Comparison of colon adenoma detection rate using transparent cap-assisted and conventional colonoscopy: result from an international trial in Asia.

Introduction: Controversy remains regarding transparent cap-assisted technique improves adenoma detection rate (ADR) in colonoscopy. We aimed to investigate the effect of transparent cap-assisted colonoscopy on ADR and other colonoscopy performance.

Methods: We performed sub-analysis of an international, multicenter, open-label database containing colonoscopy data from 11 centers in 4 Asian countries/regions on patients who underwent colonoscopy.

Mechanism behind reduced resection ability of bent snares during cold snare polypectomy.

Accidental bending of the snare sheath occasionally occurs during cold snare polypectomy (CSP). We aimed to demonstrate whether snare bending reduces resection ability and, if it does, what causes this reduction. Using currently available CSP snares and prototype snares, we investigated changes in the resection ability of bent snares as well as the stiffness of their sheaths and wire spindles.

Endoscopic hemostasis with a self-assembling peptide gel during endoscopic submucosal dissection and cold-snare polypectomy in the duodenum: Prospective exploratory study (with video).

Objectives: A novel self-assembling peptide gel (SAPG) was recently developed for hemostasis during endoscopic resection (ER) as an alternative for electrocoagulation and clip placement. Therefore, this exploratory study aimed to evaluate the hemostatic effect of SAPG on bleeding during ER of the duodenum.

Methods: Patients with superficial duodenal epithelial tumors who underwent endoscopic submucosal dissection (ESD) or cold-snare polypectomy (CSP) between June 2022 and October 2023 were enrolled in the study.

Prevalence of gastric cancer following colorectal endoscopic submucosal dissection for lesions more than 20 mm: A retrospective analysis.

Objectives: Colorectal endoscopic submucosal dissection (ESD) for large tumors is spreading worldwide. Gastric cancer (GC) sometimes occurs after colorectal ESD. However, its status including frequency and risk factors have not been examined well.

Prophylactic Clip Closure in Preventing Delayed Bleeding After Colorectal Endoscopic Submucosal Dissection on anticoagulants: A multicenter retrospective cohort study in Japan.

Background And Study Aims: Prophylactic clip closure after colorectal endoscopic submucosal dissection (ESD) among patients on anticoagulants is of uncertain effectiveness in reducing delayed bleeding (DB) risk. We aimed to assess the effect of prophylactic clip closure in preventing DB after colorectal ESD among patients on anticoagulants.

Patients And Methods: We used the ABCD-J study database, a large-scale multicenter study analyzing DB among 34,455 colorectal ESD cases from 47 Japanese institutions.

Differences in regions of interest to identify deeply invasive colorectal cancers: Computer-aided diagnosis vs expert endoscopists.

Diagnostic performance of a computer-aided diagnosis (CAD) system for deep submucosally invasive (T1b) colorectal cancer was excellent, but the "regions of interest" (ROI) within images are not obvious. Class activation mapping (CAM) enables identification of the ROI that CAD utilizes for diagnosis. The purpose of this study was a quantitative investigation of the difference between CAD and endoscopists.

[Feasibility of FP Therapy in Outpatient Setting for Inoperable Recurrent Esophageal Cancer].

With the emergence of immune checkpoint inhibitors(ICIs)in recent years, the treatment outcomes for unresectable recurrent esophageal cancer have improved markedly. In 5-FU+cisplatin(FP)first-line therapy, 5-FU administration takes 5 days and generally requires hospitalization. However, frequent hospitalization for treatment is a crucial issue that must be resolved in terms of time investment and optimal use of hospital resources.

A novel reopenable clip with sharp claw for complete closure of mucosal defects after colorectal endoscopic submucosal dissection.

Background: The MANTIS Closure Device (MCD; Boston Scientific, Marlborough, Massachusetts, USA) is a reopenable clip with a sharp claw used for closure after endoscopic submucosal dissection (ESD). We evaluated the effectiveness of the MCD for fast and complete closure after colorectal ESD.

