Publications by authors named "Daizen Hirata"

Objectives: Although accurate assessment of polyp morphology helps endoscopists select the appropriate management for colorectal polyps, some studies have reported unsatisfactory accuracy in such assessment. This study aimed to clarify the usefulness of a short educational video available on the Internet for accurate polyp morphology assessment.

Methods: This was a multicenter randomized controlled trial.

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Article Synopsis
  • - Detection and diagnosis of colon polyps are crucial for preventing colorectal cancer, and AI technologies can improve colonoscopy effectiveness through computer-aided detection (CADe) and diagnosis (CADx) systems.
  • - The REAL-Colon dataset offers a large collection of 2.7 million native video frames from real-world colonoscopy, featuring 350,000 expert-annotated bounding boxes, which provide a more realistic dataset compared to existing down-sampled images.
  • - This dataset includes comprehensive patient and procedural data, promoting transparency and enabling researchers to develop and benchmark more accurate AI algorithms for improved colonoscopy outcomes.
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Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal tumor. Some papers have reported that colonoscopy could be used to treat PEComa with a predominantly pedunculated polyp, whereas surgical intervention is often required for cases with submucosal-type tumors. These findings suggest that the morphology of PEComa changes dramatically with disease progression.

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  • Sessile serrated lesions (SSLs) are potential precursors to colorectal cancer, and selectively removing them could decrease healthcare costs, yet distinguishing them from hyperplastic polyps (HPs) during colonoscopy is difficult.* -
  • A multicenter study involved expert endoscopists using magnifying colonoscopy to differentiate SSLs from HPs, with findings showing a sensitivity of 79.8% overall and 82.4% for those diagnosed with high confidence.* -
  • Despite the expertise involved, accurately diagnosing SSLs is challenging, leading to a recommendation that all JNET type 1 lesions that are 6 mm or larger should be removed to avoid missing a significant number of SSLs.*
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Background: The endocytoscope with ultra-high magnification (x 520) allows us to observe the cellular structure of the colon epithelium during colonoscopy, known as virtual histopathology. We hypothesized that the endocytoscope could directly observe colorectal histopathological specimens and store them as endocyto-pathological images by the endoscopists without a microscope, potentially saving the burden on histopathologists.

Aim: To assess the feasibility of endocyto-pathological images taken by an endoscopist as adequate materials for histopathological diagnosis.

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The provision of endoscopic training was significantly disrupted during the coronavirus disease (COVID-19) pandemic. It is difficult to provide training on endoscopic submucosal dissection (ESD) due to the complexity of the procedure and the shortage of local trainers. We have designed and conducted a simulation training course with telementoring, incorporating the concept of rapid cycle deliberate practice (RCDP).

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Objectives: Since carbonized clots and tissue (debris) tend to adhere firmly to the tip of the endoscopic submucosal dissection (ESD) knife as the procedure proceeds, manual removing the firm debris is often challenging and time-consuming. Recently, effective ultrasonic cleaning for other medical devices has been reported. The aim of the present study was to clarify whether ultrasonic cleaning is effective in removing the debris on the insulation-tipped diathermic (IT) knife-2.

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Objectives: Three subcategories of high-risk flat and depressed lesions (FDLs), laterally spreading tumors non-granular type (LST-NG), depressed lesions, and large sessile serrated lesions (SSLs), are highly attributable to post-colonoscopy colorectal cancer (CRC). Efficient and organized educational programs on detecting high-risk FDLs are lacking. We aimed to explore whether a web-based educational intervention with training on FIND clues (fold deformation, intensive stool/mucus attachment, no vessel visibility, and demarcated reddish area) may improve the ability to detect high-risk FDLs.

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Fundic gland polyps (FGPs) are the most common gastric polyps and have been regarded as benign lesions with little malignant potential, except in the setting of familial adenomatous polyposis. However, in recent years, the prevalence of FGPs has been increasing along with the widespread and frequent use of proton pump inhibitors (PPIs). To date, several cases of FGPs with dysplasia or carcinoma (FGPD/CAs) have been reported.

