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Review
- Current status of image-enhanced endoscopy in inflammatory bowel disease
- Young Joo Yang
- Clin Endosc 2023;56(5):563-577. Published online September 26, 2023
- DOI: https://doi.org/10.5946/ce.2023.070
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Abstract
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ePub - In inflammatory bowel disease (IBD), chronic inflammation leads to unfavorable clinical outcomes and increases the risk of developing colorectal neoplasm (CRN); thereby highlighting the importance of endoscopically evaluating disease activity as well as detecting and characterizing CRN in patients with IBD. With recent advances in image-enhanced endoscopic (IEE) technologies, especially virtual chromoendoscopy (VCE) platforms, this review discusses state-of-the-art IEE techniques and their applicability in assessing disease activity and surveillance colonoscopy in patients with IBD. Among various IEE, VCE demonstrated the capacity to identify quiescent disease activity. And endoscopic remission defined by the new scoring system using VCE platform better predicted clinical outcomes, which may benefit the tailoring of therapeutic strategies in patients with IBD. High-definition dye-chromoendoscopy (HD-DCE) is numerically superior to high-definition white light endoscopy (HD-WLE) in detecting CRN in IBD; however, discrepancy is observed in the statistical significance. VCE showed comparable performance in detecting dysplasia to HD-WLE or DCE and potential for optical diagnosis to differentiate neoplastic from nonneoplastic lesions during surveillance colonoscopy. Applying these novel advanced IEE technologies would provide opportunities for personalized medicine in IBD and optimal treatment of CRN in patients with IBD.
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Citations
Citations to this article as recorded by
- Advanced Endoscopic Imaging for Detection of Dysplasia in Inflammatory Bowel Disease
Laura Alexandra Lucaciu, Edward John Despott
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 141. CrossRef - Seeing Is Believing: Does Red Dichromatic Imaging (RDI) Predict Histological Remission and Clinical Outcomes in Ulcerative Colitis Patients?
Vedran Tomašić
Digestive Diseases and Sciences.2025;[Epub] CrossRef - Classification of image-enhanced endoscopy in colon tumors
One-Zoong Kim
Clinical Endoscopy.2025; 58(3): 337. CrossRef - The application of the combination between artificial intelligence and endoscopy in gastrointestinal tumors
Shen Li, Maosen Xu, Yuanling Meng, Haozhen Sun, Tao Zhang, Hanle Yang, Yueyi Li, Xuelei Ma
MedComm – Oncology.2024;[Epub] CrossRef
- Advanced Endoscopic Imaging for Detection of Dysplasia in Inflammatory Bowel Disease
- 5,075 View
- 178 Download
- 3 Web of Science
- 4 Crossref
Original Articles
- Methylene blue chromoendoscopy is more useful in detection of intestinal metaplasia in the stomach than mucosal pit pattern or vessel evaluation and predicts advanced Operative Link on Gastric Intestinal Metaplasia stages
- Justyna Wasielica-Berger, Pawel Rogalski, Anna Pryczynicz, Agnieszka Swidnicka-Siergiejko, Andrzej Dabrowski
- Clin Endosc 2023;56(2):203-213. Published online March 9, 2023
- DOI: https://doi.org/10.5946/ce.2022.087
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Graphical Abstract
Abstract
PDFPubReaderePub - Background
/Aims: Intestinal metaplasia (IM) of the stomach is a precancerous condition that is often not visible during conventional endoscopy. Hence, we evaluated the utility of magnification endoscopy and methylene blue (MB) chromoendoscopy to detect IM.
Methods
We estimated the percentage of gastric mucosa surface staining with MB, mucosal pit pattern, and vessel visibility and correlated it with the presence of IM and the percentage of metaplastic cells in histology, similar to the Operative Link on Gastric Intestinal Metaplasia (OLGIM) stage.
Results
IM was found in 25 of 33 (75.8%) patients and in 61 of 135 biopsies (45.2%). IM correlated with positive MB staining (p<0.001) and other than dot pit patterns (p=0.015). MB staining indicated IM with better accuracy than the pit pattern or vessel evaluation (71.7% vs. 60.5% and 49.6%, respectively). At a cut-off point of 16.5% for the MB-stained gastric surface, the sensitivity, specificity, and accuracy of chromoendoscopy in the detection of advanced OLGIM stages were 88.9%, 91.7%, and 90.9%, respectively. The percentage of metaplastic cells detected on histology was the strongest predictor of positive MB staining.
