Effectiveness of color intensity analysis using updated autofluorescence imaging systems for serrated lesions

Abstract

Background and Aim: We previously reported the effectiveness of color intensity analysis using autofluorescence imaging (AFI) for differentiating colorectal neoplastic lesions from non-neoplastic lesions. However, the ability of AFI systems for differentiating serrated lesions has not been evaluated. In the present study, we assessed the effectiveness of color intensity analysis using updated AFI systems for evaluating serrated lesions. Methods:We retrospectively reviewed the data for 48 consecutive patients with 87 serrated lesions that were examined using updated AFI systems and resected at Jikei University Hospital. The mean green/red (G/R) ratio, which is obtained by dividing the mean green color intensities by the mean red color intensities, was calculated for each serrated lesion and compared between hyperplastic polyps, sessile serrated adenomas/polyps (SSA/P) with cytological dysplasia, and SSA/P without cytological dysplasia. We also assessed the area under the receiver operating characteristic curve (AUC) for determining SSA/P (both with and without cytological dysplasia) and SSA/P with cytological dysplasia.Results: The AUC for determining SSA/P was 0.68; however, the AUC for determining SSA/P with cytological dysplasia was 0.97. With a cut-off for the G/R ratio of <0.93, the sensitivity, specificity, positive predictive value, and negative predictive value for SSA/P with cytological dysplasia were 95.5%, 91.0%, 77.8%, and 98.3%, respectively. Conclusion:Color intensity analysis of serrated lesions using updated AFI systems could effectively distinguish SSA/P with cytological dysplasia from hyperplastic polyps and SSA/P without cytological dysplasia.

Diagnosis of advanced gastric cancer using image enhancement and autofluorescence imaging systems

“…8,9 In particular, the usefulness of thoracoscopy and bronchoscopy for lung cancer 10,11 and endoscopic diagnosis for gastric and colon cancers has been reported. [12][13][14][15][16] Some studies have compared the diagnostic performance of AF observation with endoscopy with white light or NBI observation. 17 On the other hand, it has been reported that the diagnostic ability can be improved using NBI observation together with AF observation, 18,19 which suggests that these diagnostic techniques should be used complementarily.…”

Endoscopic hemostasis for spurting duodenal bleeding using dual red imaging

“…It was reported that DRI improves visibility of deeper submucosal blood vessels and the bleeding point because 600 nm and 630 nm wavelengths can penetrate deep into the tissue. [1][2][3][4] We describe an educational case of spurting duodenal bleeding in which DRI was used to achieve endoscopic hemostasis.…”

“…1 Difficulty in determining their margins causes incomplete resection. 2 Although narrowband imaging (NBI) and other advanced imaging systems are reportedly useful in evaluating these polyps, 3,4 simpler and easier measures are in great demand. Acetic acid has been used in endoscopic diagnosis by using its effect of causing temporal mucosal reaction and eliminating surficial mucus.…”

Acetic acid‐indigocarmine mixture for evaluating the margins of sessile serrated adenomas/polyps

“…Difficulty in determining their margins causes incomplete resection . Although narrow‐band imaging (NBI) and other advanced imaging systems are reportedly useful in evaluating these polyps, simpler and easier measures are in great demand. Acetic acid has been used in endoscopic diagnosis by using its effect of causing temporal mucosal reaction and eliminating surficial mucus .…”