International Journal of Colorectal Disease

, Volume 27, Issue 3, pp 325–330

Autofluorescence imaging and the quantitative intensity of fluorescence for evaluating the dysplastic grade of colonic neoplasms

  • Kentaro Moriichi
  • Mikihiro Fujiya
  • Ryu Sato
  • Toshie Nata
  • Yoshiki Nomura
  • Nobuhiro Ueno
  • Chisato Ishikawa
  • Yuhei Inaba
  • Takahiro Ito
  • Kotaro Okamoto
  • Hiroki Tanabe
  • Yusuke Mizukami
  • Jiro Watari
  • Yusuke Saitoh
  • Yutaka Kohgo
Original Article

Abstract

Background and aims

Autofluorescence imaging (AFI) is a novel technology which can capture fluorescence emitted from intestinal tissues. While AFI is useful for detecting colorectal neoplasms, it is unclear whether AFI can facilitate the diagnosis by differentiating the extent of dysplasia of colorectal neoplasms. This study investigated the efficacy of AFI in discriminating high-grade from low-grade adenoma.

Materials and methods

Sixty-seven patients who underwent colonoscopy with AFI were enrolled in this study. The AFI images obtained from 158 lesions in these patients were visually classified into four categories, namely, green (G), green with magenta spots (GM), magenta with green spots (MG), and magenta (M), according to their color intensities, immediately after the examination. The AFI images of the lesions were quantified using an image-analytical software program (F index). Either the F index or the visual assessment was prospectively compared with the dysplastic grade.

Results

The F index of the high-grade adenomas was significantly lower than that of the low-grade adenomas, hyperplasia, and normal mucosa (p < 0.05). The incidence of the lesions classified into the M classification for high-grade adenomas (55.6%) was significantly higher than that of either low-grade adenomas (20.8%) or hyperplasia (0%). No correlation was observed between the F index or the visual classification and the tumor shape. The F index was not influenced by the size of the lesion, while the size was significantly associated with the visual classification of AFI.

Conclusions

AFI, particularly the F index, is considered to be a useful procedure for estimating the dysplastic grade of colonic adenomas.

