Skip Navigation
Skip to contents

Clin Endosc : Clinical Endoscopy

Search
Advanced Search
OPEN ACCESS
mobile search button mobile menu button

Articles

Page Path
HOME > Clin Endosc > Volume 53(1); 2020 > Article
Commentary The Role of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection
In Kyung Yooorcid, Joo Young Cho,orcid
Clinical Endoscopy 2020;53(1):1-2.
DOI: https://doi.org/10.5946/ce.2020.018
Published online: January 30, 2020

Department of Gastroenterology, Cha Bundang Medical Center, Cha University College of Medicine, Seongnam, Korea

Correspondence: Joo Young Cho Department of Gastroenterology, Cha Bundang Medical Center, Cha University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea Tel: +82-31-780-5641, Fax: +82-32-780-5005, E-mail: cjy6695@naver.com
• Received: January 6, 2020   • Revised: January 12, 2020   • Accepted: January 12, 2020

Copyright © 2020 Korean Society of Gastrointestinal Endoscopy

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 3,894 Views
  • 113 Download
  • 2 Web of Science
  • 2 Crossref
  • 2 Scopus
next
Full Article

Download PDF Download PDF

See the article "Clinical Usefulness of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection: A Pilot Study" on page 54.
See “Clinical Usefulness of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection: A Pilot Study” by Naoki Yorita, Shiro Oka, Shinji Tanaka, et al., on page [Related article:] 54-59.
Endoscopic submucosal dissection (ESD) is a widely used non-invasive treatment for gastric lesions, including early gastric cancer and dysplasia [1]. Novel techniques have been developed to reduce serious adverse events associated with ESD, such as bleeding and perforation. In such a scenario, endoscopic hemostasis is an important technique used to prevent distinct complexities. When intraprocedural active bleeding cannot be controlled, the procedure time might be longer and the risk of perforation increases [2]. Occasionally, emergency intervention or surgery with excessive transfusion might be necessary in case of severe bleeding [3].
Recently, image-enhanced endoscopy (IEE) has been developed, which encompasses various methods of enhancing contrast during endoscopy using optical and/or electronic methods [4]. A new IEE technique, dual red imaging (DRI), has been introduced that captures images using three kinds of wavelengths: 500 nm, 600 nm, and 630 nm. The 540 nm light can visualize small blood vessels in shallow tissue, and the latter two (600 nm and 630 nm) can penetrate deep into the tissue and reflect with little attenuation. The displayed image shows that the 600 nm light is significantly more attenuated than the 630 nm light, which enhances the visibility of the deep vessels [5]. When blood vessels are absent, the reflected light is visualized with low attenuation; however, the reflected 600 nm light becomes highly attenuated in the presence of highly concentrated blood when compared to the presence of low-concentrated blood. Thus, the reflected image becomes reddish with the concomitant occurrence of a color contrast. This enables visualization of thick vessels, allowing instant discovery of bleeding points.
Yorita et al. [6] showed that DRI enhanced the visibility of bleeding spots during gastric ESD, hence reducing the need for coagulation. Thus, they suggested that DRI could be a potentially safe method to perform gastric ESD [7]. This study had several limitations. The results were based on a small sample size with a retrospective review of images. Moreover, there was a selection bias, which is an inevitable limitation of a retrospective study.
There was a report on the role of DRI in colorectal ESD that stated that DRI improved the visibility of arteries in the submucosal layer [5], thereby enhancing the speed and safety of the procedure. Notably, it has been reported to be useful in predicting the prognosis of ulcerative colitis and the depth of esophageal varices, especially with respect to submucosal fatty tissue [8,9].
In this study, the authors have demonstrated DRI as a useful approach in gastric ESD, especially under unfavorable conditions such as blood pooling. Additional studies with a larger sample size will be needed to verify the role of DRI in gastric ESD.
  • 1. Jeon SW, Jung MK, Cho CM, et al. Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions. Surg Endosc 2009;23:1974–1979.ArticlePubMedPDF
  • 2. Yamamoto Y, Kikuchi D, Nagami Y, et al. Management of adverse events related to endoscopic resection of upper gastrointestinal neoplasms: review of the literature and recommendations from experts. Dig Endosc 2019;31 Suppl 1:4–20.ArticlePubMed
  • 3. Tajiri H, Kitano S. Complications associated with endoscopic mucosal resection: definition of bleeding that can be viewed as accidental. Dig Endosc 2004;16(Suppl 1):S134–S136.Article
  • 4. Jang JY. The past, present, and future of image-enhanced endoscopy. Clin Endosc 2015;48:466–475.ArticlePubMedPMCPDF
  • 5. Ninomiya Y, Oka S, Tanaka S, et al. Clinical impact of dual red imaging in colorectal endoscopic submucosal dissection: a pilot study. Therap Adv Gastroenterol 2016;9:679–683.ArticlePubMedPMC
  • 6. Yorita N, Oka S, Tanaka S, et al. Clinical usefulness of dual red imaging in gastric endoscopic submucosal dissection: a pilot study. Clin Endosc 2020;53:54–59.ArticlePubMedPMCPDF
  • 7. Yahagi N, Horii J, Goto O, et al. Dual red imaging; a new endoscopic imaging technology for clear visualization of bleeding points in endoscopic submucosal dissection. Gastrointest Endosc 2014;79(5 Suppl):AB464.Article
  • 8. Furuichi Y, Gotoda T, Kasai Y, et al. Role of dual red imaging to guide intravariceal sclerotherapy injection of esophageal varices (with videos). Gastrointest Endosc 2018;87:360–369.ArticlePubMed
  • 9. Naganuma M, Yahagi N, Bessho R, et al. Evaluation of the severity of ulcerative colitis using endoscopic dual red imaging targeting deep vessels. Endosc Int Open 2017;5:E76–E82.ArticlePubMedPMCPDF

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  
    • Near infrared imaging system for preventing blood vision obstruction in endoscopy
      Meng-Huang Wu, Jason C. Hsu, Jin-Sung Kim, Tsung-Jen Huang, Yi-Hung Huang, Hon Pan Yiu, Ching-Yu Lee, Jowy Tani, Cheng-Chun Chang
      Optics Express.2023; 31(26): 43877.     CrossRef
    • Clinically Available Optical Imaging Technologies in Endoscopic Lesion Detection: Current Status and Future Perspective
      Zhongyu He, Peng Wang, Yuelong Liang, Zuoming Fu, Xuesong Ye, Aiping Liu
      Journal of Healthcare Engineering.2021; 2021: 1.     CrossRef

    • PubReader PubReader
    • ePub LinkePub Link
    • Cite
      CITE
      export Copy Download
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      The Role of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection
      Clin Endosc. 2020;53(1):1-2.   Published online January 30, 2020
      DOI: https://doi.org/10.5946/ce.2020.018
      Close
    • XML DownloadXML Download
    Related articles
    The Role of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection
    The Role of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection
    Clin Endosc : Clinical Endoscopy Twitter Facebook
    © Korean Society of Gastrointestinal Endoscopy.
    Close layer
    TOP