Novel Chromoendoscopic Method Using an Acetic Acid–indigocarmine Mixture for Diagnostic Accuracy in Delineating the Margin of Early Gastric Cancers

Kawahara, Yoshiro; Takenaka, Ryuta; Okada, Hiroyuki; Kawano, Seiji; Inoue, Masafumi; Tsuzuki, Takao; Tanioka, Daisuke; Hori, Keisuke; Yamamoto, Kazuhide

doi:10.1111/j.1443-1661.2008.00824.x

Cited by 64 publications

(52 citation statements)

References 27 publications

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“…Conventional ME was carried out first, and the mode was then changed to NBI. For ME-AIM, 20 ml AIM solution (freshly prepared 0.6 % acetic acid added to 0.2 % indigo carmine) [3] was sprinkled evenly over and around the lesion using a washing pipette. The images for the AIM observation were obtained after waiting approximately 2 min for the color change reaction.…”

Section: Endoscopic Proceduresmentioning

confidence: 99%

“…Various techniques using magnifying endoscopy (ME) and chromoendoscopy [1][2][3] are expanding to enhance images of gastric tumors, and observation of the microstructures of gastric mucosa by ME [4,5] has been proposed in the recognition of early gastric cancer (EGC). It has been reported [2] that ME enhanced by acetic acid may be useful for identifying gastric tumors because it shows the superficial mucosal structure more clearly through the acetowhite reaction.…”

Section: Introductionmentioning

confidence: 99%

“…It has been reported [2] that ME enhanced by acetic acid may be useful for identifying gastric tumors because it shows the superficial mucosal structure more clearly through the acetowhite reaction. A novel chromoendoscopic method using an acetic acid-indigo carmine mixture (AIM) [3] has been reported to improve the diagnostic yield for delineating the margin of EGC. However, the method has not been applied in ME.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced magnifying endoscopy for differential diagnosis of superficial gastric lesions identified with white-light endoscopy

Guo

Yang

et al. 2013

Gastric Cancer

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Background Various techniques using magnifying endoscopy (ME) and chromoendoscopy are being developed to enhance images of gastrointestinal tumor. The aim of this study was to evaluate the diagnostic performance of ME enhanced by acetic acid-indigo carmine mixture (ME-AIM) and ME enhanced with narrow-band imaging (ME-NBI) for differential diagnosis of superficial gastric lesions identified with conventional white-light endoscopy (WLE). Methods Patients with superficial gastric lesions picked up with WLE were enrolled in the study. ME-NBI and ME-AIM were used to further characterize the lesions. All images of the lesions were evaluated by four skilled endoscopists blinded to the clinical data. The microarchitectural patterns in the lesions were analyzed with reference to the ''VS classification'' system. Results A total of 643 lesions (mean diameter, 7 mm) from 508 patients (316 men, 192 women; mean age, 63 years) were evaluated. Pathologically, 24 of the 643 lesions were diagnosed as gastric cancer; the others were noncancerous lesions. For diagnosis of gastric cancer, the negative predictive value of each of the three magnified findings (irregular microvascular pattern, irregular microsurface pattern, and demarcation line) was high (nearly 100 %). According to the ''VS classification'' system, either ME-NBI or ME-AIM had a higher specificity (99.5 % or 99.4 % vs. 89.5 %, P \ 0.001) and accuracy (99.2 % or 98.9 % vs. 89.0 %, P \ 0.001) than WLE, and ME-AIM was not superior to ME-NBI for identifying carcinoma. Conclusions Enhanced ME is useful for correctly diagnosing early gastric cancer, and in contrast with ME-AIM, ME-NBI is a more feasible and efficient method for clinical practice.

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Section: Endoscopic Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Enhanced magnifying endoscopy for differential diagnosis of superficial gastric lesions identified with white-light endoscopy

Guo

Yang

et al. 2013

Gastric Cancer

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“…In contrast, the Japanese have been instrumental in the adoption of technologies to enhance the detection of EGC, including the use of high-resolution and magnification endoscopy, chromoendoscopy, point spectroscopy, fluorescence imaging, and confocal endoscopy (15,16). Endoscopy units in western countries often use chromoendoscopy, together with indigo carmine dye, which accentuates mucosal patterns, helping to identify distorted surface topography (14,17,18).…”

Section: Discussionmentioning

confidence: 99%

Do we adequately diagnose early gastric cancer in Turkey

Koç¹,

Sarı²,

Bektaş³

et al. 2011

Turk J Gastroenterol

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“…1 Acetic acid, and acetic acid indigocarmine mixtures have also been reported to enhance the diagnosis, and margin location, respectively, of gastric cancers. 2,3 Acetic acid may also be useful for the detection of oral cancer. 4 Despite the increasing use of acetic acid, the mechanism of acetowhitening is not understood and the biological factors necessary for acetowhitening are not known.…”

Section: Introductionmentioning

confidence: 99%

Effects of acetic acid on light scattering from cells

Marina

2012

J. Biomed. Opt

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Abstract. Acetic acid has been used for decades as an aid for the detection of precancerous cervical lesions, and the use of acetic acid is being investigated in several other tissues. Nonetheless, the mechanism of acetowhitening is unclear. This work tests some of the hypotheses in the literature and measures changes in light scattering specific to the nucleus and the cytoplasm. Wide angle side scattering from both the nucleus and the cytoplasm increases with acetic application to tumorigenic cells, with the increase in nuclear scattering being greater. In one cell line, the changes in nuclear scattering are likely due to an increase in number or scattering efficiency of scattering centers smaller than the wavelength of excitation light. There are likely several cellular changes that cause acetowhitening and the cellular changes may differ with cell type. These results should lead to a better understanding of acetowhitening and potentially the development of adjunct techniques to improve the utility of acetic acid application. For the well-studied case of cervical tissue, acetowhitening has been shown to be sensitive, but not specific for oncogenic changes needing treatment.

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Novel Chromoendoscopic Method Using an Acetic Acid–indigocarmine Mixture for Diagnostic Accuracy in Delineating the Margin of Early Gastric Cancers

Abstract: This chromoendoscopic method can be used to delineate the margin of EGC accurately, easily, safely and inexpensively.

Cited by 64 publications

References 27 publications

Enhanced magnifying endoscopy for differential diagnosis of superficial gastric lesions identified with white-light endoscopy

Enhanced magnifying endoscopy for differential diagnosis of superficial gastric lesions identified with white-light endoscopy

Do we adequately diagnose early gastric cancer in Turkey

Effects of acetic acid on light scattering from cells

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