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Diagnostics
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Endoscopy in Diagnosis of Gastrointestinal Disorders
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Endoscopy in Diagnosis of Gastrointestinal Disorders

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 9642

Special Issue Editors

Prof. Dr. Miguel Mascarenhas

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Guest Editor
1. Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
2. Faculty of Medicine, University of Porto, Porto, Portugal
Interests: inflammatory bowel disease; applied artificial intelligence; capsule endoscopy; neurogastroenterology; coloproctology
Special Issues, Collections and Topics in MDPI journals
Dr. Hélder Cardoso

E-Mail Website
Guest Editor
1. Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
2. Faculty of Medicine, University of Porto, Porto, Portugal
3. World Gastroenterology Organization Porto Training Center, Porto, Portugal
Interests: gastroenterology; hepatology; endoscopy, capsule endoscopy; enteroscopy; applied artificial intelligence; liver cancer; inflammatory bowel diseases
Dr. Tiago Ribeiro

E-Mail Website
Guest Editor
Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
Interests: gastroenterology; artificial intelligence; hepatology; biliary tract diseases; endoscopy
Prof. Dr. Guilherme Macedo

E-Mail Website
Guest Editor
1. Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
2. Faculty of Medicine, University of Porto, Porto, Portugal
Interests: gastroenterology; hepatology; liver transplantation; hepatocellular carcinoma; gastrointestinal diseases; biliary tract diseases; inflammatory bowel diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We invite researchers, clinicians, and experts in the field to contribute to this Special Issue focusing on the crucial role of endoscopy in the diagnosis of gastrointestinal disorders. This Special Issue aims to explore the latest advancements, challenges, and future directions regarding the utilization of endoscopy as a diagnostic tool for various gastrointestinal conditions.

Endoscopy plays a pivotal role in the accurate and targeted diagnosis of gastrointestinal disorders. It allows for the direct visualization and examination of the digestive tract and enables the identification of abnormalities, such as ulcers, polyps, tumors, and inflammation. Furthermore, endoscopy offers the opportunity for biopsy collection, thus aiding in the detection of gastrointestinal cancers and guiding personalized treatment strategies.

We encourage the submission of papers that cover a wide range of topics, including, but not limited to, AI-assisted endoscopy, advanced imaging techniques, innovative endoscopic procedures, therapeutic interventions, and outcome assessments. Original research articles, reviews, and case studies that contribute to our understanding of the role of endoscopy in gastrointestinal disorder diagnosis are welcomed.

Join us in this Special Issue in order to advance our knowledge and contribute to the development of improved diagnostic approaches in gastrointestinal medicine. Submissions should adhere to the journal's guidelines and will undergo a rigorous peer-review process. Together, let us enhance patient care and outcomes by motivating advancements in endoscopy.

Dr. Miguel Mascarenhas Saraiva
Dr. Hélder Cardoso
Dr. Tiago Ribeiro
Prof. Dr. Guilherme Macedo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endoscopy
  • gastroenterology
  • coloproctology
  • digestive healthcare
  • artificial intelligence
  • digestive oncology
  • colonoscopy
  • capsule endoscopy
  • upper endoscopy

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (7 papers)

