Digital Chromoendoscopy for Diagnosis of Diminutive Colorectal Lesions

Abstract

Introduction. To compare the accuracy of digital and real-time chromoendoscopy for the differential diagnosis of diminutive (<5 mm) neoplastic and nonneoplastic colorectal lesions. Materials and Methods. This is a prospective randomized study comparing the Fujinon intelligent color enhancement (FICE) system (65 patients/95 lesions) and indigo carmine (69 patients/120 lesions) in the analysis of capillary meshwork and pit pattern, respectively. All lesions were less than 5 mm in diameter, and magnification was used in both groups. Histopathology was the gold standard examination. Results. Of 215 colorectal lesions, 153 (71.2%) were adenomas, and 62 were hyperplastic polyps (28.8%). Morphological analysis revealed 132 (61.4%) superficial lesions, with 7 (3.3%) depressed lesions, and 83 (38.6%) protruding lesions. Vascular meshwork analysis using FICE and magnification resulted in 91.7% sensitivity, 95.7% specificity, and 92.6% accuracy in differentiating neoplastic from nonneoplastic lesions. Pit pattern analysis with indigo carmine and magnification showed 96.5% sensitivity, 88.2% specificity, and 94.2% accuracy for the same purpose. Conclusion. Both magnifying virtual chromoendoscopy and indigo carmine chromoendoscopy showed high accuracy in the histopathological diagnosis of colorectal lesions less than 5 mm in diameter.

Rate and Risk Factors of the Advanced Adenomas Among Diminutive Colorectal Polyps

“…Endoscopic diagnosis of polyp histology during colonoscopy and forgoing of a pathologic examination can lower costs of the procedure. Santos et al reported that magnifying virtual and indigo carmine chromo-endoscopies had high accuracy for the histopathological diagnosis of colorectal lesions less than 5 mm in diameter [29]. We did not observe any complications due to the polypectomy procedure during this study.…”

ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps

“…Eight studies reported or provided information enabling the calculation of the NPV of optical biopsy performed by FICE for adenomatous polyp histology of small and diminutive colorectal polyps. [33][34][35][36][37][38][39][40] These studies collectively evaluated 1243 small or diminutive colorectal polyps in real-time by using FICE and compared the evaluation with the criterion standard histopathology. There was no evidence of publication bias based on a review of the funnel plot (Appendix 3).…”

High-definition endoscopy withiScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group

“…The positive aspect of the designation of a diagnosis for the patient should also be taken into account. [9][10][11][12][13][14][15][16][17][18] The present study addresses the value of highdefinition endoscopy with virtual chromoendoscopy (iScan ® ; Pentax EPKi processor, Pentax Japan) or chromoendoscopy by Lugol's solution compared with the gold standard of histology in patients with NERD for the detection of very small mucosal lesions.…”