cancers in Billroth II patients involved longer operative times and more frequent bleeding episodes than that in patients without Billroth II.
2.Improved visibility of palisade vessels within Barrett’s esophagus using red dichromatic imaging: a retrospective cross-sectional study in Japan
Chise UEDA ; Shinwa TANAKA ; Tetsuya YOSHIZAKI ; Hirofumi ABE ; Masato KINOSHITA ; Hiroya SAKAGUCHI ; Hiroshi TAKAYAMA ; Hitomi HORI ; Ryosuke ISHIDA ; Shinya HOUKI ; Hiroshi TANABE ; Eri NISHIKAWA ; Madoka TAKAO ; Toshitatsu TAKAO ; Yoshinori MORITA ; Takashi TOYONAGA ; Yuzo KODAMA
Clinical Endoscopy 2025;58(2):269-277
Background/Aims:
Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI).
Methods:
Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed.
Results:
Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006).
Conclusions
RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.
3.Improved visibility of palisade vessels within Barrett’s esophagus using red dichromatic imaging: a retrospective cross-sectional study in Japan
Chise UEDA ; Shinwa TANAKA ; Tetsuya YOSHIZAKI ; Hirofumi ABE ; Masato KINOSHITA ; Hiroya SAKAGUCHI ; Hiroshi TAKAYAMA ; Hitomi HORI ; Ryosuke ISHIDA ; Shinya HOUKI ; Hiroshi TANABE ; Eri NISHIKAWA ; Madoka TAKAO ; Toshitatsu TAKAO ; Yoshinori MORITA ; Takashi TOYONAGA ; Yuzo KODAMA
Clinical Endoscopy 2025;58(2):269-277
Background/Aims:
Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI).
Methods:
Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed.
Results:
Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006).
Conclusions
RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.
4.Improved visibility of palisade vessels within Barrett’s esophagus using red dichromatic imaging: a retrospective cross-sectional study in Japan
Chise UEDA ; Shinwa TANAKA ; Tetsuya YOSHIZAKI ; Hirofumi ABE ; Masato KINOSHITA ; Hiroya SAKAGUCHI ; Hiroshi TAKAYAMA ; Hitomi HORI ; Ryosuke ISHIDA ; Shinya HOUKI ; Hiroshi TANABE ; Eri NISHIKAWA ; Madoka TAKAO ; Toshitatsu TAKAO ; Yoshinori MORITA ; Takashi TOYONAGA ; Yuzo KODAMA
Clinical Endoscopy 2025;58(2):269-277
Background/Aims:
Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI).
Methods:
Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed.
Results:
Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006).
Conclusions
RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.
5.A novel method for determining dose distribution on panoramic reconstruction computed tomography images from radiotherapy computed tomography
Hiroyuki OKAMOTO ; Madoka SAKURAMACHI ; Wakako YATSUOKA ; Takao UENO ; Kouji KATSURA ; Naoya MURAKAMI ; Satoshi NAKAMURA ; Kotaro IIJIMA ; Takahito CHIBA ; Hiroki NAKAYAMA ; Yasunori SHUTO ; Yuki TAKANO ; Yuta KOBAYASHI ; Hironori KISHIDA ; Yuka URAGO ; Masato NISHITANI ; Shuka NISHINA ; Koushin ARAI ; Hiroshi IGAKI
Imaging Science in Dentistry 2024;54(2):129-137
Purpose:
Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN). Accordingly, new tools must be developed to extract critical information regarding the dose delivered to the teeth and mandible. This article proposes a novel approach for visualizing 3-dimensional planned dose distributions on panoramic reconstruction computed tomography (pCT) images.
Materials and Methods:
Four patients with HNC who underwent volumetric modulated arc therapy were included. One patient experienced ORN and required the extraction of teeth after RT. In the study approach, the dental arch curve (DAC) was defined using an open-source platform. Subsequently, pCT images and dose distributions were generated based on the new coordinate system. All teeth and mandibles were delineated on both the original CT and pCT images. To evaluate the consistency of dose metrics, the Mann-Whitney U test and Student t-test were employed.
Results:
A total of 61 teeth and 4 mandibles were evaluated. The correlation coefficient between the 2 methods was 0.999, and no statistically significant difference was observed (P>0.05). This method facilitated a straightforward and intuitive understanding of the delivered dose. In 1 patient, ORN corresponded to the region of the root and the gum receiving a high dosage (approximately 70 Gy).
Conclusion
The proposed method particularly benefits dentists involved in the management of patients with HNC. It enables the visualization of a 3-dimensional dose distribution in the teeth and mandible on pCT, enhancing the understanding of the dose delivered during RT.