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Research

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13 pages, 2868 KiB  
Article
Diagnostic Benefits and Surgical Implications of Methods for Tumor Localization in Sigmoid and Rectum Tumors
by Mehmet Onur Gul, Mehmet Akcicek, Nidal Iflazoglu, Kadir Corbaci, Cuma Ali Emir, Mehmet Guzel and Cem Kaan Parsak
Diagnostics 2024, 14(13), 1363; https://doi.org/10.3390/diagnostics14131363 - 27 Jun 2024
Viewed by 755
Abstract
(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon [...] Read more.
(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon admission, we examined the patients’ first diagnostic colonoscopies and their preoperative repeat control colonoscopies and computed tomography (CT) report. (3) Results: In this study, 23 patients (57.5%) were male. The overall accuracy rates were 80.0% (32/40) in colonoscopy, 65.0% (26/40) in preoperative CT, and 87.5% (35/40) in retro CT, and the differences among the examination methods were statistically significant (p = 0.049). The sensitivity levels decreased to 50.0% for colonoscopy and preoperative CT and 75.0% for retro CT in rectosigmoid colon tumors. In rectal tumors, the sensitivity levels were 75.0% in colonoscopy, 60.0% in preoperative CT, and 80.0% in retro CT. In two patients, the tumor location was given incorrectly, and postoperative pathological evaluations indicated T3N0 tumors; the initially planned treatment was thus changed to include radiotherapy in addition to chemotherapy in the postoperative period because the tumor was located in the middle rectum. (4) Conclusions: Accuracy in tumor localization in sigmoid, rectosigmoid, and rectum tumors still needs to be improved, which could be accomplished with prospective studies. CT evaluations for cancer localization in this patient group should be re-evaluated by a radiologist. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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19 pages, 10889 KiB  
Article
Color-Transfer-Enhanced Data Construction and Validation for Deep Learning-Based Upper Gastrointestinal Landmark Classification in Wireless Capsule Endoscopy
by Hyeon-Seo Kim, Byungwoo Cho, Jong-Oh Park and Byungjeon Kang
Diagnostics 2024, 14(6), 591; https://doi.org/10.3390/diagnostics14060591 - 11 Mar 2024
Cited by 1 | Viewed by 1293
Abstract
While the adoption of wireless capsule endoscopy (WCE) has been steadily increasing, its primary application remains limited to observing the small intestine, with relatively less application in the upper gastrointestinal tract. However, there is a growing anticipation that advancements in capsule endoscopy technology [...] Read more.
While the adoption of wireless capsule endoscopy (WCE) has been steadily increasing, its primary application remains limited to observing the small intestine, with relatively less application in the upper gastrointestinal tract. However, there is a growing anticipation that advancements in capsule endoscopy technology will lead to a significant increase in its application in upper gastrointestinal examinations. This study addresses the underexplored domain of landmark identification within the upper gastrointestinal tract using WCE, acknowledging the limited research and public datasets available in this emerging field. To contribute to the future development of WCE for gastroscopy, a novel approach is proposed. Utilizing color transfer techniques, a simulated WCE dataset tailored for the upper gastrointestinal tract is created. Using Euclidean distance measurements, the similarity between this color-transferred dataset and authentic WCE images is verified. Pioneering the exploration of anatomical landmark classification with WCE data, this study integrates similarity evaluation with image preprocessing and deep learning techniques, specifically employing the DenseNet169 model. As a result, utilizing the color-transferred dataset achieves an anatomical landmark classification accuracy exceeding 90% in the upper gastrointestinal tract. Furthermore, the application of sharpen and detail filters demonstrates an increase in classification accuracy from 91.32% to 94.06%. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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9 pages, 506 KiB  
Article
How to Study the Location and Size of Rectal Tumors That Are Candidates for Local Surgery: Rigid Rectoscopy, Magnetic Resonance, Endorectal Ultrasound or Colonoscopy? An Interobservational Study
by Anna Serracant, Beatriz Consola, Eva Ballesteros, Marta Sola, Francesc Novell, Noemi Montes and Xavier Serra-Aracil
Diagnostics 2024, 14(3), 315; https://doi.org/10.3390/diagnostics14030315 - 31 Jan 2024
Viewed by 1250
Abstract
1. Background. Preoperative staging of rectal lesions for transanal endoscopic surgery (TES) comprises digital rectal examination, intraoperative rigid rectoscopy (IRR), endorectal ultrasound (EUS), colonoscopy and rectal magnetic resonance imaging (rMRI). The gold standard for topographic features is IRR. Are the results of the [...] Read more.
1. Background. Preoperative staging of rectal lesions for transanal endoscopic surgery (TES) comprises digital rectal examination, intraoperative rigid rectoscopy (IRR), endorectal ultrasound (EUS), colonoscopy and rectal magnetic resonance imaging (rMRI). The gold standard for topographic features is IRR. Are the results of the other tests sufficiently reliable to eliminate the need for IRR? rMRI is a key test in advanced rectal cancer and is not operator-dependent. Description of anatomical landmarks is variable. Can we rely on the information regarding topographic features provided by all radiologists? 2. Materials and Methods. This is a concordance interobservational study involving four diagnostic tests of anatomical characteristics of rectal lesions (colonoscopy, EUS, rectal MRI and IRR), performed by four expert radiologists, regarding topographic rectal features with rMRI. 3. Results. Fifty-five rectal tumors were operated on by using TES. The distance of the tumor from the anal verge, location by quadrants, size by quadrants and size of tumor were assessed (IRR as gold standard). For most of the tumors, the correlation between IRR and colonoscopy or EUS was very good (ICC > 0.75); the correlation between rMRI and IRR in respect of the size by quadrants (ICC = 0.092) and location by quadrants (ICC = 0.292) was weak. Topographic landmarks studied by the expert radiologists had an excellent correlation, except for distance from the peritoneal reflection to the anal verge (ICC = 0.606). 4. Conclusions. Anatomical description of rectal lesions by IRR, EUS, colonoscopy and rMRI is reliable. Topographic data obtained by EUS and colonoscopy can serve as a reference to avoid IRR. Determination of these topographic data by rMRI is less reliable. As performed by the expert radiologists, the anatomical study by rMRI is accurate and reproducible. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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12 pages, 1012 KiB  
