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Amirshaghaghi A, Chang WC, Chhay B, Bartolomeu AR, Clapper ML, Cheng Z, Tsourkas A. Phthalocyanine-Blue Nanoparticles for the Direct Visualization of Tumors with White Light Illumination. ACS APPLIED MATERIALS & INTERFACES 2023; 15:33373-33381. [PMID: 37395349 PMCID: PMC10724988 DOI: 10.1021/acsami.3c05140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
The current standard of care for colon cancer surveillance relies heavily on white light endoscopy (WLE). However, dysplastic lesions that are not visible to the naked eye are often missed when conventional WLE equipment is used. Although dye-based chromoendoscopy shows promise, current dyes cannot delineate tumor tissues from surrounding healthy tissues accurately. The goal of the present study was to screen various phthalocyanine (PC) dye-loaded micelles for their ability to improve the direct visualization of tumor tissues under white light following intravenous administration. Zinc PC (tetra-tert-butyl)-loaded micelles were identified as the optimal formulation. Their accumulation within syngeneic breast tumors led the tumors to turn dark blue in color, making them clearly visible to the naked eye. These micelles were similarly able to turn spontaneous colorectal adenomas in Apc+/Min mice a dark blue color for easy identification and could enable clinicians to more effectively detect and remove colonic polyps.
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Affiliation(s)
- Ahmad Amirshaghaghi
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Wen-Chi Chang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Bonirath Chhay
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ariane R. Bartolomeu
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Margie L. Clapper
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Zhiliang Cheng
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Andrew Tsourkas
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
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Kumar AS, Lee JK. Colonoscopy: Advanced and Emerging Techniques-A Review of Colonoscopic Approaches to Colorectal Conditions. Clin Colon Rectal Surg 2017; 30:136-144. [PMID: 28381945 DOI: 10.1055/s-0036-1597312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A complete colonoscopy is key in the diagnostic and therapeutic approaches to a variety of colorectal diseases. Major challenges are incomplete polyp removal and missed polyps, particularly in the setting of a difficult colonoscopy. There are a variety of both well-established and newer techniques that have been developed to optimize polyp detection, perform complete polypectomy, and endoscopically treat various complications and conditions such as strictures and perforations. The objective of this article is to familiarize the colorectal surgeon with techniques utilized by advanced endoscopists.
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Affiliation(s)
- Anjali S Kumar
- Colorectal Surgery Program, Virginia Mason Medical Center, Seattle, Washington
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Abstract
The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complications such as strictures, fistulae, and colon cancers. Endoscopy plays a pivotal role in the diagnosis of colon cancer in patients with IBD through incorporation of chromoendoscopy for surveillance. In addition, endoscopic resection with surveillance is recommended in the management of polypoid dysplastic lesions without flat dysplasia. IBD-associated benign strictures with obstructive symptoms amenable to endoscopic intervention can be managed with endoscopic balloon dilation both in the colon and small intestine. In addition, endoscopy plays a major role in assessing the neoterminal ileum after surgery to risk-stratify patients after ileocolonic resection and assessment of a patient with ileoanal pouch anastomosis surgery and management of postsurgical complications. Our article summarizes the current evidence in the role of endoscopy in the diagnosis and management of complications of IBD.
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Khan TH, Mohammed SK, Imtiaz MS, Wahid KA. Efficient Color Reproduction Algorithm for Endoscopic Images Based on Dynamic Color Map. J Med Biol Eng 2016. [DOI: 10.1007/s40846-016-0120-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Khan TH, Mohammed SK, Imtiaz MS, Wahid KA. Color reproduction and processing algorithm based on real-time mapping for endoscopic images. SPRINGERPLUS 2016; 5:17. [PMID: 26759756 PMCID: PMC4703600 DOI: 10.1186/s40064-015-1612-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/13/2015] [Indexed: 01/03/2023]
Abstract
In this paper, we present a real-time preprocessing algorithm for image enhancement for endoscopic images. A novel dictionary based color mapping algorithm is used for reproducing the color information from a theme image. The theme image is selected from a nearby anatomical location. A database of color endoscopy image for different location is prepared for this purpose. The color map is dynamic as its contents change with the change of the theme image. This method is used on low contrast grayscale white light images and raw narrow band images to highlight the vascular and mucosa structures and to colorize the images. It can also be applied to enhance the tone of color images. The statistic visual representation and universal image quality measures show that the proposed method can highlight the mucosa structure compared to other methods. The color similarity has been verified using Delta E color difference, structure similarity index, mean structure similarity index and structure and hue similarity. The color enhancement was measured using color enhancement factor that shows considerable improvements. The proposed algorithm has low and linear time complexity, which results in higher execution speed than other related works.
