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Advanced imaging and artificial intelligence for Barrett's esophagus:What we should and soon will do

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World Journal of Gastroenterology 2022年第11期28卷 1113-1122页

作者： Marco Spadaccini Edoardo Vespa Viveksandeep Thoguluva Chandrasekar Madhav Desai Harsh K Patel Roberta Maselli Alessandro Fugazza Silvia Carrara Andrea Anderloni Gianluca Franchellucci Alessandro De Marco Cesare Hassan pradeep bhandari Prateek Sharma Alessandro Repici Department of Endoscopy Humanitas Research HospitalIRCCSRozzano 20089Italy Department of Biomedical Sciences Humanitas UniversityRozzano 20089Italy Department of Gastroenterology and Hepatology Mayo ClinicPhoenixAZ 85054United States Department of Gastroenterology and Hepatology Kansas City VA Medical CenterKansas CityMO 66045United States Department of Internal Medicine Ochsner Clinic FoundationNew OrleansLA 70124United States Endoscopy Unit Nuovo Regina Margherita HospitalRoma 00153Italy Department of Gastroenterology Portsmouth Hospitals University NHS TrustPortsmouth PO63LYUnited Kingdom School of Pharmacy and Biomedical Sciences University of PortsmouthPortsmouth PO63LYUnited Kingdom

Barrett’s esophagus(BE)is a well-established risk factor for esophageal *** is recommended that patients have regular endoscopic surveillance,with the ultimate goal of detecting early-stage neoplastic lesions before they can progress to invasive *** of both dysplasia or early adenocarcinoma permits curative endoscopic treatments,and with this aim,thorough endoscopic assessment is crucial and improves *** burden of missed neoplasia in BE is still far from being negligible,likely due to inappropriate endoscopic *** the last two decades,advanced imaging techniques,moving from traditional dye-spray chromoendoscopy to more practical virtual chromoendoscopy technologies,have been introduced with the aim to enhance neoplasia detection in *** witnessed in other fields,artificial intelligence(AI)has revolutionized the field of diagnostic endoscopy and is set to cover a pivotal role in BE as *** aim of this commentary is to comprehensively summarize present evidence,recent research advances,and future perspectives regarding advanced imaging technology and AI in BE;the combination of computer-aided diagnosis to a widespread adoption of advanced imaging technologies is eagerly *** will also provide a useful step-by-step approach for performing high-quality endoscopy in BE,in order to increase the diagnostic yield of endoscopy in clinical practice.

关键词： Barrett’s esophagus Endoscopy Artificial intelligence Surveillance Advanced imaging Neoplasia

Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry

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World Journal of Gastroenterology 2013年第36期19卷 6011-6019页

作者： Rehan J Haidry Mohammed A Butt Jason Dunn Matthew Banks Abhinav Gupta Howard Smart pradeep bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John Massimo Di Pietro Ian Penman Marco Novelli Laurence B Lovat Department of Surgery and Interventional Science National Medical Laser Centre UCL Department Gastroenterology University College Hospital NHS Foundation Trust Department Gastroenterology Guy’s and St Thomas’ Hospitals NHS Trust Institute for Medical Informatics Oslo University Hospital Department Gastroenterology Royal Liverpool University Hospital Merseyside Department Gastroenterology Princess Alexandra Hospital Cosham Department Gastroenterology Bradford Royal Infirmary Bradford Department Gastroenterology Central Manchester University Hospital Department Gastroenterology Glasgow Royal Infirmary Department Gastroenterology Addenbrooke’s Hospital Royal Infirmary Edinburgh

AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National ***:A Prospective cohort study from 8 tertiary referral centres in the United *** with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were *** lesions were removed by endoscopic mucosal resection(EMR)before *** initial RFA treatment,patients were followed up *** flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or *** main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse ***:Twenty patients with squamous HGD/ESCC completed treatment *** patients(25%)had EMR before starting RFA ***-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this *** per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 *** patients(20%)required endoscopic dilatations for symptomatic structuring after *** of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per *** other 2 patients required only a single dilatation to achieve an adequate symptomatic *** patient developed cancer during follow up after end of treatment ***:The role of RFA in these patients re-mains *** our series 50%patients responded at12 *** figures are lower than limited published data.