Article
The Swedish Standardized Course of Care—Diagnostic Efficacy in Esophageal and Gastric Cancer
by Philip Kanold, Nils Nyhlin, Eva Szabo and Michiel van Nieuwenhoven
Diagnostics 2023, 13(23), 3577; https://doi.org/10.3390/diagnostics13233577 - 1 Dec 2023
Viewed by 1068
Abstract
Fast-track pathways for diagnosing esophageal or gastric cancer (EGC) have been implemented in several European countries. In Sweden, symptoms such as dysphagia, early satiety, and other alarm symptoms call for a referral for gastroscopy, according to the Swedish Standardized Course of Care (SCC). [...] Read more.
Fast-track pathways for diagnosing esophageal or gastric cancer (EGC) have been implemented in several European countries. In Sweden, symptoms such as dysphagia, early satiety, and other alarm symptoms call for a referral for gastroscopy, according to the Swedish Standardized Course of Care (SCC). The aim of this study was to evaluate the diagnostic yield of the SCC criteria for EGC, to review all known EGC cases in Region Örebro County between March 2017 and February 2021, and to compare referral indication(s), waiting times, and tumor stage. In our material, EGC was found in 6.2% of the SCC referrals. Esophageal dysphagia had a positive predictive value (PPV) of 5.6%. The criterion with the highest PPV for EGC was suspicious radiological findings, with a PPV of 24.5%. A total of 139 EGCs were diagnosed, 99 (71%) through other pathways than via the SCC. Waiting times were approximately 14 days longer for patients evaluated via non-SCC pathways. There was no statistically significant association between referral pathway and primary tumor characteristics. The results show that a majority of the current SCC criteria are poor predictors of EGC, and some alarm symptoms lack a sufficiently specific definition, e.g., dysphagia. Referral through this fast track does not seem to have a positive impact on disease outcomes. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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11 pages, 3290 KiB  
Article
AI-Driven Colon Cleansing Evaluation in Capsule Endoscopy: A Deep Learning Approach
by Miguel José Mascarenhas Saraiva, João Afonso, Tiago Ribeiro, Pedro Cardoso, Francisco Mendes, Miguel Martins, Ana Patrícia Andrade, Hélder Cardoso, Miguel Mascarenhas Saraiva, João Ferreira and Guilherme Macedo
Diagnostics 2023, 13(23), 3494; https://doi.org/10.3390/diagnostics13233494 - 21 Nov 2023
Cited by 1 | Viewed by 1284
Abstract
Gastroenterology is increasingly moving towards minimally invasive diagnostic modalities. The diagnostic exploration of the colon via capsule endoscopy, both in specific protocols for colon capsule endoscopy and during panendoscopic evaluations, is increasingly regarded as an appropriate first-line diagnostic approach. Adequate colonic preparation is [...] Read more.
Gastroenterology is increasingly moving towards minimally invasive diagnostic modalities. The diagnostic exploration of the colon via capsule endoscopy, both in specific protocols for colon capsule endoscopy and during panendoscopic evaluations, is increasingly regarded as an appropriate first-line diagnostic approach. Adequate colonic preparation is essential for conclusive examinations as, contrary to a conventional colonoscopy, the capsule moves passively in the colon and does not have the capacity to clean debris. Several scales have been developed for the classification of bowel preparation for colon capsule endoscopy. Nevertheless, their applications are limited by suboptimal interobserver agreement. Our group developed a deep learning algorithm for the automatic classification of colonic bowel preparation, according to an easily applicable classification. Our neural network achieved high performance levels, with a sensitivity of 91%, a specificity of 97% and an overall accuracy of 95%. The algorithm achieved a good discriminating capacity, with areas under the curve ranging between 0.92 and 0.97. The development of these algorithms is essential for the widespread adoption of capsule endoscopy for the exploration of the colon, as well as for the adoption of minimally invasive panendoscopy. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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12 pages, 1135 KiB  
Article
Colorectal Endoscopic Submucosal Dissection: Performance of a Novel Hybrid-Technology Knife in an Animal Trial
by Jérémie Jacques, Horst Neuhaus, Markus D. Enderle, Ulrich Biber, Walter Linzenbold, Martin Schenk, Kareem Khalaf and Alessandro Repici
Diagnostics 2023, 13(21), 3347; https://doi.org/10.3390/diagnostics13213347 - 30 Oct 2023
Cited by 1 | Viewed by 1714
Abstract
Endoscopic submucosal dissection (ESD) was developed for the removal of benign and early malignant lesions in the gastrointestinal tract. We aimed to evaluate the performance and safety of a novel high-pressure waterjet-assisted ESD knife in colorectal applications. Six female German Landrace pigs with [...] Read more.
Endoscopic submucosal dissection (ESD) was developed for the removal of benign and early malignant lesions in the gastrointestinal tract. We aimed to evaluate the performance and safety of a novel high-pressure waterjet-assisted ESD knife in colorectal applications. Six female German Landrace pigs with an average weight of 62 kg (range 60–65 kg) were used in this prospective, randomized, and controlled study. Twenty-four ESDs were performed by three endoscopists: Twelve each with the new Erbe HYBRIDknife® flex T-Type (HK-T) and the Olympus DualKnife® J (DK-J), including six rectal and six colonic ESDs per instrument. The order of performance was randomized regarding anatomic position and instrument. As the primary endpoint, ESD knife performance characteristics were combined and rated on a 5-point Likert scale, with 5 Likert points (LP) representing the best response (5 = very good). The HK-T was rated significantly better than the DK-J (4.7 LP versus 4.4 LP, p = 0.0295), mainly because of HK-T injection ability (5 LP versus 3 LP, p < 0.0001) and hemostasis (5 LP versus 4 LP, p = 0.0452). There was no difference in procedure time (HK-T: 35 min versus DK-J: 34 min, p = 0.8005), resection diameter (3.1 cm versus 2.8 cm, p = 0.3492), injection volume (41 mL versus 46 mL, p = 0.5633), and complication rates. HK-T is as effective as DK-J in colorectal ESD in terms of dissection quality but has better injection and hemostatic properties. The impact of these technical advantages on the ESD treatment of patients with large superficial colorectal lesions remains to be clinically verified. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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Review

