title: High-frequency ultrasound probe sonography staging for colorectal neoplasia with superficial morphology: its utility and impact on patient management.
abstract: BACKGROUND
  This prospective study aimed to evaluate the impact of high-frequency ultrasound probe sonography (HFUPS) staging on the management of patients with superficial colorectal neoplasia (SCN) as determined by the endoscopic characteristics of lesions.
  
  
  METHODS
  Consecutive patients referred for endoscopic treatment of nonpedunculated SCN were enrolled in this study. A lesion was considered high risk if a depressed area or invasive pit pattern was present. The gold standard for final staging included histology from endoscopic or surgical resection. The impact on treatment was defined as any modification of the therapeutic algorithm based on the result of the HFUPS examination compared with that based on endoscopy alone.
  
  
  RESULTS
  In this study, 48 lesions in 48 patients were evaluated. Of these, 28 (58%) were considered high risk, and the remaining 20 (42%) were regarded as low risk. A total of seven lesions (15%) that could not be examined with HFUPS and another non-neoplastic lesion were excluded from final analysis. For the remaining 40 lesions, the overall accuracy of the HFUPS examination to predict the correct T-stage was 90% (95% confidence interval [CI], 77-96%). The HFUPS examination had a positive impact on the treatment of 0 low-risk and 11 high-risk (42%) lesions.
  
  
  CONCLUSIONS
  The impact of HFUPS on the treatment of SCN depends on their endoscopic characteristics. It is negligible for low-risk SCNs, and these lesions can be treated on the basis of their endoscopic appearance alone. Nevertheless, compared with endoscopy alone, HFUPS changed the subsequent therapeutic approach in a positive way for up to 42% of high-risk lesions, including those with a depressed component and an invasive pit pattern. These endoscopic features can therefore be recommended as the entry criteria for an HFUPS examination.
authors: Department of Gastroenterology, Hospital Vitkovice, Ostrava-Vitkovice, Czech Republic. ondrej.urban@nemvitkovice.cz
authors: Ondrej
authors: O
authors: Urban
authors: Martin
authors: M
authors: Kliment
authors: Petr
authors: P
authors: Fojtik
authors: Premysl
authors: P
authors: Falt
authors: Julius
authors: J
authors: Orhalmi
authors: Petr
authors: P
authors: Vitek
authors: Pavol
authors: P
authors: Holeczy
references: Gastrointest Endosc. 2000 Sep;52(3):322-7
references: 10968844
references: Endoscopy. 1998 Aug;30 Suppl 1:A85-7
references: 9765093
references: Endoscopy. 1993 Sep;25(7):455-61
references: 8261988
references: Gastrointest Endosc. 1995 Jun;41(6):587-92
references: 7672554
references: Gastrointest Endosc. 1996 Jul;44(1):34-9
references: 8836714
references: Gastrointest Endosc. 1994 Jul-Aug;40(4):485-9
references: 7926542
references: Dis Colon Rectum. 2000 Jun;43(6):782-7
references: 10859077
references: Gut. 2004 Feb;53(2):284-90
references: 14724165
references: Endoscopy. 2001 Apr;33(4):306-10
references: 11315890
references: Gastroenterology. 1989 Apr;96(4):1058-62
references: 2647573
references: Ultrasound Med Biol. 1989;15(3):273-80
references: 2662554
references: Gastrointest Endosc. 1990 Mar-Apr;36(2 Suppl):S40-6
references: 2184085
references: Gastrointest Endosc. 2003 Dec;58(6 Suppl):S3-43
references: 14652541
references: Endoscopy. 2001 Apr;33(4):367-73
references: 11315901
references: Endoscopy. 2010 Sep;42(9):723-9
references: 20806156
references: Gut. 2005 Nov;54(11):1585-9
references: 15964906
references: Hepatogastroenterology. 2008 Mar-Apr;55(82-83):351-5
references: 18613364
references: Endoscopy. 2002 Jul;34(7):564-8
references: 12170411
references: Gastrointest Endosc. 1998 Oct;48(4):362-70
references: 9786107
references: Surg Endosc. 2010 Feb;24(2):343-52
references: 19517168
references: Gut. 2000 Aug;47(2):251-5
references: 10896917
references: Gastrointest Endosc. 1997 Mar;45(3):291-5
references: 9087836
references: Gastrointest Endosc. 2002 Sep;56(3):354-60
references: 12196772
references: Surgery. 1998 Mar;123(3):264-9
references: 9526517
references: Ann Surg. 2000 Jul;232(1):46-50
references: 10862194