Endoscopic visible light spectroscopy: a new, minimally invasive technique to diagnose chronic GI ischemia

Noord, Désirée van; Sana, Aria; Benaron, David A.; Pattynama, Peter M. T.; Verhagen, Hence J.M.; Hansen, Bettina E.; Kuipers, Ernst J.; Mensink, Peter

doi:10.1016/j.gie.2010.10.025

Cited by 52 publications

(51 citation statements)

References 12 publications

(17 reference statements)

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“…By analysing the backscattered light the capillary oxygen saturation can be calculated (figure 6). A first study performed by our group showed promising results of application of VLS in patients referred for evaluation of possible CGI 27 57. In this study, cut-off values were determined in a test cohort and subsequently validated in a second cohort of patients.…”

Section: Diagnosis Of Cgimentioning

confidence: 98%

Chronic gastrointestinal ischaemia: shifting paradigms

Mensink

Moons

Kuipers

2010

Gut

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Chronic gastrointestinal ischaemia (CGI) is generally considered to be a rare disease entity. The majority of patients with CGI are only diagnosed after a long period of slowly progressive abdominal symptoms, in some cases with impressive weight loss. These patients may have a broad range of clinical signs and quite often undergo repeated extensive evaluation of their symptoms with negative outcome. The classical triad of symptoms, also known as 'abdominal angina', is defined as the combination of postprandial pain, weight loss due to fear of pain after eating, and an abdominal bruit during physical examination. Recent studies have shed new lights on these long unchallenged concepts. These studies first showed that CGI is more prevalent than previously thought and can occur in patients with both single- and multi-vessel disease. Second, the disease presents with a much wider range in symptoms, and only a minority of patients present with the classical triad. Third, long-term positive outcomes can be achieved after endovascular or surgical revascularisation therapy in large proportion of patients. This knowledge results from a combination of clinical research by dedicated focus groups, the current widespread availability of new imaging techniques such as CT-angiography, the development of new functional tests for assessment of mucosal perfusion, and the evolution of endovascular stenting options. Clinicians diagnosing and treating patients with acute and chronic abdominal conditions have to be aware of these new developments. We therefore here review the new insights on CGI with a focus on epidemiology, pathophysiology, current diagnostics and treatment.

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Section: Diagnosis Of Cgimentioning

confidence: 98%

Chronic gastrointestinal ischaemia: shifting paradigms

Mensink

Moons

Kuipers

2010

Gut

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“…VLS is an alternative functional assessment technique focusing on mucosal perfusion with a sensitivity of 90% and a specificity of 60% [9]. The technique noninvasively measures mucosal oxygen saturations during endoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…The established approach for patients suspected of CGI includes assessment of medical history in combination with vascular abdominal imaging and assessment of mucosal perfusion [3]. Techniques used for the assessment of mucosal perfusion include gastric exercise tonometry (GET) [3][4][5][6][7][8] and visible light spectroscopy (VLS) [9]. GET uses submaximal exercise as a provocation of gastrointestinal ischemia, in essence very similar to the concept of exercise testing commonly used for the evaluation of cardiac ischemia.…”

Section: Introductionmentioning

confidence: 99%

Combining radiological imaging and gastrointestinal tonometry

Noord

Sana²,

Moons³

et al. 2013

European Journal of Gastroenterology & Hepatology

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“…The optical parameters of the tissue can be defined by three parameters: the absorption coefficient μ a , scattering coefficient μ s , and scattering anisotropy parameter g. For the inner part of the vessel, we used the μ a of hemoglobin 12 for its absorption, where we defined the hemoglobin concentration as 150 g∕L and the oxygen saturation as 70%, a typical value for gastrointestinal mucosa. 20,21 The scattering coefficient within the vessel was set to zero to accord with the optical properties of the phantom vessels (described in Sec. 2.1.1).…”

Section: Methods For Simulation Studymentioning

confidence: 99%

Quantitative study on appearance of microvessels in spectral endoscopic imaging

et al. 2015

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Abstract. Increase in abnormal microvessels in the superficial mucosa is often relevant to diagnostic findings of neoplasia in digestive endoscopy; hence, observation of superficial vasculature is crucial for cancer diagnosis. To enhance the appearance of such vessels, several spectral endoscopic imaging techniques have been developed, such as narrow-band imaging and blue laser imaging. Both techniques exploit narrow-band blue light for the enhancement. The emergence of such spectral imaging techniques has increased the importance of understanding the relation of the light wavelength to the appearance of superficial vasculature, and thus a new method is desired for quantitative analysis of vessel visibility in relation to the actual structure in the tissue. Here, we developed microvessel-simulating phantoms that allowed quantitative evaluation of the appearance of 15-μm-thick vessels. We investigated the relation between the vascular contrast and light wavelength by the phantom measurements and also verified it in experiments with swine, where the endoscopically observed vascular contrast was investigated together with its real vascular depth and diameter obtained by microscopic observation of fluorescence-labeled vessels. Our study indicates that changing the spectral property even in the wavelength range of blue light may allow selective enhancement of the vascular depth for clinical use. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Endoscopic visible light spectroscopy: a new, minimally invasive technique to diagnose chronic GI ischemia

Cited by 52 publications

References 12 publications

Chronic gastrointestinal ischaemia: shifting paradigms

Chronic gastrointestinal ischaemia: shifting paradigms

Combining radiological imaging and gastrointestinal tonometry

Quantitative study on appearance of microvessels in spectral endoscopic imaging

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