| Theme |
Current Status of Magnifying Endoscopy |
| Title |
Differential Diagnosis between Non-neoplastic and Neoplastic Lesions on Colonoscopy |
| Author |
Kuang-I Fu |
Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine / Division of Gastrointestinal Oncology and Endoscopy, National Cancer Center Hospital East |
| Author |
Yasushi Sano |
Division of Gastrointestinal Oncology and Endoscopy, National Cancer Center Hospital East |
| Author |
Shigeharu Kato |
Kato Clinic |
| Author |
Takahiro Horimatsu |
Division of Gastrointestinal Oncology and Endoscopy, National Cancer Center Hospital East |
| Author |
Takahiro Fujii |
Fujii Takahiro Clinic |
| Author |
Takahiro Fujimori |
Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine |
| [ Summary ] |
Differential diagnosis between non-neoplastic and neoplastic lesions is essential during colonoscopy, since removal or biopsy of non-neoplastic polyps wastes time and resources. We therefore conducted a prospective study to examine whether indigo carmine dye spraying with or without magnification is more reliable than the conventional method for differential diagnosis. The results showed that the overall diagnostic accuracies with the conventional view, chromoendoscopy, and chromoendoscopy with magnification were 84.0% (173/206), 89.3% (184/206) and 95.6% (197/206), respectively. The method of magnification with chromoendoscopy, using indigo-carmine dye, significantly separated neoplastic from non-neoplastic lesions, compared to conventional colonoscopy (p=0.003) or chromoendoscopy (p=0.029). Therefore, we concluded that chromoendoscopy with magnification is the most reliable method for determining whether a colorectal lesion is non-neoplastic or neoplastic.
Narrow Band Imaging (NBI) is an innovative optical technology that can be used to clearly visualize the microvascular structure of the organ surface. We conducted a pilot study to show that endoscopic images using the NBI system may be sufficient to differentiate neoplasia from non-neoplasia, and to visualize neoplasia with image processing in real time during colonoscopy. A ramdomized controlled trial is now being conducted to evaluate whether NBI may be a useful tool to detect colorectal tumors. |