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Affiliation(s)
- Tareq H. Khan
- Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, SK S7N5A9 Canada
| | - Shahed K. Mohammed
- Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, SK S7N5A9 Canada
| | - Mohammad S. Imtiaz
- Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, SK S7N5A9 Canada
| | - Khan A. Wahid
- Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, SK S7N5A9 Canada
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Bharadwaj S, Tandon P, Kulkarni G, Rivas J, Charles R. The role of endoscopy in inflammatory bowel disease. J Dig Dis 2015; 16:689-98. [PMID: 26595156 DOI: 10.1111/1751-2980.12301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 11/18/2015] [Indexed: 12/11/2022]
Abstract
Inflammatory bowel disease (IBD) is a group of chronic immune-mediated disorders of the gastrointestinal tract. It is often the result of the interaction of genetic and environmental factors. The role of endoscopy in disease surveillance is unprecedented. However, there is considerable debate in therapeutic goals in IBD patients, ranging from the resolution of clinical symptoms to mucosal healing. Furthermore, deep remission has recently been advocated for altering disease course in these patients. Additionally, neoplasia continues to be a significant cause of morbidity and mortality in IBD patients. This review discussed the role of several endoscopic techniques in assessing mucosal healing and neoplasia with emphasis on novel non-invasive endoscopic techniques.
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Affiliation(s)
- Shishira Bharadwaj
- Department Of Gastroenterology/Hepatology, Cleveland Clinic Foundation, Cleveland, OH
| | - Parul Tandon
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Geeta Kulkarni
- Department Of Gastroenterology/Hepatology, Cleveland Clinic Foundation, Cleveland, OH
| | - John Rivas
- Department Of Gastroenterology/Hepatology, Cleveland Clinic Foundation, Cleveland, OH
| | - Roger Charles
- Department of Gastroenterology/Hepatology, Cleveland Clinic, West Palm Beach, FL
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Alcantarilla PF, Bartoli A, Chadebecq F, Tilmant C, Lepilliez V. Enhanced imaging colonoscopy facilitates dense motion-based 3D reconstruction. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2013:7346-9. [PMID: 24111442 DOI: 10.1109/embc.2013.6611255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We propose a novel approach for estimating a dense 3D model of neoplasia in colonoscopy using enhanced imaging endoscopy modalities. Estimating a dense 3D model of neoplasia is important to make 3D measurements and to classify the superficial lesions in standard frameworks such as the Paris classification. However, it is challenging to obtain decent dense 3D models using computer vision techniques such as Structure-from-Motion due to the lack of texture in conventional (white light) colonoscopy. Therefore, we propose to use enhanced imaging endoscopy modalities such as Narrow Band Imaging and chromoendoscopy to facilitate the 3D reconstruction process. Thanks to the use of these enhanced endoscopy techniques, visualization is improved, resulting in more reliable feature tracks and 3D reconstruction results. We first build a sparse 3D model of neoplasia using Structure-from-Motion from enhanced endoscopy imagery. Then, the sparse reconstruction is densified using a Multi-View Stereo approach, and finally the dense 3D point cloud is transformed into a mesh by means of Poisson surface reconstruction. The obtained dense 3D models facilitate classification of neoplasia in the Paris classification, in which the 3D size and the shape of the neoplasia play a major role in the diagnosis.
