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Endoscopy 2019; 51(06): 560-565
DOI: 10.1055/a-0790-8436
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy for diagnosis of gastric subepithelial tumors: a pilot study

Ming-Ming Zhang
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Ning Zhong
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Xiao Wang
2   Department of Pathology, Qilu Hospital, Shandong University, Jinan, China
,
Chang-Qing Li
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Rui Ji
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Zhen Li
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Xiang Gu
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Yan-Bo Yu
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Li-Xiang Li
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Xiu-Li Zuo
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
,
Yan-Qing Li
1   Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan, China
› Author AffiliationsTRIAL REGISTRATION: single-center, prospective, pilot study NCT02936986 at clinicaltrials.gov
Further Information

Publication History

submitted 12 July 2018

accepted after revision 19 October 2018

Publication Date:
20 December 2018 (online)

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Video Comment on Ming-Ming Zhang et al.Endoscopy 2019; 51(06): v15-v15
DOI: 10.1055/a-0806-2737

Abstract

Background The diagnostic yield of current techniques for gastric subepithelial tumors (SETs) is suboptimal. This prospective study aimed to develop diagnostic criteria for needle-based confocal laser endomicroscopy (nCLE) of gastric SETs, and to evaluate the diagnostic efficacy, feasibility, and safety of endoscopic ultrasound-guided nCLE (EUS-nCLE).

Methods Eligible patients were prospectively recruited to undergo EUS-nCLE. Four unblinded investigators evaluated nCLE videos and corresponding histopathology to develop the nCLE criteria. The recorded nCLE videos were reviewed off-line by one endoscopist 3 months later. Image quality (five-point scale, 1 = poor and 5 = very good) and the interobserver agreements were assessed.

Results All 33 patients underwent successful EUS-nCLE procedures. The nCLE criteria for gastric SETs were established. Overall accuracy of off-line nCLE was significantly higher than that of EUS alone (87.9 % vs. 63.6 %; P = 0.02). The mean image quality score was 3.9. The kappa values of the interobserver agreements were 0.66 for gastrointestinal stromal tumor, 0.89 for ectopic pancreas, 0.58 for leiomyoma, and 0.72 for carcinoma.

Conclusions EUS-nCLE was feasible and safe to accurately diagnose gastric SETs.

Fig e1, Table e1, e4, e5

 

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