Methods: Cases involving closure with the MCD after ESD of 20-60-mm colorectal lesions between April 2023 and January 2024 were reviewed.

Effect of texture and color enhancement imaging on the visibility of gastric tumors.

Texture and color enhancement imaging (TXI) may improve the visibility of gastric tumors and allow their early detection. However, few reports have examined the utility of TXI. Between June 2021 and October 2022, 56 gastric tumors in 51 patients undergoing endoscopic submucosal dissection at Fukuchiyama City Hospital were evaluated preoperatively using conventional white light imaging (WLI), narrow-band imaging (NBI), and TXI modes 1 and 2.

Linked Color Imaging with Artificial Intelligence Improves the Detection of Early Gastric Cancer.

Introduction: Esophagogastroduodenoscopy is the most important tool to detect gastric cancer (GC). In this study, we developed a computer-aided detection (CADe) system to detect GC with white light imaging (WLI) and linked color imaging (LCI) modes and aimed to compare the performance of CADe with that of endoscopists.

Methods: The system was developed based on the deep learning framework from 9,021 images in 385 patients between 2017 and 2020.

Efficacy of Two Kinds of Scissor-Type Knives for Colorectal Endoscopic Submucosal Dissection: A Retrospective Comparative Study.

Introduction: Scissor-type knives are spreading as safe devises in endoscopic submucosal dissection (ESD). We evaluated the efficacy of two kinds of scissor-type knives (Clutch Cutter: CC, Fujifilm Co. and SB Knife Jr2: SB, SB-KAWASUMI Laboratories.

Development of high-quality artificial intelligence for computer-aided diagnosis in determining subtypes of colorectal cancer.

Background And Aim: There are no previous studies in which computer-aided diagnosis (CAD) diagnosed colorectal cancer (CRC) subtypes correctly. In this study, we developed an original CAD for the diagnosis of CRC subtypes.

Methods: Pretraining for the CAD based on ResNet was performed using ImageNet and five open histopathological pretraining image datasets (HiPreD) containing 3 million images.

The Comparison of Diagnostic Ability between Blue Laser/Light Imaging and Narrowband Imaging for Sessile Serrated Lesions with or without Dysplasia.

Objectives: Diagnostic ability of sessile serrated lesions (SSL) and SSL with dysplasia (SSLD) using blue laser/light imaging (BLI) has not been well examined. We analyzed the diagnostic accuracy of BLI for SSL and SSLD using several endoscopic findings compared to those of narrow band imaging (NBI).

Materials And Methods: This was a subgroup analysis of prospective studies.

Detailed Superiority of the CAD EYE Artificial Intelligence System over Endoscopists for Lesion Detection and Characterization Using Unique Movie Sets.

Objectives: Detailed superiority of CAD EYE (Fujifilm, Tokyo, Japan), an artificial intelligence for polyp detection/diagnosis, compared to endoscopists is not well examined. We examined endoscopist's ability using movie sets of colorectal lesions which were detected and diagnosed by CAD EYE accurately.

Methods: Consecutive lesions of ≤10 mm were examined live by CAD EYE from March-June 2022 in our institution.

Analysis of the Characteristics of Coexisting Lesions in Colorectal Cancer Patients in an International Study: A Subgroup Analysis of the ATLAS Trial.

Introduction: We investigated coexisting lesion types in patients with invasive colorectal cancer (CRC) in a multinational study for comprehending the adenoma-carcinoma and serrated pathway about the development of CRC.

Methods: We retrospectively reviewed 3,050 patients enrolled in the international randomized controlled trial (ATLAS study) to evaluate the colorectal polyp detection performance of image-enhanced endoscopy in 11 institutions in four Asian countries/regions. In the current study, as a subgroup analysis of the ATLAS study, 92 CRC patients were extracted and compared to 2,958 patients without CRC to examine the effects of age, sex, and coexisting lesion types (high-grade adenoma [HGA], low-grade adenoma with villous component [LGAV], 10 adenomas, adenoma ≥10 mm, sessile serrated lesions [SSLs], and SSLs with dysplasia [SSLD]).