Journal of Gastroenterology

, Volume 46, Issue 1, pp 65–72

Efficacy of magnifying endoscopy with flexible spectral imaging color enhancement in the diagnosis of colorectal tumors

Authors

    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Yuji Naito
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Munehiro Kugai
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Ken Inoue
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Kazuhiko Uchiyama
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Tomohisa Takagi
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Takeshi Ishikawa
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Osamu Handa
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Hideyuki Konishi
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Naoki Wakabayashi
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Satoshi Kokura
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Nobuaki Yagi
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Yasutaka Morimoto
    • Department of GastroenterologyJR Osaka Rail Hospital
  • Akio Yanagisawa
    • Department of Surgical Pathology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
  • Toshikazu Yoshikawa
    • Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical ScienceKyoto Prefectural University of Medicine
Original Article—Alimentary Tract

DOI: 10.1007/s00535-010-0339-9

Cite this article as:
Yoshida, N., Naito, Y., Kugai, M. et al. J Gastroenterol (2011) 46: 65. doi:10.1007/s00535-010-0339-9

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

FICEColorectal tumorNBIImage-enhanced endoscopyMagnifying endoscope

Copyright information

© Springer 2010