Current status and limitations of the newly developed endocytoscope GIF‐Y0002 with reference to its diagnostic performance for common esophageal lesions

Kumagai, Youichi; Kawada, Kenro; Yamazaki, Shigeru; Iida, Michio; Odajima, Hajime; Ochiai, Takanori; Kawano, Tatsuyuki; Takubo, Kaiyo

doi:10.1111/j.1751-2980.2012.00612.x

Cited by 19 publications

(25 citation statements)

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“…However, the specificity of diagnosis by a pathologist who was blinded to the conventional endoscopic view was considerably low (46.7%) because the low magnification power of this ECS prevented any assessment of nuclear abnormality. We concluded that higher‐magnification continuous‐zoom ECS would allow a more precise pathologic diagnosis, and obviate the need for biopsy histology …”

Section: Introductionmentioning

confidence: 90%

Endocytoscopic observation of various esophageal lesions at ×600: can nuclear abnormality be recognized?

et al. 2014

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Endocytoscopy (ECS) is a novel endoscopic technique that allows detailed diagnostic examination of the gastrointestinal tract at the cellular level. We previously reported that use of ECS at ×380 magnification (GIF-Y0002) allowed a pathologist to diagnose esophageal squamous cell carcinoma (ESCC) with high sensitivity (94.9%) but considerably low specificity (46.7%) because this low magnification did not reveal information about nuclear abnormality. In the present study, we used the same magnifying endoscope to observe various esophageal lesions, but employed digital 1.6-fold magnification to achieve an effective magnification of ×600, and evaluated whether this improved the diagnostic accuracy in distinguishing neoplastic from non-neoplastic lesions.We examined the morphology of surface cells using vital staining with toluidine blue and compared the histological features of 40 cases, including 19 case of ESCC and 21 non-neoplastic esophageal lesions (18 cases of esophagitis, 1 case of glycogenic acanthosis, 1 case of leiomyoma, and 1 case of normal squamous epithelium). One endoscopist classified the lesions using the type classification, and we consulted one pathologist for judgment of the ECS images as 'neoplastic', 'borderline', or 'non-neoplastic'. At ×600 magnification, the pathologist confirmed that nuclear abnormality became evident, in addition to the information about nuclear density provided by observation at ×380. The overall sensitivity and specificity with which the endoscopist was able to predict neoplastic lesions using the type classification was 100% (19/19) and 90.5% (19/21), respectively, in comparison with values of 94.7% (18/19 cases) and 76.2% (16/21), respectively, for the pathologist using a magnification of ×600. The pathologist diagnosed two non-neoplastic lesions and one case of ESCC showing an apparent increase of nuclear density with weak nuclear abnormality as 'borderline'. Among the 21 non-cancerous lesions, two cases of esophagitis that were misdiagnosed by the endoscopist were also misinterpreted as 'neoplastic' by the pathologist. We have shown, by consultation with a pathologist, that an ECS magnification of ×600 (on a 19-inch monitor) is adequate for recognition of nuclear abnormality. We consider that it is feasible to diagnose esophageal neoplasms on the basis of ECS images, and that biopsy histology can be omitted if a combination of increased nuclear density and nuclear abnormality is observed.

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Section: Introductionmentioning

confidence: 90%

Endocytoscopic observation of various esophageal lesions at ×600: can nuclear abnormality be recognized?

et al. 2014

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“…No serious complications of ECS have been reported yet [6] . At present, a standardized endocytoscopic atypia classification system has been described for esophageal squamous cell lesions [2] and colorectal [5] adenomatous lesions.…”

Section: Another Interesting Finding Of the Present Study Is Thementioning

confidence: 99%

“…The dual CCD prototype carries both conventional magnification (× 80) and ultra-high magnification (× 480) abilities, which can be easily interchanged by pushing a button on the endocytoscope [2,6] . The single CCD prototype endocytoscope (CIF-Y0002, EC2 Olympus) has only one lens that can consecutively increase the magnification power from the conventional magnification power to × 380 using a hand lever.…”

