Original Article—Alimentary Tract

Journal of Gastroenterology

, Volume 49, Issue 1, pp 73-80

The ability of a novel blue laser imaging system for the diagnosis of invasion depth of colorectal neoplasms

  • Naohisa YoshidaAffiliated withDepartment of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Email author 
  • , Takashi HisabeAffiliated withDepartment of Gastroenterology, Fukuoka University Chikushi Hospital
  • , Yutaka InadaAffiliated withDepartment of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • , Munehiro KugaiAffiliated withDepartment of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • , Nobuaki YagiAffiliated withDepartment of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • , Fumihito HiraiAffiliated withDepartment of Gastroenterology, Fukuoka University Chikushi Hospital
  • , Kenshi YaoAffiliated withDepartment of Gastroenterology, Fukuoka University Chikushi Hospital
  • , Toshiyuki MatsuiAffiliated withDepartment of Gastroenterology, Fukuoka University Chikushi Hospital
  • , Akinori IwashitaAffiliated withDepartment of Pathology, Fukuoka University Chikushi Hospital
    • , Mototsugu KatoAffiliated withDepartment of Endoscopy, Hokkaido University Hospital
    • , Akio YanagisawaAffiliated withDepartment of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
    • , Yuji NaitoAffiliated withDepartment of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine

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Abstract

Background

Fujifilm has developed a novel endoscope system with two kinds of lasers that enables us to allow narrow-band light observation with blue laser imaging (BLI). The aim of this study was to evaluate BLI magnification in comparison with narrow-band imaging (NBI) magnification for the diagnosis of colorectal neoplasms.

Methods

This was a multicenter open study. A total of 104 colorectal neoplasms were examined with BLI and NBI magnifications in Kyoto Prefectural University of Medicine and Fukuoka University Chikushi Hospital. Vascular and surface patterns of tumors under BLI magnification were compared with those under NBI magnification, using a published NBI classification. The main outcome was the correlation between the NBI classification diagnosed by BLI or NBI magnification and the histopathological analyses.

Results

Sixty-two cases of adenoma, 34 cases of intramucosal cancer and shallowly invaded submucosal cancer, and eight cases of deeply invaded submucosal cancer were diagnosed. The diagnostic accuracy of BLI magnification in the NBI classification was 74.0 % (77/104), similar to that of NBI magnification (77.8 %). The consistency rate between BLI and NBI magnification in the NBI classification was 74.0 %. Concerning image evaluation, the interobserver variability of two expert endoscopists (N.Y. and T.H.) in BLI magnification was κ = 0.863. On the other hand, the intraobserver variability of the two endoscopists was κ = 0.893 (N.Y.) and 0.851 (T.H.).

Conclusions

BLI magnification by laser source could predict histopathological diagnosis and invasion depth of colorectal neoplasms. The diagnostic effectiveness of this method was similar to that of NBI magnification.

Keywords

BLI Laser NBI Colorectal polyps Image-enhanced endoscopy