High-sensitivity FEES® with the professional image enhancement technology “PIET”

Abstract

Purpose Flexible endoscopic evaluation of swallowing (FEES®) is a standard diagnostic tool in dysphagia. The combination of FEES® and narrow band light (narrow band imaging; NBI) provides a more precise and detailed investigation method. So far, this technique could only be performed with the NBI illumination. The new version of the “professional image enhancement technique” (PIET) provides another image enhancing system. This study investigates the eligibility of PIET in the FEES® procedure. Methods Both techniques, NBI and PIET, were compared using a target system. Furthermore, the image enhancement during FEES® was performed and recorded with the two systems during daily routine. Results Performing an image enhancement during FEES® is possible with both systems PIET and NBI. On the target system, the contrast of the PIET showed a brighter and a more detailed picture. In dysphagia patients, no difference between PIET and NBI was detected. Conclusions PIET proved to be non-inferior to NBI during image enhancement FEES®. So far, image enhancement FEES® was exclusively connected to NBI. With the PIET system, an alternative endoscopy technology is available for certain indications.

Comparison of three different image enhancement systems for detection of laryngeal lesions

“…1,2,4 Image1 S and professional image enhancement technology systems have been available for a few years. 3,9 Narrow-band imaging uses narrow-band light, and the other two systems use a digital software algorithm to visualise vascular changes. The data from this study show that all three image enhancement systems can reliably diagnose suspicious lesions in the larynx and hypopharynx with high accuracy.…”

“…The digital algorithm produces approximately the same change in contrast as illumination with narrow-band light. 3,8,9 The main focus in these techniques is neoangiogenesis and visualisation of the vessels. 4 A proliferation of vessels with dilated and submucosal capillary loops are connected in premalignant and malignant lesions.…”

“…[1][2][3][4][5][6][7]11,12 There are few data in the literature on the use of image enhancement techniques other than narrow-band imaging. 3,[7][8][9] Staníková et al showed that Image1 S and narrow-band imaging are comparable. 3 However, narrow-band imaging is an online technique using narrow-band light.…”

Do Disinfectant Solutions during Gargling Reach the Pharynx?

“…With NBI illumination, yellow and green color turns into bright red. This results in an enhanced contrast and is called “hsFEES ® ” [17, 19, 20]. Nienstedt et al [17] showed a significantly higher detection rate using the NBI technique in FEES ® .…”

“…The water was colored with commercially available yellow color particles (E 102). Previous studies show, that a dilution up to 1:10,000 is detectable with NBI in the oral cavity [17, 20]. Therefore, we decided to use a dilation of 1:1,000 in the gargling fluid.…”