Efficacy of magnifying endoscopy with flexible spectral imaging color enhancement in the diagnosis of colorectal tumors
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Magnifying endoscopy with flexible spectral imaging color enhancement (FICE) is an image-enhanced endoscopy that captures the surface and vascular patterns of colorectal tumors. We evaluated and compared FICE magnification to narrow-band imaging (NBI) magnification.
Flexible spectral imaging color enhancement or NBI magnification was performed to the visualize surface and vascular patterns of colorectal tumors, classified into 4 types: Type A, Type B, Type C1/C2, and Type C3, as previously reported. A total of 235 colorectal tumors were examined. The correlations between classifications found by FICE or NBI magnification and histopathological diagnoses were examined. Image evaluation was validated by assessing inter-observer and intra-observer agreements on examinations.
Twenty-eight hyperplastic polyps (HPs), 115 tubular adenomas (TAs), 72 mucosal and slightly invaded submucosal cancers (M-sSM), and 20 massively invaded submucosal cancers (mSM) were diagnosed. By FICE magnification, HP and TA were observed in 93.3 and 6.7% of Type A (15 lesions), respectively. TA, M-sSM, and HP were observed in 82.6, 15.4, and 2.0% of Type B (52 lesions), respectively. M-sSM, TA, and mSM were observed in 50.0, 46.0, and 4.0% of Type C1/2 (50 lesions), respectively. mSMs were observed in all 7 Type C3 lesions. In diagnosing mSM in Type C3, the sensitivity and specificity of FICE magnification were 77.7 and 100%, respectively, compared to those of NBI, at 63.6 and 99.0%, respectively. Imaging evaluation was validated accurately by intra- and intra-observer measurements showing consistent results.
The classification of colorectal tumors by FICE magnification correlated well with the histopathological diagnoses, similar to findings for NBI magnification. FICE magnification can be evaluated accurately with the same diagnostic classifications as those used for NBI magnification.
- Saito Y, Fukuzawa M, Matsuda T, Fukunaga S, Sakamoto T, Uraoka T, et al. Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors as determined by curative resection. Surg Endosc. 2010;24:343–52. CrossRef
- Kudo S, Tamegai Y, Yamano H, Imai Y, Kogure E, Kashida H. Endoscopic mucosal resection of the colon: the Japanese technique. Gastrointest Endosc Clin N Am. 2001;11:519–35. Review.
- Yoshida N, Naito Y, Yagi N, Yoshikawa T. Safe procedure in endoscopic submucosal dissection for colorectal tumors focused on preventing complications. World J Gastroenterol. 2010;16:1688–95. CrossRef
- Yoshida N, Naito Y, Sakai K, Sumida Y, Kanemasa K, Inoue K, et al. Outcome of endoscopic submucosal dissection for colorectal tumors in elderly people. Int J Colorectal Dis. 2010;25:455–60. CrossRef
- Yoshida N, Wakabayashi N, Kanemasa K, Sumida Y, Hasegawa D, Inoue K, et al. Endoscopic submucosal dissection for colorectal tumors: technical difficulties and rate of perforation. Endoscopy. 2009;41:758–61. CrossRef
- Toyonaga T, Man-I M, Morita Y, Sanuki T, Yoshida M, Kutsumi H, et al. The new resources of treatment for early stage colorectal tumors: EMR with small incision and simplified endoscopic submucosal dissection. Dig Endosc. 2009;21:S31–7. CrossRef
- Kitajima K, Fujimori T, Fujii S, Takeda J, Ohkura Y, Kawamata H, et al. Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study. J Gastroenterol. 2004;39:534–43. CrossRef
- Kudo S, Hirota S, Nakajima T, Hosobe S, Kusaka H, Kobayashi T, et al. Colorectal tumours and pit pattern. J Clin Pathol. 1994;47:880–5. CrossRef
- Tobaru T, Mitsuyama K, Tsuruta O, Kawano H, Sata M. Sub-classification of type VI pit patterns in colorectal tumors: relation to the depth of tumor invasion. Int J Oncol. 2008;33:503–8.
- Yoshida N, Wakabayashi N, Hasegawa T, OkudaT Okuda K, Yasuda Y, et al. Analysis of the correlation between the scoring of irregular pits detected with magnifying endoscope in colorectal tumors and the histological diagnosis. Gastroenterol Endosc. 2007;49:1806–14.