Keywords

Autofluorescence imaging Cancer Adenoma Dysplastic grade F index 

References

  1. 1.
    Fearon ER, Vogelstein B (1990) A genetic model for colorectal tumorigenesis. Cell 61:759–767PubMedCrossRefGoogle Scholar
  2. 2.
    Lengauer C, Kinzler K, Vogelstein B (1998) Genetic instabilities in human cancers. Nature 396:643–649PubMedCrossRefGoogle Scholar
  3. 3.
    Baker SJ, Fearon ER, Nigro JM et al (1989) Chromosome 17 deletions and p53 gene mutations in colorectal carcinomas. Science 244:217–221PubMedCrossRefGoogle Scholar
  4. 4.
    Kamb A, Gruis NA, Weaver-Feldhaus J et al (1994) A cell cycle regulator potentially involved in genesis of many tumor types. Science 264:436–440PubMedCrossRefGoogle Scholar
  5. 5.
    Schlemper RJ, Riddell RH, Kato Y et al (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47:251–255PubMedCrossRefGoogle Scholar
  6. 6.
    Takehana S, Kaneko M, Mizuno H (1999) Endoscopic diagnostic system using autofluorescence. Diagn Ther Endosc 5:59–63PubMedCrossRefGoogle Scholar
  7. 7.
    Nakashima A, Miwa H, Watanabe H et al (2001) A new technique: light-induced fluorescence endoscopy in combination with pharmacoendoscopy. Gastrointest Endosc 53:343–348Google Scholar
  8. 8.
    Georgakoudi I, Jacobson BC, van Dam J et al (2001) Fluorescence, reflectance, and light-scattering spectroscopy for evaluating dysplasia in patients with Barrett's esophagus. Gastroenterology 120:1620–1629PubMedCrossRefGoogle Scholar
  9. 9.
    Borovicka J, Fischer J, Neuweller J et al (2006) Autofluorescence endoscopy in surveillance of Barrett's esophagus. A multicenter randomized trial on diagnostic efficacy. Endoscopy 38:867–872PubMedCrossRefGoogle Scholar
  10. 10.
    Kara MA, Bergman JJGH (2006) Autofluorescence imaging and narrow-band imaging for the detection of early neoplasia inpatients with Barrett's esophagus. Endoscopy 38:627–631PubMedCrossRefGoogle Scholar
  11. 11.
    Uedo N, Iishi H, Tatsuta M et al (2005) A novel videoendoscopy system by using autofluorescence and reflectance imaging for diagnosis of esophagogastric cancers. Gastrointest Endosc 62:521–528PubMedCrossRefGoogle Scholar
  12. 12.
    Matsuda T, Saito Y, Fu KI et al (2008) Does autofluorescence imaging videoendoscopy system improve the colonoscopic polyp detection rate?—a pilot study. Am J Gastroenterol 103:1926–1932PubMedCrossRefGoogle Scholar
  13. 13.
    Messmann H, Endlicher E, Freunek G et al (2003) Fluorescence endoscopy for the detection of low and high grade dysplasia in ulcerative colitis using systemic or local 5-aminolaevulinic acid sensitization. Gut 52:1003–1007PubMedCrossRefGoogle Scholar
  14. 14.
    Matsumoto T, Moriyama T, Yao T et al (2007) Autofluorescence imaging colonoscopy for the diagnosis of dysplasia in ulcerative colitis. Inflamm Bowel Dis 13:640–641PubMedCrossRefGoogle Scholar
  15. 15.
    van den Broek FJ, Fockens P, van Eeden S et al (2008) Endoscopic tri-modal imaging for surveillance in ulcerative colitis: randomised comparison of high-resolution endoscopy and autofluorescence imaging for neoplasia detection; and evaluation of narrow-band imaging for classification of lesions. Gut 57:1083–1089PubMedCrossRefGoogle Scholar
  16. 16.
    Fujiya M, Saitoh Y, Watari J et al (2007) Auto-fluorescence imaging is useful to assess the activity of ulcerative colitis. Dig Endosc 19:145–149CrossRefGoogle Scholar
  17. 17.
    Ueno N, Fujiya M, Moriichi K, Ikuta K, Nata T, Konno Y, Ishikawa C, Inaba Y, Ito T, Sato R, Okamoto K, Tanabe H, Maemoto A, Sato K, Watari J, Ashida T, Saitoh Y, Kohgo Y (2011) Endosopic autofluorescence imaging is useful for the differential diagnosis of intestinal lymphomas resembling lymphoid heyperplasia. J Clin Gastroenterol 45:507–513PubMedCrossRefGoogle Scholar
  18. 18.
    McCallum AL, Jenkins JT, Gillen D et al (2008) Evaluation of autofluorescence colonoscopy for the detection and diagnosis of colonic polyps. Gastrointest Endosc 68:283–290PubMedCrossRefGoogle Scholar
  19. 19.
    Aihara H, Sumiyama K, Saito S, Tajiri H, Ikegami M (2009) Numerical analysis of the autofluorescence intensity of neoplastic and non-neoplastic colorectal lesions by using a novel videoendoscopy system. Gastrointest Endosc 69(3 Pt 2):726–733PubMedCrossRefGoogle Scholar
  20. 20.
    Kudo S, Hirota S, Nakajima T et al (1994) Colorectal tumours and pit pattern. J Clin Pathol 47:880–885PubMedCrossRefGoogle Scholar
  21. 21.
    Kudo S, Tamura S, Nakajima T et al (1996) Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc 44:8–14PubMedCrossRefGoogle Scholar
  22. 22.
    Gono K, Yamazaki K, Doguchi N et al (2003) Endoscopic observation of tissue by narrow band illumination. Opt Rev 10:1–5CrossRefGoogle Scholar
  23. 23.
    Gono K, Obi T, Yamaguchi M et al (2004) Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 9:568–577PubMedCrossRefGoogle Scholar
  24. 24.
    Machida H, Sano Y, Hamamoto Y et al (2004) Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study. Endoscopy 36:1094–1098PubMedCrossRefGoogle Scholar
  25. 25.
    Hirata M, Tanaka S, Oka S et al (2007) Magnifying endoscopy with narrow band imaging for diagnosis of colorectal tumors. Gastrointest Endosc 65:988–995PubMedCrossRefGoogle Scholar
  26. 26.
    Chiu HM, Chang CY, Chen CC et al (2007) A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia. Gut 56:373–379PubMedCrossRefGoogle Scholar
  27. 27.
    Tischendorf JJ, Wasmuth HE, Koch A et al (2007) Value of magnifying chromoendoscopy and narrow band imaging (NBI) in classifying colorectal polyps: a prospective controlled study. Endoscopy 39:1092–1096PubMedCrossRefGoogle Scholar
  28. 28.
    Katagiri A, Fu KI, Sano Y et al (2008) Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia. Aliment Pharmacol Ther 27:1269–1274PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kentaro Moriichi
    • 1
  • Mikihiro Fujiya
    • 1
  • Ryu Sato
    • 2
  • Toshie Nata
    • 1
  • Yoshiki Nomura
    • 1
  • Nobuhiro Ueno
    • 1
  • Chisato Ishikawa
    • 1
  • Yuhei Inaba
    • 1
  • Takahiro Ito
    • 1
  • Kotaro Okamoto
    • 1
  • Hiroki Tanabe
    • 1
  • Yusuke Mizukami
    • 1
  • Jiro Watari
    • 3
  • Yusuke Saitoh
    • 4
  • Yutaka Kohgo
    • 1
  1. 1.Division of Gastroenterology and Hematology/Oncology, Department of MedicineAsahikawa Medical UniversityAsahikawaJapan
  2. 2.Engaru-Kosei General Hospital, Internal MedicineEngaruJapan
  3. 3.Division of Upper Gastroenterology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
  4. 4.Digestive Disease CenterAsahikawa City HospitalAsahikawaJapan

Personalised recommendations