Improved visibility of colorectal flat tumors using image‐enhanced endoscopy

Oka, Shiro; Tamai, Naoto; Ikematsu, Hiroaki; Kawamura, Takuji; Sawaya, Manabu; Takeuchi, Yoji; Uraoka, Toshio; Moriyama, Tomohiko; Kawano, Hiroshi; Matsuda, Takahisa

doi:10.1111/den.12445

Cited by 13 publications

(13 citation statements)

References 30 publications

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“…In contrast, IEE allows users to switch monitors by the single push of a button on the endoscope, which makes it easier to observe details. IEE has been used to highlight Barrett’s esophagus [29], as well as minimal changes in reflux esophagitis [30], neoplastic tissue [31], ulcerative colitis [32], and small intestinal lesions [33], as well as other diseases.…”

Section: Discussionmentioning

confidence: 99%

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

et al. 2018

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Background/Aims: To evaluate the usefulness of linked color imaging (LCI) and blue LASER imaging (BLI) in Barrett’s esophagus (BE) compared with white light imaging (WLI). Methods: Five expert and trainee endoscopists compared WLI, LCI, and BLI images obtained from 63 patients with short-segment BE. Physicians assessed visibility as follows: 5 (improved), 4 (somewhat improved), 3 (equivalent), 2 (somewhat decreased), and one (decreased). Scores were evaluated to assess visibility. The inter- and intra-rater reliability (intra-class correlation coefficient) of image assessments were also evaluated. Images were objectively evaluated based on L* a* b* color values and color differences (ΔE*) in a CIELAB color space system. Results: Improved visibility compared with WLI was achieved for LCI: 44.4%, BLI: 0% for all endoscopists; LCI: 55.6%, BLI: 1.6% for trainees; and LCI: 47.6%, BLI: 0% for experts. The visibility score of trainees compared with experts was significantly higher for LCI (p = 0.02). Intra- and inter-rater reliability ratings for LCI compared with WLI were “moderate” for trainees, and “moderate-substantial” for experts. The ΔE* revealed statistically significant differences between WLI and LCI. Conclusion: LCI improved the visibility of short-segment BE compared with WLI, especially for trainees, when evaluated both subjectively and objectively.

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Section: Discussionmentioning

confidence: 99%

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

et al. 2018

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“…The physicians rated the visibility of vessels, demarcation line between the submucosal and muscle layers after injection of hyaluronate sodium with minute indigo carmine, and fibrosis ( Figure 2). As previously described [Imagawa et al 2011;Oka et al 2015aOka et al , 2015b, the visibility on each image was rated as follows: +2 (improved), +1 (somewhat improved), 0 (equivalent to white light), -1 (somewhat decreased), and -2 (decreased). The seven scores for each image were totaled and evaluated.…”

Section: Methodsmentioning

confidence: 99%

“…Endoscopic submucosal dissection (ESD) has been a reliable method for en-bloc resection of colorectal tumors regardless of lesion size [Tanaka et al 2007[Tanaka et al , 2008[Tanaka et al , 2012[Tanaka et al , 2013Tamegai et al 2007;Saito et al 2010;Oka et al 2010Oka et al , 2015aOka et al , 2015bTerasaki et al 2014;Ninomiya et al 2015]. Although colorectal ESD has been established as a procedure with reproducible safety and efficacy, complications such as bleeding and perforation remain problematic.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of dual red imaging in colorectal endoscopic submucosal dissection: a pilot study

Ninomiya

Tanaka

Hirano

et al. 2016

Therap Adv Gastroenterol

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Background: Dual red imaging (DRI), a novel image-enhanced endoscopic technique, is expected to improve visibility of thin vessels, but no reports of the clinical use of DRI in colorectal endoscopic submucosal dissection (ESD) have been published. We aimed to compare the visibility of vessels, demarcation line between the submucosal and muscle layers after injection of hyaluronate sodium with minute indigo carmine, and fibrosis on DRI with that on white light imaging (WLI). We applied the principle of DRI to the image of the submucosal layer during colorectal ESD as a pilot study. Methods: A total of seven physicians compared 17 DRI images to the corresponding WLI images in colorectal ESD. The physicians compared the number of arteries identified on DRI with the actual number of arteries. The physicians rated the visibility of vessels, the demarcation line between the submucosal and muscle layers after injection of hyaluronate sodium with minute indigo carmine, and fibrosis. Inter-observer agreement was also examined using the kappa statistic. Results: Visibility of vessels and the demarcation line between the submucosal and muscle layers after injection of hyaluronate sodium with minute indigo carmine improved with the use of DRI compared with that using WLI. DRI can discriminate between arteries and veins clearly through the color of the vessels. Conclusions: DRI improves the visibility of vessels, especially that of arteries, as they appear orange, and the demarcation line of the muscle layer. DRI may help to make colorectal ESD safer and faster.

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“…The ability to differentiate SSA/P based on findings from narrow band imaging (NBI) has been reported; however, endoscopic diagnosis using NBI is based on a subjective assessment and requires the endoscopist to be knowledgeable and experienced . We previously reported that autofluorescence imaging (AFI) systems allow better visualization of colorectal neoplasia, including laterally spreading tumors, and color intensity analysis using AFI systems enables differentiation of colorectal neoplastic lesions from non‐neoplastic lesions, especially for diminutive colorectal lesions . However, color intensity analysis using AFI systems for serrated lesions has not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

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

Tamai

Inomata

Ichikawa

et al. 2016

Digestive Endoscopy

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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.

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Improved visibility of colorectal flat tumors using image‐enhanced endoscopy

Cited by 13 publications

References 30 publications

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

Clinical impact of dual red imaging in colorectal endoscopic submucosal dissection: a pilot study

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

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