Annual Report 2018

Division of Science and Technology for Endoscopy (Kashiwa Campus)

Hiroaki Ikematsu, Tomonori Yano, Keisuke Hori, Toshihiro Takamatsu, Takako Mamada

Introduction

 Now, endoscopy is widely used for screening, diagnosis, and treatment for early cancer in aero-digestive tracts including the pharynx, esophagus, stomach, and colorectum. With conventional endoscopy, observations are made using white light to illuminate the mucosal surface with special attention paid to the appearance of reddish and irregular portions compared to adjacent areas. Thus, the detection of suspicious early cancerous lesions has been largely based on the macroscopic characteristics of the lesions. Still, the detection is difficult for all endoscopists. Therefore, we are working on the development of auxiliary diagnosis for the detection of gastrointestinal lesions by using artificial intelligence (AI).

Research activities

 Present research activities mainly focus on the development of new endoscopic imaging modalities.

 One project is the development of a diagnostic AI system for the detection of gastrointestinal lesions with the high efficiency of deep learning. Within this period, we succeeded in developing the AI model for the detection of stomach and colorectal lesions with high accuracy rate (Figure 1). Another project is a new bioimaging system using near-infrared light with a wavelength of over 1,000 nm with various spectrums. This system is capable of penetrating through the gastrointestinal wall and obtaining images. Another project is examination of gastrointestinal lesion images in photoacoustic imaging. It may be possible to visualize deep vascular networks in the future. Another project is development of an automatic colonoscope.

Figure 1. Detection of small colorectal lesions by using diagnostic AI system

Clinical trials

1) Development of diagnosticAI system for the detection of gastrointestinal lesions

2) Development of diagnostic endoscopy for GIST using near-infrared light

3) Photoacoustic imaging of fresh human surgical and endoscopic gastrointestinal specimens: a pilot study

Education

 One researcher at Tokyo University of Science was sent to our hospital (National Cancer Center Hospital East: NCCHE) by a crossappointment with Tokyo University of Science.

 Meetings are constantly conducted with faculties including technology and science students of Tokyo University of Science.

Future prospects

 In the future, we will continue to develop endoscopic equipment in cooperation with the Department of Gastroenterology and Endoscopy of the NCCHE and try innovative approaches to produce all-new endoscopy in collaboration with academia and companies.

 With the aim of acquiring new seeds, we are developing the research infrastructure necessary to collaborate with academia.

List of papers published in 2018

Journal

 1. Takeuchi Y, Sawaya M, Oka S, Tamai N, Kawamura T, Uraoka T, Ikematsu H, Moriyama T, Arao M, Ishikawa H, Ito Y, Matsuda T. Efficacy of autofluorescence imaging for flat neoplasm detection: a multicenter randomized controlled trial (A-FLAT trial). Gastrointest Endosc, 89:460-469, 2019

 2. Takashima K, Oono Y, Kojima M, Ikematsu H, Akimoto T, Yano T. Clinicopathological features and endoscopic characteristics of inverted sessile serrated adenomas/polyps. Endosc Int Open, 7:E330-E336, 2019

 3. Oono Y, Kensuke S, Yoda Y, Hori K, Ikematsu H, Yano T. Cervical esophageal adenocarcinoma arising from heterotopic gastric mucosa, treated with endoscopic submucosal dissection. Endoscopy, 51:E28-E29, 2019

 4. Kumahara K, Ikematsu H, Shinmura K, Murano T, Inaba A, Okumura K, Nishihara K, Sunakawa H, Furue Y, Ito R, Sato D, Minamide T, Okamoto N, Yamamoto Y, Suyama M, Takashima K, Nakajo K, Yoda Y, Hori K, Oono Y, Yano T. Objective evaluation of the visibility of colorectal lesions using eye tracking. Dig Endosc, 2019

 5. Nishihara K, Oono Y, Kuwata T, Ikematsu H, Yano T. Depressed gastric-type adenoma in nonatrophic gastric mucosa without Helicobacter pylori infection. Endoscopy, 51:E138-E140, 2019

 6. Wu H, Minamide T, Yano T. Role of photodynamic therapy in the treatment of esophageal cancer. Dig Endosc, 2019

 7. Oono Y, Shinmura K, Hori K, Yoda Y, Ishii G, Ikematsu H, Yano T. Endoscopic submucosal resection using a ligation device without injection for duodenal neuroendocrine tumors. Surg Endosc, 33:2008-2014, 2019

 8. Kadota T, Seo S, Fuse H, Ishii G, Itoh K, Yano T, Kaneko K, Tsukasaki K. Complications and outcomes in diffuse large B-cell lymphoma with gastric lesions treated with R-CHOP. Cancer Med, 8:982-989, 2019

 9. Suzuki H, Takizawa K, Hirasawa T, Takeuchi Y, Ishido K, Hoteya S, Yano T, Tanaka S, Endo M, Nakagawa M, Toyonaga T, Doyama H, Hirasawa K, Matsuda M, Yamamoto H, Fujishiro M, Hashimoto S, Maeda Y, Oyama T, Takenaka R, Yamamoto Y, Naito Y, Michida T, Kobayashi N, Kawahara Y, Hirano M, Jin M, Hori S, Niwa Y, Hikichi T, Shimazu T, Ono H, Tanabe S, Kondo H, Iishi H, Ninomiya M. Short-term outcomes of multicenter prospective cohort study of gastric endoscopic resection: 'Real-world evidence' in Japan. Dig Endosc, 31:30-39, 2019

