Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
6.9
3.8
Journals
Diagnostics
Special Issues
Advances in Diagnosis of Digestive Diseases
share announcement

Advances in Diagnosis of Digestive Diseases

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (31 May 2026) | Viewed by 11095

Editor

Prof. Dr. Noriaki Manabe

E-Mail Website
Guest Editor
Division of Endoscopy and Ultrasonography, Department of Clinical Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama 700-8505, Japan
Interests: neurogastroenterology; gastrointestinal ultrasound; endoscope; gastroesophageal reflux

Special Issue Information

Dear Colleagues,

At the forefront of the diagnosis of gastrointestinal diseases, approaches to addressing organic diseases and functional diseases are progressing. In addition to the detection of microscopic lesions via high-resolution endoscopy, computed tomography, and magnetic resonance imaging and advances in pathological diagnosis via genetic analysis and immunostaining, physiological function evaluation, such as high-resolution manometry and breath testing for functional gastrointestinal disorders, is gaining importance.

The advent of artificial intelligence technology has significantly enhanced the analysis of endoscopic images, facilitating early cancer detection and differential diagnosis. Furthermore, the analysis of the microbiome is poised to contribute to the elucidation of pathological conditions such as inflammatory bowel disease and irritable bowel syndrome, paving the way for personalized medicine.

These advances are propelling the development of clinical practice in gastrointestinal diseases by facilitating more precise and exhaustive diagnoses, thereby reducing the burden on patients.

This Special Issue of Diagnostics will highlight the latest advances in diagnosing patients with organic and/or functional gastrointestinal diseases.

Prof. Dr. Noriaki Manabe
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnosis of gastrointestinal disease
  • functional gastrointestinal disorders
  • organic diseases
  • personalized medicine
  • physiological function evaluation

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

19 pages, 6024 KB  
Article
Establishment and Prospective Validation of a Classification System for Surface Microvessels in Peritoneal Lesions Under Magnifying Endoscopy
by Xianwen Guo, Liqi Shen, Ronge Lei, Pengyu Huang, Jiao Li, Zhen Ding and Rong Lin
Diagnostics 2026, 16(18), 2984; https://doi.org/10.3390/diagnostics16182984 - 15 Sep 2026
Viewed by 215
Abstract
Background: Peritoneal nodules require abdominal exploration and biopsy. However, blind biopsies may yield false-negative results. We developed a magnifying endoscopy-based microvascular classification for peritoneal lesions, prospectively validated its pathological predictive accuracy, and explored a precision-targeted biopsy strategy. Methods: This two-phase study was conducted [...] Read more.
Background: Peritoneal nodules require abdominal exploration and biopsy. However, blind biopsies may yield false-negative results. We developed a magnifying endoscopy-based microvascular classification for peritoneal lesions, prospectively validated its pathological predictive accuracy, and explored a precision-targeted biopsy strategy. Methods: This two-phase study was conducted at three hospitals from June 2016 to May 2022 (retrospective classification development) and four hospitals from June 2022 to February 2023 (prospective validation). Two experienced endoscopists first extracted features independently under blinded conditions and then constructed the microvascular classification (Types 1–3D) through an unblinded iterative process. Retrospective patients undergoing white-light endoscopic exploration served as non-randomized controls. Diagnostic accuracy, biopsy number, and histological diagnostic yield were compared. Results: This retrospective cohort included 56 patients with 77 peritoneal lesions. Of the 29 prospectively enrolled patients, 25 patients with 76 peritoneal lesions were included in the final validation. Three out-of-scope cases were reported separately. At the patient level, magnifying endoscopy showed significantly higher accuracy in predicting lesion pathology than white-light endoscopy (83.93% vs. 46.00%, p < 0.001), with fewer biopsies (p = 0.002) and a higher histological diagnostic rate (p < 0.001). Prospectively, the classification accuracy was 96.05% for tuberculosis (Type 2C), 96.05% for tumor-like lesions (Type 3A), 96.05% for mesothelioma (Type 3B), 97.37% for Müllerian epithelial tumors (Type 3C), and 90.79% for metastatic carcinoma (Type 3D). Conclusions: The microvascular classification showed promising preliminary accuracy for predicting peritoneal lesion pathology and may support precision-targeted biopsy. External validation and formal reproducibility assessment are required before clinical implementation. Full article
(This article belongs to the Special Issue Advances in Diagnosis of Digestive Diseases)
►▼ Show Figures