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Use of Confocal Laser Endomicroscopy to Assess the Adequacy of Endoscopic Treatment of Gastrointestinal Neoplasia. Surg Laparosc Endosc Percutan Tech 2015; 25:1-5. [DOI: 10.1097/sle.0000000000000072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Lee YJ, Kim ES, Park KS, Cho KB, Lee MY, Kim SK, Jeon SW, Jung MK, Jang BI, Kim KO, Lee SH, Kim EY, Kwon JG, Jung JT, Yang CH, Kim WJ, Kim HJ, Seo HE. Inter-observer agreement in the endoscopic classification of colorectal laterally spreading tumors: a multicenter study between experts and trainees. Dig Dis Sci 2014; 59:2550-6. [PMID: 24828919 DOI: 10.1007/s10620-014-3206-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/03/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM The risk of cancer varies with the subtype of colorectal "laterally spreading tumors" (LSTs). However, visual interpretations vary among endoscopists. The aim of this study was to evaluate inter-observer agreement and accuracy in the endoscopic classification of LST subtypes among experts and trainees. METHODS In total, 40 LST images were collected and reviewed independently by 14 gastroenterology experts and 10 trainees. All investigators recorded their findings as one of the following four categories: homogeneous, nodular mixed, flat-elevated, and pseudo-depressed. Agreement was assessed in terms of the kappa (κ) statistic and AC1 estimate. Accuracy is reported as percentage agreement with the gold standard, based on the gross morphology of the resected specimens. RESULTS Of the possible 91 pair-wise κ estimates among experts, 41 (45.1%) were >0.75, indicating excellent agreement, while only 2 (4.44%) of the 45 pair-wise κ estimates among trainees were >0.75. Agreements for individual LST subtypes in the trainee group were significantly lower than those in the expert group. The κ and AC1 estimates showed similar values in individual subtypes of LSTs. The overall accuracy of LST was also significantly higher for the experts than the trainees (85.9 vs. 72.5%, P < 0.001). Notably, the flat-elevated subtype showed the lowest agreement and accuracy and was frequently misclassified as the pseudo-depressed subtype by both groups. CONCLUSIONS Inter-observer agreement and accuracy for LST subtype classification differ significantly between experts and trainees. Implementation of an adequate training system for beginners is necessary to better identify colorectal LSTs.
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Affiliation(s)
- Yoo Jin Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, 194 Dongsan-dong, Jung-gu, Daegu, 700-712, Korea
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Feature space optimization for virtual chromoendoscopy augmented by topography. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2014; 17:642-9. [PMID: 25333173 DOI: 10.1007/978-3-319-10404-1_80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Optical colonoscopy is the preferred modality for the screening and prevention of colorectal cancer. Chromoendoscopy can increase lesion detection rate by highlighting tissue topography with a colored dye, but is too time-consuming to be adopted in routine colonoscopy screening. We developed a fast and dye-free technique that generates virtual chromoendoscopy images that incorporate topography features acquired from photometric stereo endoscopy. We demonstrate that virtual chromoendoscopy augmented by topography achieves similar image quality to conventional chromoendoscopy in ex-vivo swine colon.
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Sinagra E, Tomasello G, Raimondo D, Sturm A, Giunta M, Messina M, Damiano G, Palumbo VD, Spinelli G, Rossi F, Facella T, Marasà S, Cottone M, Lo Monte AI. Advanced endoscopic imaging for surveillance for dysplasia and colorectal cancer in inflammatory bowel disease: could the pathologist be further helped? Saudi J Gastroenterol 2014; 20:26-38. [PMID: 24496155 PMCID: PMC3952417 DOI: 10.4103/1319-3767.126314] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Patients with inflammatory bowel disease (IBD) have an increased risk of developing intestinal cancer. The magnitude of that increased risk as well as how best to mitigate it remain a topic of ongoing investigation in the field. It is important to quantify the risk of colorectal cancer in association with IBD. The reported risk varies widely between studies. This is partly due to the different methodologies used in the studies. Because of the limitations of surveillance strategies based on the detection of dysplasia, advanced endoscopic imaging and techniques involving the detection of alterations in mucosal antigens and genetic abnormalities are being investigated. Development of new biomarkers, predicting future occurrence of colonic neoplasia may lead to more biomarker-based surveillance. There are promising results that may lead to more efficient surveillance in IBD patients and more general acceptance of its use. A multidisciplinary approach, involving in particular endoscopists and pathologists, together with a centralized patient management, could help to optimize treatments and follow-up measures, both of which could help to reduce the IBD-associated cancer risk.
