Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series
Introduction: Large rectal lesions can conceal submucosal invasion and cancer nodules. Despite the increasing diffusion of high-definition endoscopes and the importance of an accurate morphological evaluation, a complete assessment in this setting can be challenging. Endoscopic ultrasound (EUS) play...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/13/2267 |
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| author | Giulia Gibiino Monica Sbrancia Cecilia Binda Chiara Coluccio Stefano Fabbri Paolo Giuffrida Graziana Gallo Luca Saragoni Roberta Maselli Alessandro Repici Carlo Fabbri |
| author_facet | Giulia Gibiino Monica Sbrancia Cecilia Binda Chiara Coluccio Stefano Fabbri Paolo Giuffrida Graziana Gallo Luca Saragoni Roberta Maselli Alessandro Repici Carlo Fabbri |
| author_sort | Giulia Gibiino |
| collection | DOAJ |
| description | Introduction: Large rectal lesions can conceal submucosal invasion and cancer nodules. Despite the increasing diffusion of high-definition endoscopes and the importance of an accurate morphological evaluation, a complete assessment in this setting can be challenging. Endoscopic ultrasound (EUS) plays an established role in the locoregional staging of rectal cancer, although this technique has a tendency toward the over-estimation of the loco-regional (T) staging. However, there are still few data on contrast-enhanced endoscopic ultrasound (CH-EUS), especially if this ancillary technique may increase the accuracy for predicting invasive nodules among large rectal lesions. Material and Methods: Consecutive large (≥20 mm) superficial rectal lesions with high-definition endoscopy, characterized by focal areas suggestive for invasive cancer/2B type according to JNET classification, were considered for additional standardized evaluation via CH-EUS with Sonovue ©. Results: From 2020 to 2023, we evaluated 12 consecutive superficial rectal lesions with sizes ranging from 20 to 180 mm. This evaluation provided additional elements to support the therapeutic decision made. Lesions were treated with surgical (3/12) or endoscopic treatment (9/12) according to their morphology and CH-EUS evaluation. Conclusion: Contrast-enhanced endoscopic ultrasound can provide an additional evaluation for large and difficult-to-classify rectal lesions. In our experience, CH-EUS staging corresponded to the final pathological stages in 9/12 (75%) lesions, improving the distinction between T1 and T2 lesions. Larger prospective studies and randomized trials should be conducted to support and standardize this approach. |
| first_indexed | 2024-03-11T01:43:40Z |
| format | Article |
| id | doaj.art-0f4e478d242844fab92aa0507345b53c |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T01:43:40Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-0f4e478d242844fab92aa0507345b53c2023-11-18T16:22:20ZengMDPI AGDiagnostics2075-44182023-07-011313226710.3390/diagnostics13132267Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case SeriesGiulia Gibiino0Monica Sbrancia1Cecilia Binda2Chiara Coluccio3Stefano Fabbri4Paolo Giuffrida5Graziana Gallo6Luca Saragoni7Roberta Maselli8Alessandro Repici9Carlo Fabbri10Gastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyGastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyGastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyGastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyGastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyGastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyPathology Department, M. Bufalini Hospital, Emilia Romagna, 47521 Cesena, ItalyPathology Department, G.B. Morgagni-L. Pierantoni Hospital, Emilia-Romagna, 47121 Forlì, ItalyEndoscopy Unit, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, ItalyEndoscopy Unit, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, ItalyGastroenterology and Digestive Endoscopy Unit, 47121 Forlì, ItalyIntroduction: Large rectal lesions can conceal submucosal invasion and cancer nodules. Despite the increasing diffusion of high-definition endoscopes and the importance of an accurate morphological evaluation, a complete assessment in this setting can be challenging. Endoscopic ultrasound (EUS) plays an established role in the locoregional staging of rectal cancer, although this technique has a tendency toward the over-estimation of the loco-regional (T) staging. However, there are still few data on contrast-enhanced endoscopic ultrasound (CH-EUS), especially if this ancillary technique may increase the accuracy for predicting invasive nodules among large rectal lesions. Material and Methods: Consecutive large (≥20 mm) superficial rectal lesions with high-definition endoscopy, characterized by focal areas suggestive for invasive cancer/2B type according to JNET classification, were considered for additional standardized evaluation via CH-EUS with Sonovue ©. Results: From 2020 to 2023, we evaluated 12 consecutive superficial rectal lesions with sizes ranging from 20 to 180 mm. This evaluation provided additional elements to support the therapeutic decision made. Lesions were treated with surgical (3/12) or endoscopic treatment (9/12) according to their morphology and CH-EUS evaluation. Conclusion: Contrast-enhanced endoscopic ultrasound can provide an additional evaluation for large and difficult-to-classify rectal lesions. In our experience, CH-EUS staging corresponded to the final pathological stages in 9/12 (75%) lesions, improving the distinction between T1 and T2 lesions. Larger prospective studies and randomized trials should be conducted to support and standardize this approach.https://www.mdpi.com/2075-4418/13/13/2267rectum polypsendoscopic submucosal dissectionrectum stagingtumor angiogenesis |
| spellingShingle | Giulia Gibiino Monica Sbrancia Cecilia Binda Chiara Coluccio Stefano Fabbri Paolo Giuffrida Graziana Gallo Luca Saragoni Roberta Maselli Alessandro Repici Carlo Fabbri Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series Diagnostics rectum polyps endoscopic submucosal dissection rectum staging tumor angiogenesis |
| title | Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series |
| title_full | Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series |
| title_fullStr | Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series |
| title_full_unstemmed | Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series |
| title_short | Usefulness of Contrast-Enhanced Endoscopic Ultrasound (CH-EUS) to Guide the Treatment Choice in Superficial Rectal Lesions: A Case Series |
| title_sort | usefulness of contrast enhanced endoscopic ultrasound ch eus to guide the treatment choice in superficial rectal lesions a case series |
| topic | rectum polyps endoscopic submucosal dissection rectum staging tumor angiogenesis |
| url | https://www.mdpi.com/2075-4418/13/13/2267 |
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