Advanced diagnostic endoscopy in the lower gastrointestinal tract: A review of JGES core sessions

Abstract

At each of the 89th to the 92nd congresses of the Japan Gastroenterological Endoscopy Society, a series of featured discussion sessions concerning advanced diagnostic endoscopy in the lower gastrointestinal tract were presented. In total, 45 lectures were presented in this subject area. It was shown that, in recent years, several convenient and less invasive colonoscopic modalities have been developed. This review article summarizes these core sessions and the efficacy of the techniques discussed.

Use of image-enhanced endoscopy in the characterization of colorectal polyps: Still some ways to go

“…To overcome the human element of variation in the differentiation between hyperplastic polyps and neoplastic lesions, the use of computer-aided diagnosis with a deep neural network is being developed, and has produced results that are promising where this system was able to differentiate between hyperplastic and neoplastic lesions with a sensitivity of 96.3%, specificity of 78.1%, a positive predictive value of 89.6%, and a NPV of 91.5%,[34] which was similar to expert endoscopists but better than novices. [34] How these new computer-aided detection and diagnosis systems will function in the future is unclear[35] but might act as “a second reader” for the endoscopist. [36]…”

Adaptive denoising hyperspectral data for visualization enhancement of intraoperative tissue

“…Different from the HSI imaging, narrow-band imaging (NBI) made use of only small amount of bands and demonstrated good capability to reveal those key biological chromophore compositions as well as related anatomic structures such as cholesteatoma, nervous tissue, superficial vascular and mucosal structures associated with the development of cancerous and precancerous changes [22][23][24]. It has been widely used complementally with the common white light endoscopic imaging modality to enhance the perception of those surgically important tissues and improve the detection of small or flat lesions within a variety of organs [25,26].…”

Necessity of image‐enhanced endoscopy for detecting colorectal lesions

“…Additionally, a systematic review showed the effect of NBI was achieved only with good preparation. The Japan Gastroenterological Endoscopy Society held core sessions, including many important studies on this point, to discuss IEE and motivate endoscopists to use it efficiently 4 . Thus, many endoscopists are now familiar with the use of NBI for upper and lower endoscopy.…”

“…These modes have been reported to be useful for polyp detection and characterization. 3,4 Furthermore, an innovative endoscopy system using four-color light-emitting diode (LED) multilight technology (ELUXEO; Fujifilm) was released in 2016-2017 for some areas in which LASER endoscopes had not yet been approved for use, including the United States and Europe. This system enables the performance of BLI and LCI with an LED light source instead of a LASER light source using multilight technology.…”

“…The system allows for BLI and LCI to be performed as modes of narrow‐band light observation. These modes have been reported to be useful for polyp detection and characterization 3,4 . Furthermore, an innovative endoscopy system using four‐color light‐emitting diode (LED) multilight technology (ELUXEO; Fujifilm) was released in 2016–2017 for some areas in which LASER endoscopes had not yet been approved for use, including the United States and Europe.…”