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Affiliation(s)
- Emanuele Sinagra
- PhD Course in Surgical Biotechnology and Regenerative Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy,Ospedale San Raffaele - Giglio, Gastroenterology and Endoscopy Unit, Cefalù, Italy,Address for correspondence: Dr. Emanuele Sinagra, Via Degli orti 41, 90143 Palermo, Italy. E-mail:
| | - Giovanni Tomasello
- DICHIRONS Department, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
| | - Dario Raimondo
- Ospedale San Raffaele - Giglio, Gastroenterology and Endoscopy Unit, Cefalù, Italy
| | - Andreas Sturm
- Krankenhaus Waldfriede, Akademisches Lehrkrankenhaus DER Charite, Argentinische Allee 40, 14163 Berlin, Germany
| | - Marco Giunta
- Ospedali Riuniti Villa Sofia - Cervello, Unit of Gastroenterology, via Trabucco 180, 90146 Palermo, Italy
| | - Marco Messina
- Ospedale San Raffaele - Giglio, Unit of Oncology, Cefalù, Italy
| | - Giuseppe Damiano
- AOUP Paolo Giaccone, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
| | - Vincenzo D. Palumbo
- AOUP Paolo Giaccone, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
| | - Gabriele Spinelli
- AOUP Paolo Giaccone, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
| | - Francesca Rossi
- Ospedale San Raffaele - Giglio, Gastroenterology and Endoscopy Unit, Cefalù, Italy
| | - Tiziana Facella
- Ospedale San Raffaele - Giglio, Gastroenterology and Endoscopy Unit, Cefalù, Italy
| | | | - Mario Cottone
- DIBIMIS Department, Ospedali Riuniti Villa Sofia - Cervello, Unit of Internal Medicine, via Trabucco 180, 90146 Palermo, Italy
| | - Attilio I. Lo Monte
- DICHIRONS Department, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
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Zhao YR, Zhao ZG, Ma J, Huang H, Liu C, Zhong YL, Cui J, Li ZF, Ren JL, Wu HF, Hu GM. Differential expression of Ki67 and CDX2 proteins in intestinal metaplasia among gastric mucosa appearing as type C, D, or E pit pattern. Shijie Huaren Xiaohua Zazhi 2012; 20:3310-3316. [DOI: 10.11569/wcjd.v20.i34.3310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To detect the expression of Ki67 and CDX2 in intestinal metaplasia (IM) among gastric mucosa appearing as type C, D or E pit pattern, and to assess the correlation between the degree of IM and the morphology of gastric pits.
METHODS: Immunohistochemistry was used to examine the expression of Ki67 and CDX2 proteins in 452 cases of gastric mucosal lesions with different pit patterns. The degree of IM was evaluated by hematoxylin and eosin staining.
RESULTS: The positive rates of Ki67 in non-atrophic gastritis (NAG) appearing as type B pit pattern (BG), atrophic gastritis (AG) with IM appearing as type C pit pattern (CIM), AG with IM appearing as type D pit pattern (DIM), AG with IM appearing as type E pit pattern (EIM), low intraepithelial neoplasia (LIN), and gastric antrum adenocarcinoma (GAAC) were 16.2%, 40.5%, 44.0%, 64.3%, 71.4%, and 87.1%, respectively. The positive rate of Ki67 protein in EIM was significantly different from those in CIM and DIM (P = 0.002, 0.008), but there was no difference between CIM and DIM. The positive rates of CDX2 protein were 21.6%, 75.0%, 78.6%, 81.0%, 80.4%, and 84.3% in the above groups, respectively. The positive rate of CDX2 protein in EIM was significantly different from that in BG (P = 0.000), but not different from those in CIM and DIM. The degree of IM was significantly higher in EIM than in DIM and CIM (P = 0.000).
CONCLUSION: CDX2 may have no relationship with micromorphology of IM in gastric mucosa. The expression of Ki67 protein and the degree of IM in EIM were higher than those in CIM and DIM.
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Barkin JA, Sussman DA, Abreu MT. Chromoendoscopy and Advanced Imaging Technologies for Surveillance of Patients with IBD. Gastroenterol Hepatol (N Y) 2012; 8:796-802. [PMID: 24693269 PMCID: PMC3971893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Inflammatory bowel disease patients with long-standing colitis have an increased risk of colorectal cancer. The high rate of interval colitis-associated cancers among patients who adhere to a nontargeted, random biopsy surveillance strategy underlies the need for improved methods of early dysplasia detection. Compelling evidence supports the efficacy of chromoendoscopy for increasing the detection rate of dysplasia; however, this technology is currently underutilized in the clinical setting. Other contrast-based technologies-including confocal laser endomicroscopy (Pentax), endocytoscopy, multiband imaging, i-scan (Pentax), and molecular-targeted techniques-show promise in the detection of dysplasia in patients with inflammatory bowel disease. The strategies currently available for identifying patients with dysplasia or colitis-associated cancers remain inadequate and need to demonstrate both cost and time efficiency before they can be adopted in community-based practices.
