Diagnosis of colorectal tumorous lesions by magnifying endoscopy

Kudo, Shin‐ei; Tamura, Shinji; Nakajima, Takashi; Yamano, Hiro‐o; Kusaka, Hisashi; Watanabe, Hidenobu

doi:10.1016/s0016-5107(96)70222-5

Cited by 956 publications

(785 citation statements)

References 3 publications

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“…These authors observed that the area and volume of the adenomatous glands are larger than those of the normal gland (9) , an aspect which is also observed in the current study, when morphometric measures are applied to the endoscopic image. Comparing magnified endoscopy and histology, the same author observed a high correlation between diagnoses in the cases of adenomas (82.9%), slightly less in villous adenomas (73.4%) and much less in the cases of cancer (57.7%) (7) .…”

Section: Discussionmentioning

confidence: 92%

Morphometric digital measurement of the luminal opening area of colonic crypts (pits) can differentiate the adenomas from other colonic lesions

Saul

Prolla

Silva

et al. 2009

Arq. Gastroenterol.

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-Context -Differential diagnosis of hyperplastic vs adenomatous lesions is of crucial importance on the daily practice of colonoscopy.Objectives -This study aimed at quantifying digital morphometric characteristics of colonoscopic images obtained with magnification and chromoscopy of three different types of colonic lesions: hyperplastic, adenomas and carcinomas, and the normal mucosa surrounding the lesions. Methods -A total of 2,177 consecutive colonoscopies were analyzed and 105 images were chosen for analysis, divided into 37 hyperplastic lesions, 42 adenomas and 26 carcinomas. Specific digital morphometry was used, to measure the diameter and area of the pits from hyperplastic lesions, adenomatous and carcinomatous lesions, always comparing them with the normal mucosa surrounding pits. Results -Different morphometric measures were performed via image analysis software to measure the mean pit opening diameters and their respective area. The mean pit opening diameters and corresponding area measurements were statistically significant for all groups of lesions examined. Conclusions -The morphometric characteristics of colonoscopy images allowing the observer to compare differences between hyperplastic and adenomatous polyps and colorectal carcinoma lesions. Digital morphometric studies are feasible like the present study shows. This can help the colonoscopist in clinical decisions. A software with morphometric measures can apply and will permit the digital morphometric analysis. The data generated from the application of software, can provide valuable points in differentiation of various lesions, guiding the conduct clinical, already during the endoscopic procedure. Morphometric analysis is more an instance of decision to the colonoscopist and it has important value not for being subjective, but for being objective, since it generates digits of its measures. In these aspects, and among different characteristics, the measure of the area showed to be the most important measure in the differential aspect. Different lesions have different patterns of morphometric measures and theses patterns can be obtained from the study of the characteristics in databases. The endoscopic removal of adenomatous polyps (polypectomy), or a more detailed study of the neoplastic lesions for helping the decision if endoscopic removal (mucosectomy) or surgical resection, and a conservative position in hyperplastic lesions, are proceedings that morphometrics, with another parameters, can help to decide.

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Section: Discussionmentioning

confidence: 92%

Morphometric digital measurement of the luminal opening area of colonic crypts (pits) can differentiate the adenomas from other colonic lesions

Saul

Prolla

Silva

et al. 2009

Arq. Gastroenterol.

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“…In this respect, the diagnostic process that uses magnifying endoscopy is similar to that used by the examining pathologist, although discrepancies might exist between the pathological features of the surface and of deeper tissues 5 . Several studies on the combined use of magnifying endoscopy and choromoendoscopy have led to acceptance of Kudo s classi cation of pit patterns as a standard, and this classi cation is currently the most widely used system for differentiating normal mucosa from neoplasms 3,5 .…”

Section: Evaluation Of Publication Biasmentioning

confidence: 99%

A Comparison of Magnifying Chromoendoscopy Versus Narrow Band Imaging in the Diagnosis of Depth of Invasion for Early Colorectal Cancers