 10. Oono Y, Kuwata T, Takashima K, Shinmura K, Hori K, Yoda Y, Ikematsu H, Shitara K, Kinoshita T, Yano T. Human epidermal growth factor receptor 2-, epidermal growth factor receptor-, and mesenchymal epithelial transition factor-positive sites of gastric cancer using surgical samples. Gastric Cancer, 22:335-343, 2019

 11. Nakajo K, Yoda Y, Hori K, Takashima K, Sinmura K, Oono Y, Ikematsu H, Yano T. Technical feasibility of endoscopic submucosal dissection for local failure after chemoradiotherapy or radiotherapy for esophageal squamous cell carcinoma. Gastrointest Endosc, 88:637-646, 2018

 12. Yoshida M, Takizawa K, Suzuki S, Koike Y, Nonaka S, Yamasaki Y, Minagawa T, Sato C, Takeuchi C, Watanabe K, Kanzaki H, Morimoto H, Yano T, Sudo K, Mori K, Gotoda T, Ono H. Conventional versus traction-assisted endoscopic submucosal dissection for gastric neoplasms: a multicenter, randomized controlled trial (with video). Gastrointest Endosc, 87:1231-1240, 2018

 13. Sakai Y, Takemoto S, Hori K, Nishimura M, Ikematsu H, Yano T, Yokota H. Automatic detection of early gastric cancer in endoscopic images using a transferring convolutional neural network. Conf Proc IEEE Eng Med Biol Soc, 2018:4138-4141, 2018

 14. Hombu T, Yano T, Hatogai K, Kojima T, Kadota T, Onozawa M, Yoda Y, Hori K, Oono Y, Ikematsu H, Fujii S. Salvage endoscopic resection (ER) after chemoradiotherapy for esophageal squamous cell carcinoma: What are the risk factors for recurrence after salvage ER? Dig Endosc, 30:338-346, 2018

 15. Kadota T, Hatogai K, Yano T, Fujita T, Kojima T, Daiko H, Fujii List of papers published in 2018 Journal 488 S. Pathological tumor regression grade of metastatic tumors in lymph node predicts prognosis in esophageal cancer patients. Cancer Sci, 109:2046-2055, 2018

 16. Iwatate M, Sano Y, Tanaka S, Kudo SE, Saito S, Matsuda T, Wada Y, Fujii T, Ikematsu H, Uraoka T, Kobayashi N, Nakamura H, Hotta K, Horimatsu T, Sakamoto N, Fu KI, Tsuruta O, Kawano H, Kashida H, Takeuchi Y, Machida H, Kusaka T, Yoshida N, Hirata I, Terai T, Yamano HO, Nakajima T, Sakamoto T, Yamaguchi Y, Tamai N, Nakano N, Hayashi N, Oka S, Ishikawa H, Murakami Y, Yoshida S, Saito Y. Validation study for development of the Japan NBI Expert Team classification of colorectal lesions. Dig Endosc, 30:642-651, 2018

 17. Mori Y, Kudo SE, Misawa M, Saito Y, Ikematsu H, Hotta K, Ohtsuka K, Urushibara F, Kataoka S, Ogawa Y, Maeda Y, Takeda K, Nakamura H, Ichimasa K, Kudo T, Hayashi T, Wakamura K, Ishida F, Inoue H, Itoh H, Oda M, Mori K. Real-Time Use of Artificial Intelligence in Identification of Diminutive Polyps During Colonoscopy: A Prospective Study. Ann Intern Med, 169:357-366, 2018

 18. Kudo T, Saito Y, Ikematsu H, Hotta K, Takeuchi Y, Shimatani M, Kawakami K, Tamai N, Mori Y, Maeda Y, Yamada M, Sakamoto T, Matsuda T, Imai K, Ito S, Hamada K, Fukata N, Inoue T, Tajiri H, Yoshimura K, Ishikawa H, Kudo SE. New-generation full-spectrum endoscopy versus standard forward-viewing colonoscopy: a multicenter, randomized, tandem colonoscopy trial (J-FUSE Study). Gastrointest Endosc, 88:854-864, 2018

 19. Oono Y, Kuwata T, Takashima K, Yoda Y, Ikematsu H, Shitara K, Kinoshita T, Yano T. Clinicopathological features and endoscopic findings of HER2-positive gastric cancer. Surg Endosc, 32:3964- 3971, 2018

 20. Nakajo K, Oono Y, Kuwata T, Yano T. A case of a protruded lesion formed by a poorly differentiated intramucosal adenocarcinoma of the stomach: an immunohistochemical analysis. Clin J Gastroenterol, 11:127-132, 2018

 21. Nakajo K, Oono Y, Kuwata T. Case of pyloric gland adenoma accompanied by a component of foveolar epithelial-type adenoma within the lesion. Dig Endosc, 30:673, 2018