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Affiliation(s)
- Jodie A Barkin
- Dr. Barkin is an Internal Medicine Resident at the University of Miami Leonard M. Miller School of Medicine and Jackson Memorial Hospital, both in Miami, Florida. Dr. Sussman is an Assistant Professor of Medicine in the Division of Gastroenterology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida. Dr. Abreu is a Professor of Medicine, a Professor of Microbiology and Immunology, and the Martin Kalser Chair in Gastroenterology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida
| | - Daniel A Sussman
- Dr. Barkin is an Internal Medicine Resident at the University of Miami Leonard M. Miller School of Medicine and Jackson Memorial Hospital, both in Miami, Florida. Dr. Sussman is an Assistant Professor of Medicine in the Division of Gastroenterology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida. Dr. Abreu is a Professor of Medicine, a Professor of Microbiology and Immunology, and the Martin Kalser Chair in Gastroenterology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida
| | - Maria T Abreu
- Dr. Barkin is an Internal Medicine Resident at the University of Miami Leonard M. Miller School of Medicine and Jackson Memorial Hospital, both in Miami, Florida. Dr. Sussman is an Assistant Professor of Medicine in the Division of Gastroenterology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida. Dr. Abreu is a Professor of Medicine, a Professor of Microbiology and Immunology, and the Martin Kalser Chair in Gastroenterology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida
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Hood colonoscopy in trainees: a useful adjunct to improve the performance. Dig Dis Sci 2012; 57:2675-9. [PMID: 22581341 DOI: 10.1007/s10620-012-2213-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 04/25/2012] [Indexed: 12/22/2022]
Abstract
BACKGROUND The use of a transparent hood to improve colonoscopic performance has recently been proposed. AIMS The purpose of this study was to evaluate whether using the hood might improve the cecal intubation rate, cecal intubation time, number of attempts needed to intubate the ileo-cecal valve, and polyp detection rate in trainees. METHODS Patients undergoing colonoscopy (n = 378) were randomized in two groups, one studied with hood colonoscopy (n = 179) and the other (n = 199) with standard examination. RESULTS No differences were found between hood and standard colonoscopy with respect to cecal intubation rate (95 vs 92 %), whereas hood colonoscopy significantly shortened the cecal intubation time, the number of attempts needed to intubate the ileo-cecal valve, and the overall polyp detection rate (p < 0.01 for all these variables). CONCLUSIONS Hood colonoscopy might represent a useful adjunct to standard colonoscopy, especially improving the performance of endoscopic trainees.
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Zhang J, Guo SB, Duan ZJ. Application of magnifying narrow-band imaging endoscopy for diagnosis of early gastric cancer and precancerous lesion. BMC Gastroenterol 2011; 11:135. [PMID: 22168239 PMCID: PMC3259040 DOI: 10.1186/1471-230x-11-135] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 12/14/2011] [Indexed: 12/13/2022] Open
Abstract
Background Gastric carcinoma is the second commonest cause of cancer deaths worldwide. Early detection and diagnosis of gastric cancer in the stomach is important for improving the prognosis of gastric cancer. This retrospective study was designed to investigate the value of magnifying narrow-band imaging (NBI) in the diagnosis of precancerous lesions and early gastric cancer. Methods This study included 122 patients who were diagnosed with early gastric cancer or precancerous gastric lesions by endoscopy. The patients underwent an examination with conventional endoscopy, magnifying NBI, and magnifying chromoendoscopy. Images resolution was evaluated, and the morphology, pit patterns and blood capillary forms of lesions were analyzed. The presence of gastric carcinoma and high grade intraepithelial neoplasia in the biopsy samples was considered as a positive pathological result, which is used to assess accuracy of endoscopic diagnosis. Results For image resolution, magnifying NBI and magnifying chromoendoscopy were significantly superior to magnifying conventional endoscopy in morphology, pit pattern and blood capillary form (P < 0.01), and magnifying NBI was significantly superior to magnifying chromoendoscopy in blood capillary form (P < 0.01). IV, V1, and VI type of gastric pit pattern were detected in 14 cases, 43 cases, and 17 cases in patients with high grade intraepithelial neoplasia, respectively. V1 and VI type of gastric pit pattern were detected in 9 cases and 39 cases in patients with early gastric cancer, respectively. The presence of irregular minute vessels and variation in the caliber of vessels was found in 109 cases. The accuracy, sensitivity, specificity, false positive rate and false negative rate for diagnosis of early gastric cancer and precancerous gastric lesions were 68.9%, 95.1%, 63.1%, 24.5%, and 32.4% for conventional endoscopy, 93.6%, 92.7%, 94.5%, 5.7%, and 6.9% for magnifying NBI, and 91.3%, 88.6%, 93.2%, 13.2%, and 21.48% for magnifying chromoendoscopy, respectively. Conclusions This study demonstrates that magnifying NBI is superior to conventional endoscopy in the diagnosis of early gastric cancer and precancerous gastric lesions, and can be used for screening early malignancies of the stomach.
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Affiliation(s)
- Jing Zhang
- Department of Gastroenterology, the First Affiliated Hospital of Dalian Medical University, Dalian 0086-116011, Liaoning Province, China
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