Fujinon intelligent color enhancement for the diagnosis of early esophageal squamous cell carcinoma and precancerous lesion

Abstract

Background/Aims: Esophageal squamous cell carcinoma is a common malignant tumor in recent years, and the key for improving the survival rate is early diagnosis and treatment. Computed virtual chromoendoscopy with the Fujinon intelligent color enhancement (FICE) system was reported to improve visualization of neoplastic and nonneoplastic lesions in gastroscopy and colonoscopy. The purpose of this study was to evaluate the value of FICE in the diagnosis of early esophageal squamous cell carcinoma and precancerous lesions. Materials and Methods: Two hundred fifty-seven patients with suspicious lesions of the esophagus were examined successively by FICE, magnifying FICE, Lugol chromoendoscopy, and magnifying Lugol chromoendoscopy in the hospital. The lesions and the intrapapillary capillary loop (IPCL, microvessels at the surface of esophageal carcinoma) were observed and compared with the pathologic diagnosis that was regarded as the golden standard. Results: The positive rates of early esophageal squamous cell carcinoma were 92.6% and 88.9% as examined by FICE and Lugol chromoendoscopy (p>0.05), and 96.3% and 92.6% as examined by magnifying FICE and magnifying Lugol chromoendoscopy (p>0.05), respectively. The magnifying FICE could observe the IPCL of the esophagus clearly. Early esophageal squamous cell carcinoma and high-grade intraepithelial neoplasia were mainly type IV and type V. Low-grade intraepithelial neoplasia and esophagitis were type II and type III, and normal esophagus was type I; however, the observation of the IPCL by magnifying Lugol chromoendoscopy was not clear. Conclusion: Fujinon intelligent color enhancement and magnifying FICE are complements to Lugol chromoendoscopy and magnifying Lugol chromoendoscopy in the diagnosis of early esophageal lesions.

Current Status of Image-Enhanced Endoscopy for Early Identification of Esophageal Neoplasms

“…However, there was no statistical significance (92.6% vs. 88.9%, p> 0.05; 96.3% vs. 92.6%, p > 0.05, respectively). 71 i-SCAN is a technology that post-processes endoscopic imaging to provide surface, contrast, and tone enhancement. 72 It has been shown to be superior to WLE in the detection of BE.…”

Narrowed-spectrum Technologies in Endoscopic Imaging of The Upper Gastrointestinal Tract

“…47 FICE and magnifying FICE have shown diagnostic rates of 92.6% and 96.3%, respectively, for early ESCC. 48 One of the drawbacks of FICE is the lack of visualization of IPCLs, especially in comparison to NBI. 49 In a prospective single center non-inferiority study from China, the detection rate of ESCC using i-SCAN was 10.4% and found to be non-inferior to LCE which had a detection rate of 12.9%.…”

The Value of Virtual Chromoendoscopy in the Workup of Patients with Head and Neck Squamous Cell Carcinoma

“…Few studies evaluating FICE, I-Scan and CLE have been conducted. FICE is considered complementary to LCE and has been shown to be a promising technique [27,34,37]. M-FICE and NM-FICE have shown similar detection rates as LCE [27,34].…”

“…FICE is considered complementary to LCE and has been shown to be a promising technique [27,34,37]. M-FICE and NM-FICE have shown similar detection rates as LCE [27,34]. I-Scan too showed a non-inferiority when compared with LCE, despite its unsatisfactory screening performance (Table 2) [37].…”