Conclusions
MB chromoendoscopy can serve as a screening method for detecting advanced OLGIM stages. MB mainly stains IM areas with a high concentration of metaplastic cells. -
Citations
Citations to this article as recorded by- The prediction model of operative link on gastric intestinal metaplasia stage III-IV: A multicenter study
Song Wang, Meng Qian, Min Wu, Shuo Feng, Kaiguang Zhang
Heliyon.2023; 9(11): e21905. CrossRef
- The prediction model of operative link on gastric intestinal metaplasia stage III-IV: A multicenter study
- 3,960 View
- 172 Download
- 2 Web of Science
- 1 Crossref
- Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms
- Piyapan Prueksapanich, Thanawat Luangsukrerk, Rapat Pittayanon, Anapat Sanpavat, Rungsun Rerknimitr
- Clin Endosc 2019;52(2):144-151. Published online October 5, 2018
- DOI: https://doi.org/10.5946/ce.2018.091
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Abstract
PDFPubReaderePub
- Background
/Aims: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) and Lugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamous cell neoplasms (ESCNs) in patients with a history of head and neck cancer.
Methods
From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology has historically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined.
Results
Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelial neoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy of dNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively.
Conclusions
The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detecting esophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guided biopsy could reduce the number of unnecessary biopsies. -
Citations
Citations to this article as recorded by- Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer
Wei Han, Rui Kong, Nan Wang, Wen Bao, Xinli Mao, Jie Lu
Cancers.2023; 15(3): 776. CrossRef - Usefulness of Probe-Based Confocal Laser Endomicroscopy for Esophageal Squamous Cell Neoplasm
Sang Kil Lee
Clinical Endoscopy.2019; 52(2): 91. CrossRef - Confocal Laser Endomicroscopy as a Guidance Tool for Pleural Biopsies in Malignant Pleural Mesothelioma
Lizzy Wijmans, Paul Baas, Thomas E. Sieburgh, Daniel M. de Bruin, Petra M. Ghuijs, Marc J. van de Vijver, Peter I. Bonta, Jouke T. Annema
Chest.2019; 156(4): 754. CrossRef
- Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer
- 7,915 View
- 126 Download
- 3 Web of Science
- 3 Crossref
Focused Review Series: Current Status of Endoscopy in the Management of Inflammatory Bowel Disease
- Role of Advanced Endoscopic Imaging Techniques in the Management of Inflammatory Bowel Disease
- Eun Soo Kim
- Clin Endosc 2017;50(5):424-428. Published online September 29, 2017
- DOI: https://doi.org/10.5946/ce.2017.143
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Abstract
PDFPubReaderePub
- Endoscopy plays a crucial role in the management of inflammatory bowel disease (IBD) in terms of diagnosis, monitoring of mucosal status, and surveillance of colitis-associated neoplasia. Mucosal healing evaluated by endoscopy has been recognized as the target of treatment in the era of powerful biologics therapy. The optimal modality for identifying dysplasia in IBD has yet to be well defined. Increasing progress has recently been made in endoscopic technologies to more accurately assess mucosal inflammation and more effectively detect dysplasia. Here we review the data of advanced endoscopic imaging techniques such as chromoendoscopy, virtual chromoendoscopy, endocytoscopy, and confocal laser endomicroscopy in the management of IBD.
