Abstract
Background and aim
Autofluorescence (AF) imaging, which can potentially differentiate tissue types based on differences in fluorescence emission, may be useful in the diagnosis and treatment of colorectal malignancies. This study was designed to assess the potential usefulness of AF colonoscopy for evaluating superficial colorectal neoplastic lesions.
Methods
A total of 49 colorectal lesions in 43 patients were investigated. All superficial colorectal neoplastic lesions were identified with white light (WL) colonoscopy. Each detected lesion was investigated by WL colonoscopy, AF colonoscopy, and chromoendoscopy using 0.2% indigo carmine dye. Three endoscopists, blinded to each patient's history, evaluated the still images (as obtained with these three methods) in random order and evaluated their influence on the assessment of lesion visualization. All the lesions were biopsied or resected endoscopically, with the pathological results used as the gold standard.
Results
For visualization of the surface appearance and differences in color of the lesions compared with the surrounding mucosa, AF colonoscopy was superior to WL colonoscopy (p < 0.01) and comparable to chromoendoscopy (Mann–Whitney U test). For visualization of the circumferential margin, AF colonoscopy was superior to WL colonoscopy (p < 0.05) but inferior to chromoendoscopy (p < 0.01).
Conclusions
AF colonoscopy may be a valuable tool for detection and diagnosis of superficial colorectal neoplastic lesions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- AF:
-
Autofluorescence
- WL:
-
White light
References
Kudo S, Hirota S, Nakajima T, Hosobe S, Kusaka H, Kobayashi T, Himori M, Yagyuu A (1994) Colorectal tumors and pit pattern. J Clin Pathol 47:880–885
Kudo S, Kashida H, Nakajima T, Tamura S, Nakajo K (1997) Endoscopic diagnosis and treatment of early colorectal cancer. World J Surg 21:694–701
Fujii T, Hasegawa RT, Saitoh Y, Fleischer D, Saito Y, Sano Y, Kato S (2001) Chromoscopy during colonoscopy. Endoscopy 33:1036–1041
Kato S, Fujii T, Koba I, Sano Y, Fu KI, Parra-Blanco A, Tajiri H, Yoshida H, Rembacken B (2001) Assessment of colorectal lesions using magnifying colonoscopy and mucosal dye spraying: can significant lesions be distinguished? Endoscopy 33:306–310
Konishi K, Kaneko K, Kurahashi T, Yamamoto T, Kushima M, Kanda A, Tajiri H, Mitamura K (2003) A comparison of magnifying and nonmagnifying colonoscopy for diagnosis of colorectal polyps: a prospective study. Gastrointest Endosc 57:48–53
DaCosta RS, Wilson BC, Marcon NE (2005) Optical techniques for the endoscopic detection of dysplastic colonic lesions. Curr Opin Gastroenterol 21:70–79
Haringsma J, Tytgat GN, Yano H, Iishi H, Tatsuta M, Ogihara T, Watanabe H, Sato N, Marcon N, Wilson BC, Cline RW (2001) Autofluorescence endoscopy: feasibility of detection of GI neoplasms unapparent to white light endoscopy with an evolving technology. Gastrointest Endosc 53:642–650
Kiesslich R, von Bergh M, Hahn M, Hermann G, Jung M (2001) Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon. Endoscopy 33:1001–1006
Matsuda T, Fujii T, Ono A, Kozu T, Saito Y, Kakugawa Y, Kobayashi N, Ikehara H, Ikematsu H, Hasuda K, Saito D (2003) Effectiveness of magnifying colonoscopy in diagnosing the depth of invasion of colorectal neoplastic lesions: invasive pattern is an indication for surgical treatment. Gastrointest Endosc 57:AB176
Saito Y, Emura F, Matsuda T, Saito D, Fujii T (2004) Invasive pattern is an indication for surgical treatment. Gut http://gut.bmjjournals.com/cgi/eletters/53/2/284
Sutedja TG, Codrington H, Risse EK, Breuer RH, van Mourik JC, Golding RP, Postmus PE (2001) Autofluorescence bronchoscopy improves staging of radiographically occult lung cancer and has an impact on therapeutic strategy. Chest 120:1327–1332
Arens C, Dreyer T, Maizahn K, Glanz H (2004) Direct and indirect autofluorescence laryngoscopy in the diagnosis of laryngeal cancer and its precursor lesions. Otolaryngol Pol 58:197–203
Mayinger B, Neidhardt S, Reh H, Martus P, Hahn EG (2001) Fluorescence induced with 5-aminolevulinic acid for the endoscopic detection and follow-up of esophageal lesions. Gastrointest Endosc 54:572–578
Uedo N, Iishi H, Tatsuta M, Yamada T, Ogiyama H, Imanaka K, Sugimoto N, Higashino K, Ishihara R, Narahara H, Ishiguro S (2005) A novel videoendoscopy system by using autofluorescence and reflectance imaging for diagnosis of esophagogastric cancers. Gastrointest Endosc 62:521–528
Kato M, Kaise M, Yonezawa J, Tajiri H (2007) Autofluorescence endoscopy versus conventional white light endoscopy for the detection of superficial gastric neoplasia: a prospective comparative study. Endoscopy 39:937–941
Acknowledgments
The authors thank Mr. Katsuichi Imaizumi in the research department of Olympus Medical Systems Co, Ltd, for providing technical support.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Inoue, K., Wakabayashi, N., Morimoto, Y. et al. Evaluation of autofluorescence colonoscopy for diagnosis of superficial colorectal neoplastic lesions. Int J Colorectal Dis 25, 811–816 (2010). https://doi.org/10.1007/s00384-010-0943-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-010-0943-4