| Theme |
NBI in colon and rectum |
| Title |
Magnified observation of microvascular architecture using Narrow Band Imaging for differential diagnosis of non-neoplastic and neoplastic colorectal lesions |
| Author |
Takahiro Horimatsu |
Division of Endoscopy, National Cancer Hospital East |
| Author |
Toyoki Kudo |
Division of Endoscopy, National Cancer Hospital East |
| Author |
Atsushi Katagiri |
Division of Endoscopy, National Cancer Hospital East |
| Author |
Hiroaki Ikematsu |
Division of Endoscopy, National Cancer Hospital East |
| Author |
Kuang-I Fu |
Department of Radiology, Dokkyo Medical University |
| Author |
Yasushi Sano |
Division of Endoscopy, National Cancer Hospital East / Gastointestinal Center, SANO Hospital |
| [ Summary ] |
We report on observations of surface structures (pit pattern) using NBI colonoscopy, which we have found to be useful for differentiating neoplasia from non-neoplasia. Recently, we described how the presence of “meshed brown capillary (MC) vessels” arranged in a honeycomb pattern around the mucosal glands, as seen with NBI colonoscopy, is also useful for differential diagnosis without the application of a dye solution. In this report, we describe a prospective study concerning differentiating neoplasia from non-neoplasia by determining the presence of micro-capillary vessels. Detected lesions were classified into the following two groups according to their capillary pafterns using magnified NBI colonoscopy : the neoplastic category for lesions with positive MC vessels and the non-neoplastic category for lesions without MC vessels. For histological examinations, those lesions diagnosed as non-neoplastic were subjected to biopsy and those determined to be neoplastic were removed endoscopically. The accuracy rates for endoscopic diagnosis were evaluated by referring to final pathological diagnoses. Overall diagnostic accuracy, sensitivity, and specificity using the presence of MC vessels for determining distinctions between neoplastic and non-neoplastic lesions was 95.3 %, 96.4 % and 92.3 % , respectively (p < 0.0001). Magnification, using NBI colonoscopy for the observation of the presence of MC vessels, is extremely useful for distinguishing differences between non-neoplastic and neoplastic lesions without the application of a dye solution. These results suggest that NBI colonoscopy allows for simpler and more efficient screening colonoscopy. |