Figure 1

17 pages, 1284 KB  
Article
Artificial Intelligence-Based Prediction of Pancreatic Stone Clearance in Pancreatolithiasis Using Pretreatment CT Images and Clinical Features
by Satoshi Yamamoto, Atsushi Teramoto, Tomoyuki Ono, Senju Hashimoto, Yoshiaki Katano, Takashi Kobayashi, Hisanori Muto, Yoshihiko Tachi, Hironao Miyoshi and Kazuo Inui
Diagnostics 2026, 16(17), 2700; https://doi.org/10.3390/diagnostics16172700 - 24 Aug 2026
Viewed by 353
Abstract
Background/Objectives: Nonsurgical treatment for pancreatolithiasis is widely performed. However, treatment success remains difficult to predict before treatment initiation, complicating the selection of an appropriate treatment strategy. This study aimed to predict pancreatic stone clearance after nonsurgical treatment for pancreatolithiasis associated with chronic pancreatitis [...] Read more.
Background/Objectives: Nonsurgical treatment for pancreatolithiasis is widely performed. However, treatment success remains difficult to predict before treatment initiation, complicating the selection of an appropriate treatment strategy. This study aimed to predict pancreatic stone clearance after nonsurgical treatment for pancreatolithiasis associated with chronic pancreatitis by integrating pretreatment computed tomography (CT) images and clinical information using deep learning and machine learning models. Methods: Of 195 patients with pancreatolithiasis associated with chronic pancreatitis who underwent nonsurgical treatment, including extracorporeal shock wave lithotripsy, at our institution between 1992 and 2024, only 91 (47%) had extractable pretreatment noncontrast abdominal CT images and were included in the AI analysis. Multiple deep learning models (VGG16/19, InceptionV3, ResNet50, DenseNet121/169/201, Vision Transformer, and Swin Transformer) were trained using CT images, and their predictive performance was compared. Imaging-derived and clinical predictors selected using only the training data in each patient-level cross-validation fold were combined and used as inputs for conventional machine learning models, including random forest, support vector machine, naïve Bayes, neural network, and gradient boosting. Results: Successful pancreatic stone clearance was achieved in 54 of 91 patients (59%). Compared with the 104 patients without extractable CT data, the analyzed cohort had a higher proportion of asymptomatic pancreatolithiasis (43% vs. 15%) and a markedly lower pancreatic stone clearance rate (59% vs. 88%), indicating potential selection bias. Asymptomatic pancreatolithiasis and a pancreatic stone size of ≥15 mm, defined using a data-derived exploratory cutoff, were significantly associated with unsuccessful stone clearance. Among the deep learning models, ResNet50 achieved the highest performance (area under the receiver operating characteristic curve [AUC], 0.718), followed by Vision Transformer (Large model, 16 × 16 patches) (AUC, 0.700). When image-derived features were combined with clinical features, the neural network achieved the best performance, with a mean AUC of 0.757, a median sensitivity of 0.568, a median specificity of 0.704, and a median accuracy of 0.659. Conclusions: A neural network integrating CT-derived image features with clinical information showed moderate internal predictive performance for pancreatic stone clearance. Because this was a single-center retrospective study without external validation, the present model should be regarded as a preliminary predictive model requiring validation in independent cohorts before clinical application. Full article
(This article belongs to the Special Issue Advances in Diagnosis of Digestive Diseases)
►▼ Show Figures