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Citations
Citations to this article as recorded by- Moxifloxacin promotes two-photon microscopic imaging for discriminating different stages of DSS-induced colitis on mice
Yingtong Chen, Xiaoyi Xu, Min Wang, Xiang Wang, Yan Wang, Yong Zhang, Jin Huang, Yuwen Tao, Wentao Fan, Lili Zhao, Li Liu, Zhining Fan
Photodiagnosis and Photodynamic Therapy.2024; 48: 104220. CrossRef - Meta-analysis of Virtual-based Chromoendoscopy Compared With Dye-spraying Chromoendoscopy Standard and High-definition White Light Endoscopy in Patients With Inflammatory Bowel Disease at Increased Risk of Colon Cancer
Mohammed El-Dallal, Ye Chen, Qianyun Lin, Shana Rakowsky, Lindsey Sattler, Joshua Foromera, Laurie Grossberg, Adam S Cheifetz, Joseph D Feuerstein
Inflammatory Bowel Diseases.2020; 26(9): 1319. CrossRef - Artificial intelligence‐assisted endoscopy changes the definition of mucosal healing in ulcerative colitis
Hiroshi Nakase, Takehiro Hirano, Kohei Wagatsuma, Tadashi Ichimiya, Tsukasa Yamakawa, Yoshihiro Yokoyama, Yuki Hayashi, Daisuke Hirayama, Tomoe Kazama, Shinji Yoshii, Hiro‐o Yamano
Digestive Endoscopy.2020;[Epub] CrossRef - Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease
Kyeong Ok Kim, Michael V. Chiorean
Intestinal Research.2020; 18(4): 438. CrossRef - Surgical Management of Dysplasia and Cancer in Inflammatory Bowel Disease
James Ansell, Fabian Grass, Amit Merchea
Surgical Clinics of North America.2019; 99(6): 1111. CrossRef
- Moxifloxacin promotes two-photon microscopic imaging for discriminating different stages of DSS-induced colitis on mice
- 7,159 View
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- 6 Web of Science
- 5 Crossref
Original Article
- Increased Detection of Colorectal Polyps in Screening Colonoscopy Using High Definition i-SCAN Compared with Standard White Light
- Woo Jung Kim, Sang Young Park, Iksoo Park, Wook Jin Lee, Jaechan Park, Nuri Chon, Tak Geun Oh, Kwang Hyun Kim
- Clin Endosc 2016;49(1):69-75. Published online January 28, 2016
- DOI: https://doi.org/10.5946/ce.2016.49.1.69
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Abstract
PDFPubReaderePub
- Background
/Aims: The aim of this study was to evaluate the efficacy of high definition (HD) i-SCAN for colorectal polyp detection in screening colonoscopy.
Methods
We retrospectively analyzed the records of 501 patients who had undergone screening colonoscopy performed by three endoscopists with either HD i-SCAN (n=149) or standard white light (n=352) from January 2, 2014 through June 30, 2014. Patient information and inter-endoscopist variation as well as polyp number, endoscopic findings, and pathologic characteristics were reviewed.
Results
The detection rates of colorectal and neoplastic polyps were significantly higher using HD i-SCAN than standard white light colonoscopy (52% vs. 38.1%, p=0.004 for colorectal polyps; and 37.2% vs. 27.9%, p=0.041 for neoplastic polyps). Analysis of endoscopic findings revealed no difference in detected polyp size between HD i-SCAN and standard white light colonoscopy (4.59±2.35 mm vs. 4.82±2.81 mm, p=0.739), but non-protruding polyps were more commonly detected by i-SCAN than by standard white light colonoscopy (24.6% vs. 13.5%, p=0.007).
Conclusions
Colonoscopy using HD i-SCAN had a significantly higher detection rate of colorectal polyps, including neoplastic polyps, because of improved sensitivity for detecting non-protruding lesions. -
Citations
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Focused Review Series: Image Enhanced Endoscopy
- The Past, Present, and Future of Image-Enhanced Endoscopy
- Jae-Young Jang
- Clin Endosc 2015;48(6):466-475. Published online November 30, 2015
- DOI: https://doi.org/10.5946/ce.2015.48.6.466
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Abstract
PDFPubReaderePub
- Despite the remarkable progress recently made to enhance the resolution of white-light endoscopy, detection, and diagnosis of premalignant lesions, such as adenomas and subtle early-stage cancers, remains a great challenge. As for example, although chromoendoscopy, such as endoscopy using indigo carmine, is useful for the early diagnosis of subtle lesions, the technique presents various disadvantages ranging from the time required for spray application of the dye and suctioning of excess dye to the increased difficulty in identifying lesions in the presence of severe inflammation and obstruction of visual field due to the pooling of solution in depressed-type lesions. To overcome these diagnostic problems associated with chromoendoscopy, research has focused on the development of endoscopes based on new optical technologies. Several types of image-enhanced endoscopy methods have recently been presented. In particular, image-enhanced endoscopy has emerged as a new paradigm for the diagnosis of gastrointestinal disorders. Image-enhanced endoscopes provide high-contrast images of lesions by means of optical or electronic technologies, including the contrast enhancement of the mucosal surface and of blood vessels. Chromoendoscopy, narrow-band imaging, i-SCAN, and flexible spectral imaging color enhancement are representative examples of image-enhanced endoscopy discussed in this paper.
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Focused Review Series: Optical Diagnosis and New Management Strategy of Colorectal Polyps
- New Paradigms for Colonoscopic Management of Diminutive Colorectal Polyps: Predict, Resect, and Discard or Do Not Resect?
