Clin Endosc.  2014 Jul;47(4):330-333. 10.5946/ce.2014.47.4.330.

Equipment-Based Image-Enhanced Endoscopy for Differentiating Colorectal Polyps

• Koo JS

• KMID: 1907933
• DOI: http://doi.org/10.5946/ce.2014.47.4.330

Abstract

The use of colonoscopy for the screening and surveillance of colorectal cancer has increased. However, the miss rate of advanced colorectal neoplasm is known to be 2% to 6%, which could be affected by the image intensity of colorectal lesions. Image-enhanced endoscopy (IEE) is capable of highlighting lesions, which can improve the colorectal adenoma detection rate and diagnostic accuracy. Equipment-based IEE methods, such as narrow band imaging (NBI), Fujinon intelligent color enhancement (FICE), and i-Scan, are used to observe the mucosal epithelium of the microstructure and capillaries of the lesion, and are helpful in the detection and differential diagnosis of colorectal tumors. Although NBI is similar to chromoendoscopy in terms of adenoma detection rates, NBI can be used to differentiate colorectal polyps and to predict the submucosal invasion of malignant tumors. It is also known that FICE and i-Scan are similar to NBI in their detection rates of colorectal lesions. Through more effective and advanced endoscopic equipment, diagnostic accuracy could be improved and new treatment paradigms developed.

Keyword

Image enhancement; Narrow band imaging; Colorectal polyp

MeSH Terms

Adenoma
Capillaries
Colonoscopy
Colorectal Neoplasms
Diagnosis, Differential
Diagnostic Equipment
Endoscopy*
Epithelium
Image Enhancement
Mass Screening
Narrow Band Imaging
Polyps*

Figure

• 

  Fig. 1 (A, C) White light (WLE) and (B, D) narrow-band imaging (NBI) of two colonic neoplastic lesions. (A) WLE showing a 6-mm lesion in the sigmoid colon. (B) NBI demonstrating thick brown vessels and a branched surface, compatible with NBI international colorectal endoscopic (NICE) type 2. After snare polypectomy of the lesion, microscopic evaluation showed tubular adenoma with low-grade dysplasia. (C) WLE showing a 1.5-cm slightly elevated lesion with a central depression on the mid ascending colon. (D) NBI showing a distorted surface and missing vessels, compatible with NICE type 3. On histologic evaluation of the resected lesion, an adenocarcinoma that invaded into the submucosal layer was found.

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