Figure 1

11 pages, 357 KB  
Article
Risk Factors for Inadequate Bowel Preparation Before Colonoscopy in Patients with Ulcerative Colitis in Clinical and Endoscopic Remission: A Multicenter Retrospective Cohort Study
by Davide Scalvini, Stiliano Maimaris, Elisa Stasi, Marco Valvano, Daniele Brinch, Mario Romeo, Michele Dota, Marcello Dallio, Virginia Gregorio, Chiara Sophie Sabbione, Marta Vernero, Giovanni Santacroce, Stefano Mazza, Simona Agazzi, Aurelio Mauro, Alessandro Federico, Annalisa Schiepatti, Davide Giuseppe Ribaldone, Marco Vincenzo Lenti, Gianpiero Manes, Antonio Facciorusso, Antonio Di Sabatino, Federico Biagi, Cristina Bezzio, Simone Saibeni and Andrea Anderloniadd Show full author list remove Hide full author list
Diagnostics 2026, 16(3), 490; https://doi.org/10.3390/diagnostics16030490 - 5 Feb 2026
Viewed by 1586
Abstract
Background/Objectives: Adequate bowel preparation (BP) is crucial for effective colorectal cancer (CRC) surveillance in ulcerative colitis (UC). While active inflammation is known to negatively impact cleansing, data regarding predictors of BP quality specifically in UC patients with inactive disease remain limited. This [...] Read more.
Background/Objectives: Adequate bowel preparation (BP) is crucial for effective colorectal cancer (CRC) surveillance in ulcerative colitis (UC). While active inflammation is known to negatively impact cleansing, data regarding predictors of BP quality specifically in UC patients with inactive disease remain limited. This study aimed to investigate risk factors for inadequate BP in UC patients in clinical/endoscopic remission and to compare the efficacy of 1L-PEG-ASC versus 2L-PEG regimens. Methods: A multicentric, retrospective, cohort study was conducted across eight Italian centers. Consecutive adult outpatients with UC undergoing colonoscopy between January-2021 and December-2022 who were in endoscopic and clinical remission were included. Boston Bowel Preparation Scale (BBPS) was assessed in patients undergoing 1L-PEG-ASC or 2L-PEG bowel preparation. Univariable and multivariable logistic regression analyses were performed to identify risk factors for inadequate BP and compare outcomes between PEG regimens. Results: A total of 379 patients were included (58% M, mean age 52.3 ± 15.4 years). The overall rate of adequate BP was 90.5%. Traditional risk factors, including demographic, clinical, and endoscopic characteristics, were not predictive of inadequate preparation in this remission cohort. Comparing regimens, 1L-PEG-ASC yielded significantly higher median total BBPS scores compared to 2L-PEG (8 [IQR 7–9] vs. 6 [IQR 6–8]; p < 0.001) and a higher exam completion rate (99.5% vs. 95.7%; p = 0.02), although the difference in adequate BP rates did not reach statistical significance (92.6% vs. 87.7%; p = 0.12). Multivariable analysis confirmed that 2L-PEG was independently associated with lower odds of achieving higher BBPS scores (OR 0.30; 95% CI 0.20–0.45). Conclusions: In UC patients with clinical and endoscopic remission, BP adequacy rates are high and comparable to the general population, suggesting that traditional IBD-related risk factors are less relevant in the absence of active inflammation. However, the 1L-PEG-ASC regimen demonstrated superior cleansing quality and exam completion rates compared to 2L-PEG. These findings support the prioritization of 1L-PEG-ASC to optimize mucosal visualization during CRC surveillance in this population. Full article
(This article belongs to the Special Issue Advances in Diagnosis of Digestive Diseases)
►▼ Show Figures

Figure 1

14 pages, 737 KB  
Article
Diagnostic Evaluation of an Increased Risk of Developing Small Intestinal Bacterial Overgrowth Associated with Glucagon-like Peptide-1 (GLP-1) Receptor Agonists and Dual GLP-1/GIP Receptor Agonists: A Global Retrospective Multicenter Cohort Analysis
by Yan Sun, Donovan Veccia, Benjamin Douglas Xun Liu, William Tse, Ronnie Fass and Gengqing Song
Diagnostics 2025, 15(17), 2264; https://doi.org/10.3390/diagnostics15172264 - 7 Sep 2025
Cited by 2 | Viewed by 4622
Abstract
Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) effectively manage type 2 diabetes mellitus (T2DM) but may impair gastrointestinal motility, increasing the risk of small intestinal bacterial overgrowth (SIBO). Diagnostic evaluation of SIBO commonly involves breath testing and clinical assessment. This study aimed to [...] Read more.
Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) effectively manage type 2 diabetes mellitus (T2DM) but may impair gastrointestinal motility, increasing the risk of small intestinal bacterial overgrowth (SIBO). Diagnostic evaluation of SIBO commonly involves breath testing and clinical assessment. This study aimed to assess the association between GLP-1 RAs or dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) RAs are associated with incident SIBO. Methods: We conducted a retrospective cohort study using the TriNetX global database, identifying adult T2DM patients initiating GLP-1 RA or dual GLP-1/GIP RA therapy versus other second-line T2DM agents (OSLT2DM) from 1 January 2006 to 2 December 2024. Patients with major abdominal surgery, connective tissue disorders, gastroparesis, or other high-risk conditions for SIBO were excluded. 1:1 Propensity score matching was applied. Short-term (<1 year) and long-term (up to 5 years) risks were evaluated with Kaplan–Meier curves and univariable Cox models. Results: After matching, 216,173 patients per cohort were analyzed. Short-term analysis demonstrated a higher incidence of diagnostically confirmed SIBO in patients treated with GLP-1 RA/GIP (0.177 per 1000 patient-years) compared to OSLT2DM (0.083 per 1000 patient-years; HR 2.14, 95% CI 1.13–4.07; p = 0.0491). Long-term analysis indicated a non-significant trend toward increased risk in the GLP-1 RA/GIP group (HR 2.02, 95% CI 0.98–4.12), though Kaplan–Meier analysis revealed a sustained divergence (p = 0.017). Conclusions: GLP-1 RA and dual GLP-1/GIP RA therapy are associated with increased short-term SIBO risk. Symptom-driven SIBO breath-test evaluation may be warranted in patients initiating these agents. Full article
(This article belongs to the Special Issue Advances in Diagnosis of Digestive Diseases)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

