Pit Pattern Diagnosis for Colorectal Neoplasia Using Narrow Band Imaging Magnification

Abstract

Narrow band imaging (NBI) is a newly developed technology that uses optical filters for RGB sequential illumination and narrows the bandwidth of spectral transmittance. NBI enables the observation of the fine capillaries in the superficial mucosa of the gastrointestinal tract. In this report, the authors assessed the clinical usefulness of NBI magnification in pit pattern diagnosis for colorectal neoplasia. A total of 90 colorectal lesions including nine cases of hyperplasia, 60 of tubular adenoma and 21 of early carcinoma were analyzed. Histologic diagnosis was undertaken according to World Health Organization classifications. Magnified observation of the lesions was performed using NBI without chromoendoscopy, and pit pattern diagnosis was then recorded. After endoscopic or surgical resection of the lesion, the authors performed stereoscopic examination to confirm the pit pattern. From these data, the authors estimated the ability to diagnose pit patterns using NBI magnification without chromoendoscopy. The correspondence rate of pit pattern diagnosis between NBI magnification without chromoendoscopy and stereoscopic findings was 100% (9/9) for type II, 100% (56/56) for type IIIL, 100% (3/3) for type IV, 80% (12/15) for type VI, and 57% (4/7) for type VN. NBI magnification without chromoendoscopy demonstrated good results for pit pattern diagnosis of colorectal neoplasia, especially for lesions with regular pit pattern.

Estudo comparativo entre MBI (FICE®) e a magnificação com índigo-carmin no diagnóstico diferencial de lesões neoplásicas e não-neoplásicas de cólon e reto

“…Nos últimos anos, vários estudos analisaram a capacidade da cromoscopia virtual de diferenciar lesões neoplásicas de não-neoplásicas (3,4,5,13,20,21) . A NBI ("Narrow Band Imaging") da empresa Olympus utiliza-se de um filtro óptico para separar os comprimentos de onda.…”

“…Nos últimos anos, a magnificação de imagens com ou sem o emprego da cromoscopia, tem ganho grande importância como recurso propedêutico para endoscopia digestiva, em especial, da colonoscopia (6,9,11,16,19,20) . Maior precisão diagnóstica requer detecção de pequenas alterações estruturais ou de coloração (8) , que podem ser diagnosticadas por meio da colonoscopia de alta resolução aliada à magnificação de imagens.…”

Magnifying narrow-band imaging of surface patterns for diagnosing colorectal cancer

“…They also calculated weighted kappa values of vascular pattern intensity and surface pattern, and found that agreement of vascular pattern (weighted k=0.64) was higher than that of surface pattern (weighted k=0.48). Tanaka et al (26) reported that the correspondence rate of pit pattern diagnosis between magnifying NBI and stereoscopic findings was 57% (4/7) for the V N pit pattern. They reported that higher-grade irregular pit patterns are more difficult to detect by magnifying NBI.…”

“…These false negatives were especially more frequent in protruded and flat elevated cancers. Tanaka et al (26) reported that magnifying NBI was useful for diagnosed colorectal lesions that revealed a regular pit pattern. Ikematsu et al (33) described the efficacy of capillary pattern classification.…”

“…Surface pattern classification and macroscopic type. When observing colorectal lesions with magnifying NBI, regular pit pattern demarcated by the appearance of meshed brown capillary vessels can be seen without the application of any dye solution (1,4,26,27). In the case of a severely irregular pit pattern or non-structure (type V I high-grade or type V N pit pattern), the pit cannot be identified by magnifying NBI (26).…”