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Dual red imaging (novel advanced endoscopy) can increase visibility and can predict the depth in diagnosing esophageal varices

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Abstract

Background

Dual red imaging (DRI) is a new technology that can increase the visibility of deeper veins compared with narrow band imaging (NBI). As esophageal varices (EVs) are a vascular disease occurring in the submucosal layer, their visibility might be increased by DRI. We prospectively clarified whether the visibility of EVs with red color sign (RCS) can be increased by DRI, and clarified the relation between the visibility scores and the obtained endoscopic ultrasound (EUS) images.

Methods

Forty patients were enrolled. The visibility of the EVs on DRI and NBI endoscopic images was evaluated by five observers in a blinded manner and was compared with a white light image (bad, 0; equal, 1; good, 2). The diameter of the lumen and the depth of the EVs and RCS from the epithelium were measured by EUS. The relation between the visibility scores and the EUS findings was investigated.

Results

The DRI scores were 1.66 ± 0.34 for the EV substance and 1.79 ± 0.28 for the RCS, whereas the NBI scores were 0.68 ± 0.38 and 0.41 ± 0.28, respectively. A significant negative correlation was found between the depth and the visibility score (r = −0.505, p = 0.001 for EVs; r = −0.458, p = 0.003 for RCS).

Conclusions

DRI increased the visibility of the EVs and RCS. The visibility of the EVs or RCS in the shallower position was more enhanced by DRI. Visual recognition of the changing degrees of visibility by DRI enables the prediction of the depth of EVs.

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Abbreviations

CT:

Computed tomography

DRI:

Dual red imaging

EIS:

Endoscopic injection sclerotherapy

EVL:

Endoscopic variceal ligation

EVs:

Esophageal varices

EUS:

Endoscopic ultrasonography

ICC:

Intraclass correlation coefficient

NBI:

Narrow band imaging

RCS:

Red color sign

SD:

Standard deviation

WLI:

White light

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Acknowledgments

We thank Mayumi Kojima for her technical assistance. We also thank Dr. Edward F. Barroga, Associate Professor and Senior Editor of the Department of International Medical Communications of Tokyo Medical University, for the editorial review of the English manuscript. This study was partly supported by a Health Labour Sciences Research Grant from Research on Measures for Intractable Diseases, the Intractable Hepato-Biliary Diseases Study Group in Japan.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Yoshihiro Furuichi, Takuji Gotoda, Fuminori Moriyasu, Saori Ogawa, Yoshitaka Kasai, Hirohito Takeuchi, Yuu Yoshimasu, Takatomo Sano, Katsutoshi Sugimoto, Takashi Kawai, Yoshiyuki Kobayashi, Ikuo Nakamura & Takao Itoi

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  1. Yoshihiro Furuichi
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  2. Takuji Gotoda
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  3. Fuminori Moriyasu
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  4. Saori Ogawa
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  5. Yoshitaka Kasai
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  6. Hirohito Takeuchi
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  7. Yuu Yoshimasu
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  10. Takashi Kawai
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  13. Takao Itoi
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Corresponding author

Correspondence to Yoshihiro Furuichi.

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We declare that we have no conflict of interest.

Financial support

This study was partly supported by a Health and Labour Sciences Research Grant from the Japanese Ministry of Health, Labour and Welfare for Research on Intractable Diseases and Portal Hemodynamic Abnormalities.

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Furuichi, Y., Gotoda, T., Moriyasu, F. et al. Dual red imaging (novel advanced endoscopy) can increase visibility and can predict the depth in diagnosing esophageal varices. J Gastroenterol 52, 568–576 (2017). https://doi.org/10.1007/s00535-016-1249-2

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  • DOI: https://doi.org/10.1007/s00535-016-1249-2

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