Estimation of Invasion Depth: The First Key to Successful Colorectal ESD
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초록
Colorectal tumors with superficial submucosal invasion, which cannot be removed by snaring, are one of the most optimal indicationsfor colorectal endoscopic submucosal dissection (ESD). Therefore, estimation of the invasion depth is the first key to successfulcolorectal ESD. Although estimation of the invasion depth based on the gross morphology may be useful in selected cases, its diagnosticaccuracy could not reach the clinical requirement. The Japan Narrow-band Imaging (NBI) Expert Team (JNET) classification of NBImagnifying endoscopy findings is a useful method for histologic prediction and invasion depth estimation. However, magnifyingchromoendoscopy is still necessary for JNET type 2B lesions to reach a satisfactory diagnostic accuracy. Endocytoscopy with artificialintelligence is a promising technology in invasion depth estimation; however, more data are needed for its clinical application.
Abstract
Colorectal tumors with superficial submucosal invasion, which cannot be removed by snaring, are one of the most optimal indicationsfor colorectal endoscopic submucosal dissection (ESD). Therefore, estimation of the invasion depth is the first key to successfulcolorectal ESD. Although estimation of the invasion depth based on the gross morphology may be useful in selected cases, its diagnosticaccuracy could not reach the clinical requirement. The Japan Narrow-band Imaging (NBI) Expert Team (JNET) classification of NBImagnifying endoscopy findings is a useful method for histologic prediction and invasion depth estimation. However, magnifyingchromoendoscopy is still necessary for JNET type 2B lesions to reach a satisfactory diagnostic accuracy. Endocytoscopy with artificialintelligence is a promising technology in invasion depth estimation; however, more data are needed for its clinical application.
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