- Cesare Hassan, Alessandro Repici, Angelo Zullo, Prateek Sharma
- Clin Endosc 2013;46(2):130-137. Published online March 31, 2013
- DOI: https://doi.org/10.5946/ce.2013.46.2.130
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Abstract
PDFPubReaderePub
The possibility to predict
in vivo the histology of colorectal polyps by advanced endoscopic imaging has resulted in the implementation of a more conservative management for diminutive lesions detected at colonoscopy. In detail, a predict-and-do-not-resect strategy has been proposed for diminutive lesions located in the rectosigmoid tract, whilst a predict-resect-and-discard policy has been advocated for nonrectosigmoid diminutive polyps. Recently, the American Society for Gastrointestinal Endoscopy set required thresholds to be met, before allowing the adoption of these policies in the clinical field. The ability of current endoscopic imaging in reaching these thresholds would depend on a complex interaction among the accuracy of advanced endoscopic imaging in differentiating between adenomatous and hyperplastic lesions, the prevalence of (advanced) neoplasia within diminutive lesions, and the type of surveillance intervals recommended. Aim of this review is to summarize the data supporting the application of both a predict-and-do-not-resect and a predict-resect-and-discard policies, also addressing the potential pitfalls associated with these strategies.-
Citations
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Nurhan DEMİR
Artuklu International Journal of Health Sciences.2022; 2(3): 20. CrossRef - POLYP AND ADENOMA DETECTION RATE AND EVALUATION OF DIFFERENT POLYP RETRIEVAL METHODS IN PATIENTS UNDERGOING COLONOSCOPY IN KURDISTAN CENTER FOR GASTROENTEROLOGY AND HEPATOLOGY/SULAIMANI CITY (KCGH)
Sarkawt Ameen, Muhsin Mohammed, Mohammed Alshaikhani, Mohammed Mohammed, Taha Al-Karbuly, Dana Gharib, Araz Latif
JOURNAL OF SULAIMANI MEDICAL COLLEGE.2021; 11(4): 407. CrossRef - Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: Systematic review and meta‐analysis
Satoshi Shinozaki, Yasutoshi Kobayashi, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor, Hironori Yamamoto
Digestive Endoscopy.2018; 30(5): 592. CrossRef - Clinical, endoscopic and pathological characteristics of colorectal polyps in elderly patients: Single-center experience
Lei Zhou, Heng Zhang, Shengbin Sun, Manling Huang, Jing Liu, Dan Xu, Min Song, Chenming Sun, Hui Li, Dan Zheng, Yan Fan, Yusheng Liao, Ping Wang, Jie Wu
Molecular and Clinical Oncology.2017; 7(1): 81. CrossRef - Results of total colonoscopy in the diagnosis of polyps. Case studies in Villavicencio, Colombia
Mauricio Alberto Melo-Peñaloza
Revista de la Facultad de Medicina.2017; 65(3): 433. CrossRef - Narrow-band Imaging International Colorectal Endoscopic Classification to predict polyp histology: REDEFINE study (with videos)
Alessandro Repici, Camilla Ciscato, Loredana Correale, Raf Bisschops, Pradeep Bhandari, Evelien Dekker, Oliver Pech, Franco Radaelli, Cesare Hassan
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Diac Andreea Raluca, Brusnic Olga, Gabos Gabriella, Onisor Danusia, Drasoveanu Silvia Cosmina, Boeriu Alina, Dobru Daniela Ecaterina
Acta Medica Marisiensis.2015; 61(3): 161. CrossRef - Risk factors for polyp retrieval failure in colonoscopy
Carlos Fernandes, Rolando Pinho, Iolanda Ribeiro, Joana Silva, Ana Ponte, João Carvalho
United European Gastroenterology Journal.2015; 3(4): 387. CrossRef - Accuracy of visual prediction of pathology of colorectal polyps: how accurate are we?
