On the Cause of Tertiary Contractions and Related Disturbances of the Esophagus

Stiennon, O. Arthur

doi:10.2214/ajr.104.3.617

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…The prediction results showed that the tertiary waves are a major factor leading to misdiagnosis in the proposed DLS. Tertiary waves are characterized by intermittently weakened or absent peristalsis associated with multiple nonperistaltic contractions of varying severity ( 4 , 35 ), whose incidence increases in older patients and in many primary or secondary esophageal motility disorders ( 36 , 37 ).…”

Section: Discussionmentioning

confidence: 99%

“…Benign esophageal strictures typically appear as relatively symmetric segments of narrowing with smooth contours and tapered margins, whereas malignant structures are more asymmetric and have nodular, irregular, or ulcerated contours and abrupt, shelflike margins ( 4 ). Other reasons, such as the inability of the entire esophageal circumferential sheath to contract freely, or delayed bolus clearance due to adhesions to the aorta or mediastinal lymph nodes, can also be responsible for the false positive/negative classification ( 36 ). Additionally, the radiologic identification of some cancers at the distal esophagus and esophagogastric junction remains a challenge to the deep learning detection system.…”

Section: Discussionmentioning

confidence: 99%

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Development of a Deep Learning System to Detect Esophageal Cancer by Barium Esophagram

et al. 2022

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BackgroundImplementation of deep learning systems (DLSs) for analysis of barium esophagram, a cost-effective diagnostic test for esophageal cancer detection, is expected to reduce the burden to radiologists while ensuring the accuracy of diagnosis.ObjectiveTo develop an automated DLS to detect esophageal cancer on barium esophagram.MethodsThis was a retrospective study using deep learning for esophageal cancer detection. A two-stage DLS (including a Selection network and a Classification network) was developed. Five datasets based on barium esophagram were used for stepwise training, validation, and testing of the DLS. Datasets 1 and 2 were used to respectively train and test the Selection network, while Datasets 3, 4, and 5 were respectively used to train, validate, and test the Classification network. Finally, a positioning box with a probability value was outputted by the DLS. A region of interest delineated by experienced radiologists was selected as the ground truth to evaluate the detection and classification efficiency of the DLS. Standard machine learning metrics (accuracy, recall, precision, sensitivity, and specificity) were calculated. A comparison with the conventional visual inspection approach was also conducted.ResultsThe accuracy, sensitivity, and specificity of our DLS in detecting esophageal cancer were 90.3%, 92.5%, and 88.7%, respectively. With the aid of DLS, the radiologists’ interpretation time was significantly shortened (Reader1, 45.7 s vs. 72.2 s without DLS aid; Reader2, 54.1 s vs. 108.7 s without DLS aid). Respective diagnostic efficiencies for Reader1 with and without DLS aid were 96.8% vs. 89.3% for accuracy, 97.5% vs. 87.5% for sensitivity, 96.2% vs. 90.6% for specificity, and 0.969 vs. 0.890 for AUC. Respective diagnostic efficiencies for Reader2 with and without DLS aid were 95.7% vs. 88.2% for accuracy, 92.5% vs. 77.5% for sensitivity, 98.1% vs. 96.2% for specificity, and 0.953 vs. 0.869 for AUC. Of note, the positioning boxes outputted by the DLS almost overlapped with those manually labeled by the radiologists on Dataset 5.ConclusionsThe proposed two-stage DLS for detecting esophageal cancer on barium esophagram could effectively shorten the interpretation time with an excellent diagnostic performance. It may well assist radiologists in clinical practice to reduce their burden.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of a Deep Learning System to Detect Esophageal Cancer by Barium Esophagram

et al. 2022

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“…The ability of radiography to document or characterize motility disorders other than achalasia is unknown (Katz and Castell 1984;Winans 1978), but when videofluoroscopy or cineradiographic techniques are performed and recorded by an expert, reliable qualitative information about peristalsis can be obtained (Winans 1978). A number of older patients, however, are reported to have radiographic abnormalities resembling diffuse spasm, but dysmotility may not be documented by other evaluations (Stiennon 1968). Dynamic imaging can be particularly useful in the patient with a pharyngeal or cervical esophageal problem.…”

Section: Radiologymentioning

confidence: 99%

A rational clinical approach to esophageal motor disorders

DiPalma

Meyer

1987

Dysphagia

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“…However, it is not altogether inelastic and when there is a sliding hernia with elevation of the squamocolumnar mucosal junction there may be some redundancy of the mucosa. Stiennon (1968), discussing tertiary contractions in the oesophagus, maintains that transverse mucosal folds may be present when factors maintaining oesophageal length in spite of longitudinal muscle contractions are negated. He refers to hiatal hernia where the inferior attachments of the oesophagus are stretched.…”

Section: Anatomy and Physiologymentioning

confidence: 99%

Circumferential oesophageal myotomy

Davidson

1972

Journal of British Surgery

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SUMMARYCircumferential division of the oesophageal muscle combined with hiatal hernia repair has been carried out in 26 patients, 19 of whom had a peptic stricture. The object of the procedure is to achieve slight elongation and relaxation of the oesophagus so as to make reduction of the hernia easier in the presence of slight degrees of oesophageal shortening and to reduce the likelihood of recurrence. The rationale and technique are described and details of illustrative cases are given. The postoperative radiological appearances, which are somewhat unusual, are illustrated. The indications and contra-indications are discussed. It is claimed that while circumferential myotomy is useless in the presence of gross shortening of the oesophagus it is of value in borderline cases where reduction of the hernia can be effected only by exerting slight tension on the oesophagus.IN the presence of a peptic stricture with acquired shortening of the oesophagus, reduction of the hernia may be difficult or impossible and recurrence is likely.

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On the Cause of Tertiary Contractions and Related Disturbances of the Esophagus

Cited by 8 publications

References 9 publications

Development of a Deep Learning System to Detect Esophageal Cancer by Barium Esophagram

Development of a Deep Learning System to Detect Esophageal Cancer by Barium Esophagram

A rational clinical approach to esophageal motor disorders

Circumferential oesophageal myotomy

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