- Machida H, Sano Y, Hamamoto Y, Muto M, Kozu T, Tajiri H, et al. Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study. Endoscopy. 2004;36:1094–8. CrossRef
- Horimatsu T, Sano Y, Kaneko K, Ikematsu H, Katagiri A, Yano T, et al. Relationship between MVD and meshed-capillaries using magnifying NBI colonoscopy in colorectal precursor lesions. Hepatogastroenterology. 2009;56:372–7.
- Sano Y, Ikematsu H, Fu KI, Emura F, Katagiri A, Horimatsu T, et al. Meshed capillary vessels by use of narrow-band imaging for differential diagnosis of small colorectal polyps. Gastrointest Endosc. 2009;69:278–83. CrossRef
- Ikematsu H, Matsuda T, Emura F, Saito Y, Uraoka T, Fu KI, et al. Efficacy of capillary pattern type IIIA/IIIB by magnifying narrow band imaging for estimating depth of invasion of early colorectal neoplasms. BMC Gastroenterol. 2010;27:10–33.
- Kanao H, Tanaka S, Oka S, Hirata M, Yoshida S, Chayama K. Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc. 2009;69:631–6. CrossRef
- Santos CE, Lima JC, Lopes CV, Malaman D, David Salomão A, Garcia AC, et al. Computerized virtual chromoendoscopy versus indigo carmine chromoendoscopy combined with magnification for diagnosis of small colorectal lesions: a randomized and prospective study. Eur J Gastroenterol Hepatol. 2010;22:1364–71. CrossRef
- Parra-Blanco A, Jiménez A, Rembacken B, González N, Nicolás-Pérez D, Gimeno-García AZ, et al. Validation of Fujinon intelligent chromoendoscopy with high definition endoscopes in colonoscopy. World J Gastroenterol. 2009;15:5266–73. CrossRef
- Togashi K, Osawa H, Koinuma K, Hayashi Y, Miyata T, Sunada K, et al. A comparison of conventional endoscopy, chromoendoscopy, and the optimal-band imaging system for the differentiation of neoplastic and non-neoplastic colonic polyps. Gastrointest Endosc. 2009;69:734–41. CrossRef
- Pohl J, Nguyen-Tat M, Pech O, May A, Rabenstein T, Ell C. Computed virtual chromoendoscopy for classification of small colorectal lesions: a prospective comparative study. Am J Gastroenterol. 2008;103:562–9. CrossRef
- Chung SJ, Kim D, Song JH, Park MJ, Kim YS, Kim JS, et al. Efficacy of computed virtual chromoendoscopy on colorectal cancer screening: a prospective, randomized, back-to-back trial of Fuji intelligent color enhancement versus conventional colonoscopy to compare adenoma miss rates. Gastrointest Endosc. 2010;72:136–42. CrossRef
- Pohl J, Lotterer E, Balzer C, Sackmann M, Schmidt KD, Gossner L, et al. Computed virtual chromoendoscopy versus standard colonoscopy with targeted indigocarmine chromoscopy: a randomised multicentre trial. Gut. 2009;58:73–8. CrossRef
- Hamilton SR, Aaltonen LA, editors. World Health Organization classification of tumors. Pathology and genetics of tumours of the digestive system. Lyon: IARC Press; 2000. p. 104–109.
- Participants in the Paris workshop. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003;58(Suppl):S3–S43.
- Higashi R, Uraoka T, Kato J, Kuwaki K, Ishikawa S, Saito Y, et al. Diagnostic accuracy of narrow-band imaging and pit pattern analysis significantly improved for less-experienced endoscopists after an expanded training program. Gastrointest Endosc. 2010;72:127–35. CrossRef
- Efficacy of magnifying endoscopy with flexible spectral imaging color enhancement in the diagnosis of colorectal tumors
Journal of Gastroenterology
Volume 46, Issue 1 , pp 65-72
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Colorectal tumor
- Image-enhanced endoscopy
- Magnifying endoscope
- Industry Sectors
- Author Affiliations
- 1. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
- 2. Department of Gastroenterology, JR Osaka Rail Hospital, Osaka, Japan
- 3. Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan