Advances in image enhancement in colonoscopy for detection of adenomas

Abstract

High-quality colonoscopy is mandatory to prevent adenoma recurrence and colorectal cancer. In the past few years, technical advances have been developed with the purpose of improving adenoma detection rate (ADR), one of the most important validated colonoscopy quality benchmarks. Several techniques or devices are used to optimize visualization: observation techniques; add-on devices; auxiliary imaging devices; colonoscopes with increased field of view; and colonoscopes with an integrated inflatable reusable balloon. Image-enhanced endoscopy (IEE) facilitates the detection and characterization of polyps and especially nonpolypoid colorectal neoplasms. Indigo carmine is the most frequently used dye in colonoscopy as it deposits in depressed areas, improving detection of flat and depressed lesions. Virtual chromoendoscopy has emerged as an effective contrast enhancement technology without the limitation of preparing dyes and applying them through the colonoscope working channel. Narrow-band imaging (NBI) enhances the capillary pattern and surface of the mucosa using optical filters, and second-generation NBI provides a twofold brighter image than the previous system, yielding promising ADR results. Moreover, a second-generation blue laser imaging system, LASEREO, has been reported to improve not only polyp detection rate but also ADR, becoming a promising IEE modality. Herein, we describe technical advances in colonoscopy imaging and their effect on ADR.

How I do it: Flexible 3‐D endoscope for endoscopic submucosal dissection

“…GASTROINTESTINAL CANCERS REMAIN the commonest cancers worldwide . Recent development in image‐enhanced endoscopy (IEE) as well as the increased implementation of gastrointestinal cancer screening programs for colorectal and gastric cancers has led to earlier diagnosis of gastrointestinal cancers . With improvement in endoscopic recognition of early gastrointestinal cancers, as well as implementation of gastrointestinal cancer screening programs worldwide, there is an increasing trend in recognition of early gastric, esophageal and colon neoplasia.…”

“…1 Recent development in image-enhanced endoscopy (IEE) as well as the increased implementation of gastrointestinal cancer screening programs for colorectal and gastric cancers has led to earlier diagnosis of gastrointestinal cancers. 2,3 With improvement in endoscopic recognition of early gastrointestinal cancers, as well as implementation of gastrointestinal cancer screening programs worldwide, there is an increasing trend in recognition of early gastric, esophageal and colon neoplasia. Endoscopic submucosal dissection (ESD) has been developed to achieve en bloc resection for upper gastrointestinal neoplasia, 4,5 whereas colorectal ESD is increasingly carried out for treatment of laterally spreading tumors detected during screening colonoscopy.…”

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

“…In these core sessions, it was shown that several convenient and less invasive colonoscopic modalities have been developed in recent years. IEE improves the detectability of colorectal lesions, and predicts precise histopathological diagnosis using magnification . However, at present, there remain some problems.…”

Advances in endoscopic diagnosis of colorectal cancer

“…Novel methods were therefore developed to overpass anatomical difficulties of the colon, enable more accurate, even microscopic identification of abnormalities in the size, density and shape of crypts and vessels [13,[16][17][18]. They can be roughly divided into three categories, ones that improve overall mucosal examination and increase the polyp detection, those that enable more thorough examination (almost histological) of the detected lesions and minimally invasive techniques.…”