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Article Synopsis
  • Accurate estimation of polyp size is crucial for determining treatment and monitoring intervals in colorectal care, yet many endoscopists make these estimations incorrectly without realizing it.
  • A study involving 261 endoscopists in Japan assessed how experience influenced their ability to size polyps, revealing that those with fewer colonoscopy procedures performed in the past year were more likely to misjudge sizes.
  • Results showed that inexperienced endoscopists tended to overestimate polyp sizes significantly more than their experienced counterparts, highlighting the need for better training and awareness in size estimation.
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In recent years, the serrated neoplasia pathway where serrated polyps arise as a colorectal cancer has gained considerable attention as a new carcinogenic pathway. Colorectal serrated polyps are histopathologically classified into hyperplastic polyps (HPs), sessile serrated lesions, and traditional serrated adenomas; in the serrated neoplasia pathway, the latter two are considered to be premalignant. In western countries, all colorectal polyps, including serrated polyps, apart from diminutive rectosigmoid HPs are removed.

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Background And Aim: Accurate polyp size estimation is necessary for appropriate management of colorectal polyps. Polyp size is often determined by subjective visual estimation in clinical situations; however, it is inaccurate, especially for beginner endoscopists. We aimed to clarify the usefulness of our short training video, available on the Internet, for accurate polyp size estimation.

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  • This study explored the benefits of removing colorectal polyps immediately during the insertion phase of a colonoscopy, instead of waiting until the withdrawal phase.
  • A randomized trial involved 220 patients with small left-sided polyps, comparing instant polypectomy to the traditional method, and found that the instant removal reduced overall procedure time significantly.
  • Results showed that instant removal not only shortened the procedure but also prevented any missed polyps, suggesting it as a more efficient approach without negative impacts on the examination.
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Five years have passed since the Japan Narrow Band Imaging Expert Team (JNET) classification was proposed in 2014. However, the diagnostic performance of this classification has not yet been established. We conducted a retrospective study and a systematic search of Medical Literature Analysis and Retrieval System On-Line.

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An 80-year-old man was found to have a reddish depressed lesion on the middle thoracic esophagus. The morphology of the lesion had been almost unchanged for 3 years, but it transformed to a 2-cm depressed lesion with elevated margins and an irregular nodular surface. The lesion was resected endoscopically and ultimately diagnosed as a combined neuroendocrine carcinoma and squamous cell carcinoma with submucosal invasion.

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Background And Aim: In recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert-based consensus to standardize the preparation, detection and characterization for the diagnosis of early-stage colorectal neoplasia.

Methods: A professional group was formed by 36 experts of the Asian Novel Bio-Imaging and Intervention Group (ANBI G) members.

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Aim: To clarify the diagnostic performance of endocytoscopy for differentiation between neoplastic and non-neoplastic colorectal diminutive polyps.

Methods: Patients who underwent endocytoscopy between October and December 2016 at Sano Hospital were prospectively recruited. When diminutive polyps (≤ 5 mm) were detected, the lesions were evaluated by endocytoscopy after being stained with 0.

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Background And Aim: Magnifying chromoendoscopy has been one of the most reliable diagnostic methods for distinguishing neoplastic from non-neoplastic lesions. The aim of this prospective study was to clarify the clinical usefulness of magnifying chromoendoscopy for colorectal polyps initially diagnosed with low confidence (LC) by magnifying narrow-band imaging (NBI).

Methods: Consecutive adult patients who underwent total colonoscopic examination with magnifying NBI between July and December 2016 at Sano Hospital were prospectively recruited.

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We report a case of resected hepatocellular carcinomas (HCCs) after drug-eluting bead transarterial chemoembolization (DEB-TACE). A 67-year-old man with alcoholic liver disease was diagnosed with HCCs. Serological markers for hepatitis B and C viruses were negative.

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