CHA Bundang Hospital said Professor Cho Joo-young’s team has developed the world’s first endoscopic ultrasound (EUS)-elastography technique that can detect submucosal tumors.
|Professor Cho Joo-young|
A submucosal tumor is a tumor located in the middle of the gastrointestinal wall covered with normal mucosa. Endoscopic biopsy is impossible, and endoscopy alone cannot confirm whether the tumor is malignant or benign. Since tumors are located under the lesion mucosa, it is also difficult to accurately diagnose the tumor as it is impossible to reach the lesion.
Therefore, hospitals have used EUS or regular endoscopy to estimate the size and internal features of tumors and to evaluate the change in size. However, it was difficult to establish a treatment guideline as it was difficult to predict whether the tumor would grow or become malignant, and many patients were anxious and frustrated with follow-up treatment without an accurate diagnosis.
Professor Cho’s team examined 31 patients with gastric submucosal tumors from April to December 2018 and performed a preoperative gastroelastic endoscopic ultrasonography to determine the relationship between the strain ratio depending on the stiffness of the tissue and the actual biopsy results. It also measured the strain of gastric submucosal tumor with elastography using the difference of tissue stiffness according to histopathological characteristics.
As a result, gastric endoscopic ultrasonography showed a high risk of malignant gastrointestinal stromal tumors when the mean values of lipoma, leiomyoma, ectopic pancreas, gastrointestinal stromal tumor, and schwannoma exceeded 22.7.
“This study opened the way to predict and treat submucosal tumors as well as to reduce unnecessary procedures and operations for the diagnosis of such tumors,” Professor Cho said. “It is expected that new research paradigms may be suggested through recent research in advanced diagnostic endoscopy.”
Gastrointestinal Endoscopy published the results of the study.