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Small depressed neoplasms of the large bowel: radiographic visualization and clinical significance
1Central Clinic of the Foundation for the Detection of Early Gastric Cancer, Tokyo, Japan.
Abstract:
Small depressed and flat neoplasms (small flat adenomas) exist-in the large bowel and in the stomach. Most have been detected with colonoscopy. We tried to delineate these lesions radiographically. Radiographically, the contour of the lesions measuring 5 mm and less was visualized in 32 (60.4%) of 53 lesions. Radiographic examination preceded colonoscopy in 23 (71.9%) of these lesions. Ten (83.3%) of 12 lesions measuring 6-10 mm were visualized. The central depression was clearly delineated in 32 (60.4%) of 53 lesions measuring 5 mm and less and in 5 of the 12 (41.7%) lesions measuring 6-10 mm. The central depression was not demonstrated in all lesions whose contours were not visualized. The clinical significance of the small depressed neoplasm lies in the fact that a certain number may be a precursor of rapidly growing carcinoma with early submucosal invasion.
Insights
Radiography can visualize small depressed neoplasms in the gastrointestinal tract, aiding in early detection. This imaging technique helps identify precursors to carcinoma, improving diagnostic capabilities.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Oncology
Background:
- Small depressed and flat neoplasms, such as small flat adenomas, are found in the large bowel and stomach.
- Most of these lesions are currently detected via colonoscopy.
- Early detection is crucial due to their potential to become rapidly growing carcinomas.
Purpose of the Study:
- To evaluate the radiographic delineation of small depressed and flat neoplasms.
- To assess the feasibility of using radiography for identifying these lesions before colonoscopy.
Main Methods:
- Retrospective analysis of radiographic examinations preceding colonoscopy for small depressed and flat neoplasms.
- Evaluation of lesion contour visualization and central depression delineation based on size.
Main Results:
- Radiographic contours of 60.4% of lesions (≤5 mm) and 83.3% of lesions (6-10 mm) were visualized.
- Central depression was clearly delineated in 60.4% of smaller lesions and 41.7% of larger lesions.
- Lesions with unvisualized contours did not demonstrate central depression.
Conclusions:
- Radiography can visualize the contours and central depressions of small depressed and flat neoplasms.
- Radiographic detection may precede colonoscopy, offering an alternative or complementary diagnostic approach.
- Identifying these neoplasms radiographically is significant for detecting potential precursors to invasive carcinoma.