Prashant Sharma, John Frye, Frank Frizelle
ANZ Journal of Surgery.2014; 84(5): 365. CrossRef
- Pit Pattern Analysis of Colorectal Polyps Using Storz Professional Image Enhancement System (Spies) Endoscopy
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- 10 Crossref
Review
- Endoscopic Imaging in Barrett's Oesophagus: Applications in Routine Clinical Practice and Future Outlook
- Sam Costello, Rajvinder Singh
- Clin Endosc 2011;44(2):87-92. Published online December 31, 2011
- DOI: https://doi.org/10.5946/ce.2011.44.2.87
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Abstract
PDFPubReaderePub
The practice for endoscopic surveillance of Barrett's oesophagus has evolved from "blind" or random 4 quadrant biopsies (Seattle protocol) to a more "intelligent" targeted biopsy approach. This evolution has been possible due to the rapid advances in endoscopic imaging technology and expertise in the last decade. Previous endoscopes had relatively poor image resolution that often did not allow the subtle mucosal changes associated with dysplastic Barrett's mucosa to be identified. Newer endoscopic imaging techniques available today may allow endoscopists to identify areas of dysplasia or malignancy and target biopsies accordingly. These modalities which include narrow band imaging, chromoendoscopy, autofluorescence imaging, and confocal endomicroscopy as well as a few novel imaging modalities on the horizon will be discussed further.
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Citations
Citations to this article as recorded by- The Role of Adjunct Imaging in Endoscopic Detection of Dysplasia in Barrett’s Esophagus
Pujan Kandel, Michael B. Wallace
Gastrointestinal Endoscopy Clinics of North America.2017; 27(3): 423. CrossRef - Red Flag Imaging Techniques in Barrett's Esophagus
Payal Saxena, Marcia Irene Canto
Gastrointestinal Endoscopy Clinics of North America.2013; 23(3): 535. CrossRef - Preliminary feasibility study using a novel narrow‐band imaging system with dual focus magnification capability in Barrett's esophagus: Is the time ripe to abandon random biopsies?
Rajvinder Singh, Muhammad Asif Shahzad, Willam Tam, Kenichi Goda, Lawrence Ho Khek Yu, Mitsuhiro Fujishiro, Noriya Uedo, Andrew Ruszkiewicz
Digestive Endoscopy.2013; 25(S2): 151. CrossRef
- The Role of Adjunct Imaging in Endoscopic Detection of Dysplasia in Barrett’s Esophagus
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- 58 Download
- 3 Crossref
- Is Chromoendoscopy with Indigocarmine Useful for Detecting Additional Lesions in Patients Referred for Endoscopic Resection of Gastric Adenoma or Cancer?
- Jung Ho Park, M.D., Jun Haeng Lee, M.D., Yun Jeong Lim, M.D., Poong-Lyul Rhee, M.D., Jae J. Kim, M.D., Seung Woon Paik, M.D., Jong Chul Rhee, M.D. and Cheol Keun Park, M.D.*
- Korean J Gastrointest Endosc 2005;30(1):1-6. Published online January 30, 2005
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Abstract
PDF
- Background
/Aims: Endoscopic mucosal resection (EMR) is frequently performed for the treatment of gastric adenoma or early gastric cancer. These lesions are commonly associated with atrophic gastritis and synchronous lesions are not uncommon. The aim of this study was to evaluate the usefulness of chromoendoscopy with indigocarmine in detecting additional lesions patients referred for EMR. Methods: Chromoendoscopy was performed in 51 patients (M：F=41：10, mean age= 60 year). After a careful examination, the stomach was stained with a 30 mL of indigocarmine (0.2%) with a spraying catheter. The changes in size of the lesions and the possibility of finding additional lesions were compared between before and after spraying dye. Results: Before dye- spraying, six additional lesions were found. On the other hand, before the chromoendoscopy with indigocarmine. And among these, microscopic examination confirmed the presence of adenomas for additional three lesions. After spraying indigocarmine, eight additional lesions were found suspicious for adenoma, after the dye spraying. However, there was no neoplastic lesions histopathologically. With dye-spraying, the lesions looked bigger in four cases. And the three lesions among them showed similar size compared to the patholgic report. Conclusions: A conventional gastroscopic examination was enough to find additional adenoma or cancer, whereas chromoendoscopy was not so helpful in detecting additional lesions. In addition, because indigocarmine dye-spraying could outline mucosal elevations, chromoendoscopy was benefical in accurately measuring the size of the lesion. (Korean J Gastrointest Endosc 2005;30:16)
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- 19 Download
Original Article
- Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms
- Published online November 30, 1999
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Abstract
- Background
/Aims: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) and Lugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamous cell neoplasms (ESCNs) in patients with a history of head and neck cancer.
Methods
From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology has historically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined.
Results
Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelial neoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy of dNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively.
Conclusions
The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detecting esophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guided biopsy could reduce the number of unnecessary biopsies.
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- 0 Download
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