10 pages, 540 KB  
Review
Not All Patients Need a CT When the Appendix Is Not Seen on Ultrasound: A Scoping Review
by Ali Ramji, Justin J. Y. Kim, Gavin Low, Karim Samji and Mitchell P. Wilson
Diagnostics 2026, 16(2), 304; https://doi.org/10.3390/diagnostics16020304 - 17 Jan 2026
Viewed by 1833
Abstract
Background/Objective: Recent North American guidelines suggest that CT is indicated for further evaluation where ultrasound (US) is negative, although the negative predictive value (NPV) of ultrasound in adult patients when the appendix is not seen remains unclear. To assess the negative predictive [...] Read more.
Background/Objective: Recent North American guidelines suggest that CT is indicated for further evaluation where ultrasound (US) is negative, although the negative predictive value (NPV) of ultrasound in adult patients when the appendix is not seen remains unclear. To assess the negative predictive value (NPV) of ultrasound in adult patients when the appendix is not seen. Methods: A scoping review of MEDLINE and EMBASE was performed from inception to 13 May 2025 using PRISMA-ScR guidelines to identify studies evaluating the outcome of adult patients where the appendix is not seen on ultrasound, with preference for studies where there were no secondary signs of acute appendicitis (right lower quadrant free fluid, abscess, ileus, echogenic fat or regional lymphadenopathy). Original studies with at least 10 patients were included in the review. The reference standard included a combination of clinical follow-up, CT and/or pathology. Data synthesis was provided as a qualitative review of the existing literature. Results: Six studies were included in the review. The number of included patients range from 12 to 179 with a mean age of 29–38 years. Few studies reported the patient BMI. NPVs ranged from 80 to 90% for all indeterminate ultrasounds and 83 to 95% for studies where secondary signs of appendicitis were excluded (90 to 95% when non-surgical reference standards were included). Two studies reported NPVs of 96–100% when the pre-test probability was low. Conclusions: The NPV of indeterminate ultrasound for adult patients with right lower quadrant pain and no secondary signs of appendicitis is likely ≥90%. When combined with a low clinical suspicion, the NPV is likely >95%. The appropriateness of a subsequent CT indication when the appendix is not visualized on ultrasound should be determined on an individualized basis. Full article
(This article belongs to the Special Issue Advances in Diagnosis of Digestive Diseases)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

12 pages, 8150 KB  
Case Report
Management of Gastric Fistulas After Gastric Sleeve Using E-VAC Therapy
by Bogdan Mihnea Ciuntu, Alexandra-Simona Zamfir, Mădălina Maxim, Carmen Lăcrămioara Zamfir, Roxana Elena Ciuntu, Mihai Lucian Zabara, Irina Mihaela Abdulan, Mihaela Corlade-Andrei, Daniel Vasile Timofte and Gheorghe G. Balan
Diagnostics 2025, 15(21), 2811; https://doi.org/10.3390/diagnostics15212811 - 6 Nov 2025
Cited by 1 | Viewed by 1571
Abstract
Background and Clinical Significance: Sleeve gastrectomy is an effective and widely performed bariatric procedure that provides long-term, sustained weight loss, but it carries risks of early and late complications. Among these, gastric fistula is a rare occurrence associated with an increased mortality rate [...] Read more.
Background and Clinical Significance: Sleeve gastrectomy is an effective and widely performed bariatric procedure that provides long-term, sustained weight loss, but it carries risks of early and late complications. Among these, gastric fistula is a rare occurrence associated with an increased mortality rate and must be carefully considered to ensure timely diagnosis and appropriate management. Case Presentation: We will present the complex case of a patient who was referred to the general surgery department due to severe abdominal pain, exertional dyspnea, nausea, fever and fatigue, symptoms that appeared one month after a robotic gastric sleeve. The investigations led to the diagnostic of high gastric fistula secondary to a gastric sleeve procedure. The patient underwent exploratory laparotomy with jejunostomy, peritoneal lavage, drainage, and endoscopic placement of an endoluminal vacuum assisted closure (E-VAC) system. Close clinical, laboratory, imaging, and endoscopic monitoring demonstrated progressive improvement, with complete resolution of the fistula achieved after seven weeks of E-VAC therapy. Conclusions: The particularity of this case lies in the occurrence of a delayed mechanical gastric suture dehiscence, with late diagnosis, managed using E-VAC. Even though rare, gastric fistulas represent a potentially life-threatening complication of sleeve gastrectomy. Early diagnosis and a multidisciplinary approach, which includes infection control, surgical intervention and minimally invasive techniques like E-VAC, are essential for effective management and favorable outcomes. Full article
(This article belongs to the Special Issue Advances in Diagnosis of Digestive Diseases)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-6
Back to TopTop