Kobayashi

Kudo

Miyachi

et al. 2011

Showa Univ J Med Sci

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: Although chromoendoscopy and narrow band imaging NBI are widely used in diagnosing the invasion depth of colorectal cancers, comparative studies of these modalities are lacking. This meta-analysis compared the performance of these two modalities in colorectal cancer diagnosis. MEDLINE, EMBASE, and Cochrane Library were searched for relevant original articles published up to December 20 th , 2010. Major criteria for article inclusion were : i magnifying chromoendoscopy or NBI was used as a diagnostic modality and pit pattern or vascular pattern was used as a diagnostic classi cation ; ii sensitivity and speci city were reported ; iii absolute numbers of true-positive, false-positive, true-negative, and false-negative cases, or their equivalent, were provided ; and iv pathology of biopsy, endoscopy, or surgical treatment was used as the reference standard. Sensitivity and speci city were pooled using a random effects model. Regression analysis was performed to compare the discriminatory power between chromoendoscopy and NBI by including a dummy variable. We made the assumption that a positive regression coef cient implied a better discriminatory power for NBI, and vice versa. Of 1846 screened articles, 16 ful lled all inclusion criteria. Pooled sensitivity for chromoendoscopy and NBI was 0.85 95 CI : 0.82-0.87 and 0.80 0.76-0.85 , respectively, and specificity was 0.98 0.97-0.99 and 0.98 0.97-0.99 , respectively. The regression coef cient for chromoendoscopy versus NBI was 0.02 95 CI : 1.18-1.71 . These results indicate that chromoendoscopy and NBI may have similar power for the diagnostic assessment of colonic neoplasms. However, other factors such as convenience, time, and cost still must be taken into account in making the nal diagnostic choice.

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“…Indeed, the frequently quoted Kudo classifi cation derives its fame for being the fi rst attempt to use a standardized classifi cation method to describe the mucosal surface characteristics of colon polyps ( 9 ). Kudo et al ( 9 ) classifi ed polyps based on their pit pattern appearance aft er application of the colorants indigo carmine and cresyl violet.…”

mentioning

confidence: 99%

“…Kudo et al ( 9 ) classifi ed polyps based on their pit pattern appearance aft er application of the colorants indigo carmine and cresyl violet. Of note, this classifi cation was " lesion-based " , i.e., once the polyp was detected the endoscopist focused on the polyp, washed the lesion to remove the mucus, applied the colorant indigo carmine followed by cresyl violet, and then used endoscopy with magnifi cation to characterize the lesion ( 9 ).…”

mentioning

confidence: 99%

“…Note that the classic study from Kudo was performed using magnifi cation endoscopes, which are capable of magnifying the image up to × 100 ( 9 ). In another study, Matsuda et al ( 11 ) Besides observing the types of scopes used, we also need to realize that the chromocolonoscopy techniques are very variable, starting with the dye concentration, the amount of dye used, and extending to the technique of mucosal inspection, including basic aspects such as endoscope retrieval.…”

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confidence: 99%

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Editorial: An Advanced Chromocolonoscopic Picture Is Worth a Thousand Words, but Is It Worth the Effort?

Mönkemüller

Zimmermann

2010

American Journal of Gastroenterology

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Chromocolonoscopy is a commonly used advanced or multimodal colon imaging method to interrogate the colon mucosa and colon polyps. The two main objectives of chromocolonosopy are to (a) detect a colon polyp and (b) defi ne (differentiate) the lesion. Although data supporting the use of chromocolonoscopy for colon polyp detection are not strongly founded, this technique may be helpful in differentiating colon polyps and may aid in their endoscopic resection.

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Diagnosis of colorectal tumorous lesions by magnifying endoscopy

Cited by 956 publications

References 3 publications

Morphometric digital measurement of the luminal opening area of colonic crypts (pits) can differentiate the adenomas from other colonic lesions

Morphometric digital measurement of the luminal opening area of colonic crypts (pits) can differentiate the adenomas from other colonic lesions

A Comparison of Magnifying Chromoendoscopy Versus Narrow Band Imaging in the Diagnosis of Depth of Invasion for Early Colorectal Cancers

Editorial: An Advanced Chromocolonoscopic Picture Is Worth a Thousand Words, but Is It Worth the Effort?

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