| [ Summary ] |
The clinical significance of magnifying colonoscopy lies in its ability to render detailed diagnosis nearly reaching the levels of pathological diagnosis, thus allowing the processes of screening, diagnosis, and treatment to be completed all together in the clinical setting. Moreover, with the narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team (JNET classification) currently in effect, magnifying colonoscopy is also expected to achieve further gains in efficiency and diagnostic performance. The current diagnostic approach to colorectal tumors using magnifying colonoscopy is also more readily accessible by incorporating an algorithm based on the JNET classification and the Kudo/Tsuruta pit pattern classification of colorectal tumors. This diagnostic strategy allows a typical JNET type 2A lesion to be diagnosed as adenoma, with the diagnosis of any less typical/certain JNET type 2A lesion established based on its pit pattern classification with dye-spray magnifying colonoscopy. It also allows an appropriate treatment policy to be formulated for any lesion classified as JNET type 2B or above, with its diagnosis established based on the pit pattern shown on crystal violet (CV) magnifying colonoscopy. Thus, it is currently recommended that, all colonoscopes should be equipped with the standard feature of magnifying capacity similar to digital cameras, with the colonoscopists performing magnifying colonoscopy routinely, using the Kudo/Tsuruta pit pattern classification and JNET classification as the existing standards. |