Evidence map›Paper›PMID 41171422›Full record

ArticleSurgical endoscopy2026

Improved diagnostic accuracy and safety of gel-endoscopic ultrasonography for deep submucosal invasion in early gastric cancer.

Ai Fujimoto, Junji Tanaka, Nobuyuki Sato, Kenzo Hara, Keita Suzuki, Hikari Kobayashi, Yusuke Nishikawa, Masashi Ono, Kazuhisa Yamaguchi, Takahito Toba and 1 more

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ai FujimotoDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan. aifujimoto0517@gmail.com.ORCID 0000-0003-3489-3356
Junji TanakaDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Nobuyuki SatoDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Kenzo HaraDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Keita SuzukiDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Hikari KobayashiDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Yusuke NishikawaDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Masashi OnoDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Kazuhisa YamaguchiDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Takahito TobaDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.
Takahisa MatsudaDepartment of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Otaku, Tokyo, 143-8541, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate diagnosis of the depth of invasion is critical in determining appropriate treatment in early gastric cancer (EGC), especially when submucosal deep invasion (d-SM) is suspected. The diagnostic accuracy of conventional endoscopic ultrasonography (EUS) remains limited; however, the use of large volumes of de-aerated water carries a risk of aspiration pneumonia.

methodsThis retrospective study evaluated the diagnostic performance and safety of gel-EUS, a method that uses a transparent, viscous gel instead of water. A total of 81 EGC lesions suspected of submucosal invasion were investigated: 52 underwent conventional EUS (group W) and 29 underwent gel-EUS (group G). The diagnostic sensitivity, specificity, safety outcomes, and examination time were compared between the two groups.

resultsGel-EUS showed significantly higher sensitivity in detecting d-SM cancer compared to conventional EUS (83.3% vs. 25.0%), while its specificity was somewhat lower (70.6% vs. 89.7%). The examination time was significantly shorter in group G (median 3.0 vs. 8.0 min, p < 0.001). Aspiration events occurred less frequently in group G (3.7% vs. 13.4%). The single aspiration case in group G occurred before the gel infusion. Although midazolam use was higher in group G, there were no significant differences in oxygen use, saturation, or blood pressure.

conclusionsGel-EUS is a safe and efficient alternative to conventional EUS, offering higher sensitivity, shorter examination time, and reduced aspiration risk. This novel approach may improve the diagnostic accuracy for deep submucosal invasion in EGC and assist in optimal treatment selection.

Indexed as

EndosonographyGastric MucosaStomach NeoplasmsAgedAged, 80 and overFemaleGelsHumansMaleMiddle AgedNeoplasm InvasivenessRetrospective StudiesSensitivity and SpecificityGelsDepth diagnosisEndoscopic ultrasonographyGastric cancerSubmucosal invasionViscous gel

Identifiers

PMID41171422

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.