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A feasibility study of the use of computed virtual chromoendoscopy for laparoscopic evaluation of peritoneal metastases

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An Erratum to this article was published on 12 July 2016

Abstract

Background

Detection of an incipient peritoneal carcinomatosis (PC) is still challenging, and there is a crucial need for technological improvements in order to diagnose and to treat early this condition. Fujinon Intelligent Chromo Endoscopy (FICE) is a spectral image processing technology that enhances the contrast of the target tissue. The aim of this study is to investigate the usefulness of FICE system during peritoneal endoscopy and to establish the optimal FICE preset(s) for peritoneal exploration and PC detection.

Methods

A total of 561 images corresponding to 51 different areas of PC nodules and normal peritoneum were recorded during peritoneal endoscopies (For each area, one white light endoscopy (WLE) image and 10 FICE images). Three groups of 5 evaluators each: senior surgeons, surgical residents and medical students assessed these images. In a first questionnaire, the evaluators gave a score ranging from 1 to 10 to each image, and the three best FICE channels were determined. In a second questionnaire, five criteria were studied specifically: contrast, brightness, vascular architecture, differentiation between organs and detection of PC. The evaluators ranked the WLE and the three best FICE channel images according to these criteria.

Results

The three best FICE channels were channels 6, 2 and 9 with mean scores of 6.21 ± 1.59, 6.17 ± 1.48 and 6.06 ± 1.52, respectively. FICE Channel 2 was superior to WLE and other FICE channels, in terms of contrast (p < 10−4), visualization of vascular architecture (p < 10−4), differentiation between organs (p < 10−4) and detection of PC (p < 10−4); and ranked first in 38.8, 41.5, 31 and 46.9 % of the cases, respectively.

Conclusion

FICE system provides adequate illumination of the abdominal cavity and a unique contrast that enhances the vascular architecture. FICE Channel 2 is the optimal channel for peritoneal exploration and could be a useful tool for the diagnosis of PC during peritoneal explorations.

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Acknowledgments

The authors would like to thank Drs. Karine Pautrat, Romain Amato, Silvia Basato, Giulia Boarini, and our surgical residents Iris Bitumba, Louise Montalva, Florie Pirot, Pauline Dewaele, Firas Dridi and Nicolas Leguimazon for their helpful contribution to this work.

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Authors and Affiliations

  1. Department of Oncologic and Digestive Surgery, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Haythem Najah, Réa Lo Dico, Clarisse Eveno & Marc Pocard

  2. Sorbonne Paris Cité, CART, INSERM U965, Université Paris Diderot, 74575, Paris, France

    Haythem Najah, Réa Lo Dico, Anthony Dohan, Clarisse Eveno & Marc Pocard

  3. Department of Abdominal Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Anthony Dohan

  4. Department of Anesthesiology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Lucy Marry

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  1. Haythem Najah
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  2. Réa Lo Dico
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Correspondence to Haythem Najah.

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Disclosures

Fujifilm Medical System Company paid the inscription and the travel to the «United European Gastroenterology Week» which took place in Stockholm in October 2011. One member of the team was present for the poster presentation (Dr. R.L.D.). It is also a partner to the INSERM U965 Unit to study impact of endoscopy on evaluation of peritoneal carcinomatosis. Drs. L. Marry, A. Dohan, H. Najah, C. Eveno, M. Pocard have no conflicts of interest or financial ties to disclose.

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An erratum to this article is available at http://dx.doi.org/10.1007/s00464-016-5101-9.

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Najah, H., Lo Dico, R., Dohan, A. et al. A feasibility study of the use of computed virtual chromoendoscopy for laparoscopic evaluation of peritoneal metastases. Surg Endosc 31, 743–751 (2017). https://doi.org/10.1007/s00464-016-5028-1

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