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22 pages, 6844 KiB  
Review
Updates in Diagnosis and Endoscopic Management of Cholangiocarcinoma
by Roxana-Luiza Caragut, Madalina Ilie, Teodor Cabel, Deniz Günșahin, Afrodita Panaitescu, Christopher Pavel, Oana Mihaela Plotogea, Ecaterina Mihaela Rînja, Gabriel Constantinescu and Vasile Sandru
Diagnostics 2024, 14(5), 490; https://doi.org/10.3390/diagnostics14050490 - 24 Feb 2024
Cited by 1 | Viewed by 1630
Abstract
Cholangiocarcinoma (CCA) is an adenocarcinoma originating from the epithelial cells of the bile ducts/hepatocytes or peribiliary glands. There are three types of cholangiocarcinoma: intrahepatic, perihilar and distal. CCA represents approximately 3% of the gastrointestinal malignancies. The incidence of CCA is higher in regions [...] Read more.
Cholangiocarcinoma (CCA) is an adenocarcinoma originating from the epithelial cells of the bile ducts/hepatocytes or peribiliary glands. There are three types of cholangiocarcinoma: intrahepatic, perihilar and distal. CCA represents approximately 3% of the gastrointestinal malignancies. The incidence of CCA is higher in regions of the Eastern world compared to the Western countries. There are multiple risk factors associated with cholangiocarcinoma such as liver fluke, primary sclerosing cholangitis, chronic hepatitis B, liver cirrhosis and non-alcoholic fatty liver disease. Endoscopy plays an important role in the diagnosis and management of cholangiocarcinoma. The main endoscopic methods used for diagnosis, biliary drainage and delivering intrabiliary local therapies are endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. The purpose of this review is to analyze the current data found in literature about cholangiocarcinoma, with a focus on the actual diagnostic tools and endoscopic management options. Full article
(This article belongs to the Special Issue Endoscopy in Diagnosis of Gastrointestinal Disorders)
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