关键词： Squamous neoplasia Oesophageal cancer Endoscopic mucosal resection High-grade dysplasia Radiofrequency ablation

英国胃肠病学会关于胃癌风险患者的诊断和管理指南

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中华胃肠内镜电子杂志 2020年第2期7卷 49-83页

作者： Matthew Banks David Graham Marnix Jansen TakujiGotoda Sergio Coda Massimiliano di Pietro NoriyaUedo pradeep bhandari D Mark Pritchard Ernst J Kuipers Manuel Rodriguez-Justo Marco R Novelli KrishRagunath Neil Shepherd Mario Dinis-Ribeiro 乌雅罕(译) 张冬雪(译) 牛占岳(校) 刘鑫(校) 丁士刚(译/校) 伦敦大学学院医院伦敦大学学院医院NHS基金会英国伦敦目标干预研究部伦敦大学学院英国伦敦外科与介入科学部伦敦大学学院生物科学部英国伦敦伦敦大学学院病理学系英国伦敦日本大学医学院医学研究所消化科日本东京板桥区健康集团内镜英国伦敦医学研究委员会癌症中心剑桥大学英国剑桥剑桥大学医院NHS基金会消化科英国剑桥内镜训练和学习中心大阪癌症及心血管疾病医学中心胃肠肿瘤科日本大阪朴茨茅斯大学英国朴茨茅斯转化医学研究所利物浦大学英国利物浦伊拉斯谟大学医学中心荷兰鹿特丹诺丁汉消化疾病中心诺丁汉大学医院英国诺丁汉格洛斯特郡大学细胞病理实验室切尔滕纳姆综合医院英国切尔滕纳姆波尔多葡萄牙肿瘤学研究所消化科葡萄牙波尔多北京大学第三医院消化科北京100191 不详

胃癌预后较差,部分原因在于诊断较晚。胃癌的危险因素包括幽门螺杆菌(***,HP)感染和胃癌家族史,尤其是遗传性弥漫性胃癌和恶性贫血。胃癌发展的阶段包括慢性胃炎、胃黏膜萎缩(GA)、胃黏膜肠化生(GIM)和异型增生。胃癌早期发现和提高生... 详细信息

胃癌预后较差,部分原因在于诊断较晚。胃癌的危险因素包括幽门螺杆菌(***,HP)感染和胃癌家族史,尤其是遗传性弥漫性胃癌和恶性贫血。胃癌发展的阶段包括慢性胃炎、胃黏膜萎缩(GA)、胃黏膜肠化生(GIM)和异型增生。胃癌早期发现和提高生存率的关键是在内镜检查前以非侵入性方式识别高危人群。然而,尽管生物标志物可能有助于检测慢性萎缩性胃炎,但尚无足够的证据支持其用于人群筛查。高质量内镜检查是胃癌早期发现的重要组成部分,图像增强内镜结合组织病理学活检是GA和GIM最佳的诊断方法,并能准确进行风险分层。按照悉尼标准从胃窦、角切迹、小弯和大弯进行活检,既能明确诊断,也能对胃癌进行风险分层。理想状态应当是在高质量内镜检查中对GA或GIM区域活检。英国属于低危地区,可根据需要接受常规诊断性胃镜检查,但没有足够证据支持筛查,对于广泛GA或GIM的患者,每3年检查内镜。对于胃异型增生和早期癌,只要满足标准,内镜下黏膜切除术或内镜黏膜下剥离术的治疗有效,成功率高,复发率低。

关键词：慢性萎缩性胃炎内镜检查内镜黏膜下剥离术恶性贫血常规诊断角切迹早期癌胃肠病学

Influential aspects on seismic performance of confined masonry construction

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Natural Science 2013年第8期5卷 56-62页

作者： Ajay Chourasia Sriman K. Bhattacharyya pradeep K. Bhargava Navratan M. bhandari CSIR-Central Building Research Institute Roorkee India Department of Civil Engineering Indian Institute of Technology Roorkee Roorkee India

Recent earthquakes around the world have resulted in loss of human lives and high economic losses due to poor performance of unreinforced masonry constructions as well as poorly-built reinforced concrete framed buildings. This has necessitated alternative building technologies with improved seismic performance. Confined masonry (CM) construction, has shown excellent behavior during past earthquakes across the world and requires similar skill at a marginally higher cost than that of unreinforced masonry. This paper summarizes the main features of generic construction and gains insight into the behavior of CM elements under earthquake excitations, representing a viable alternative for safe and economical construction in seismic areas.?The paper discusses various influential aspects like sequence of construction, properties and type of masonry material, structural configuration, reinforcement detailing in tie column/beam and masonry, panel aspect ratio, interface between concrete and masonry, axial stress, multiple confining column, opening in wall panels and damage pattern etc. along with solution to overcome the limitations.

关键词： Confined Masonry Reinforcement Detailing Panel Aspect Ratio Masonry Interface Multiple Confining Column Damage Pattern