Section: Introductionmentioning

confidence: 99%

“…Not only structural atypia, but also cellular atypia, with observation of lumens and nuclei, is achieved by recent advances in ECS [5][6][7][8][9] . Two different integrated type endocytoscopes (GIF-Q260, Olympus Medical Systems Corp, Tokyo, Japan) have been recently developed [2,6] . The first is a dual charged couple device (CCD) integrated type (CIF-Y0001, EC1 Olympus, Tokyo, Japan) and the other is a single CCD integrated type (CIF-Y0002, EC2 Olympus).…”

Section: Introductionmentioning

confidence: 99%

“…The video processor (prototype, Olympus CV-260X) with a light source (Olympus CLV-260) allows narrow-band imaging (NBI) [2] . Methylene blue or toluidine blue single staining was initially used for endocytoscopic evaluation of esophageal lesions [6,10,11] . Recently, however double staining with a mixture of 0.05% crystal violet and 0.1% methylene blue (CM) has been also proposed during ECS [2,3] .…”

Section: Introductionmentioning

confidence: 99%

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Endocytoscopic visualization of squamous cell islands within Barrett’s epithelium

Eleftheriadis¹

2013

WJGE

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AIM:To study the endocytoscopic visualization of squamous cell islands within Barrett's epithelium. METHODS:Endocytoscopy (ECS) has been studied in the surveillance of Barrett's esophagus, with controversial results. In initial studies, however, a soft catheter type endocytoscope was used, while only methylene blue dye was used for the staining of Barrett's mucosa. Integrated type endocytoscopes (GIF-Q260 EC, Olympus Corp, Tokyo, Japan) have been recently developed, with the incorporation of a high-power magnifying endocytoscope into a standard endoscope together with narrow-band imaging (NBI). Moreover, double staining with a mixture of 0.05% crystal violet and 0.1% of methylene blue (CM) during ECS enables higher quality images comparable to conventional hematoxylin eosin histopathological images. RESULTS:In vivo endocytoscopic visualization of papillary squamous cell islands within glandular Barrett's epithelium in a patient with long-segment Barrett's esophagus is reported. Conventional white light endoscopy showed typical long-segment Barrett's esophagus, with small squamous cell islands within normal Barrett's mucosa, which were better visualized by NBI endoscopy. ECS after double CM staining showed regular Barrett's esophagus, while higher magnification (× 480) revealed the orifices of glandular structures better. Furthermore, typical squamous cell papillary protrusion, classified as endocytoscopic atypia classification (ECA) 2 according to ECA, was identified within regular glandular Barrett's mucosa. Histological examination of biopsies taken from the same area showed squamous epithelium within glandular Barrett's mucosa, corresponding well to endocytoscopic findings. CONCLUSION:To our knowledge, this is the first report of in vivo visualization of esophageal papillary squamous cell islands surrounded by glandular Barrett's epithelium.© 2013 Baishideng. All rights reserved.Key words: Endocytoscopy; Barrett's esophagus; Surveillance; Endocytoscopic atypia classification; Crystal violet; Methylene blue; Hematoxylin eosin stain Core tip: Endocytoscopy has been also studied in surveillance of Barrett's esophagus, with controversial results. In initial studies, however, a soft catheter type endocytoscope was used, while only methylene blue dye was used for staining of Barrett's mucosa. In the present study, in vivo endocytoscopic visualization of papillary squamous cell islands within glandular Barrett's epithelium in a patient with long-segment Barrett's esophagus is reported.

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Endocytoscopic observation of various types of esophagitis

et al. 2015

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Current status and limitations of the newly developed endocytoscope GIF‐Y0002 with reference to its diagnostic performance for common esophageal lesions

Abstract: The low percentage of specificity for the pathologist's diagnosis was considered to be attributed to the low magnification power of the GIF-Y0002. A further increase in the magnifying power of this instrument will be necessary to broaden its clinical applications.

Cited by 19 publications

References 20 publications

Endocytoscopic observation of various esophageal lesions at ×600: can nuclear abnormality be recognized?

Endocytoscopic observation of various esophageal lesions at ×600: can nuclear abnormality be recognized?

Endocytoscopic visualization of squamous cell islands within Barrett’s epithelium

Endocytoscopic observation of various types of esophagitis

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