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Efficacy of a novel auto-fluorescence imaging system with computer-assisted color analysis for assessment of colorectal lesions

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World Journal of Gastroenterology 2013年第41期19卷 7146-7153页

作者： Hiroko Inomata Naoto Tamai Hiroyuki Aihara Kazuki Sumiyama shoichi saito Tomohiro Kato Hisao Tajiri Department of Endoscopy The Jikei University School of MedicineTokyo 105-8461Japan Division of Gastroenterology and Hepatology Department of Internal MedicineThe Jikei University School of MedicineTokyo 105-8461Japan

AIM:To evaluate the efficacy of computer-assisted color analysis of colorectal lesions using a novel auto-fluorescence imaging(AFI)system to distinguish neoplastic lesions from non-neoplastic lesions and to predict the depth of ***:From January 2013 to April 2013,consecutive patients with known polyps greater than 5 mm in size who were scheduled to undergo endoscopic treatment at The Jikei University Hospital were prospectively recruited for this *** lesions were evaluated using a novel AFI system,and color-tone sampling was performed in a region of interest determined from narrow band imaging or from chromoendoscopy findings without *** green/red(G/R)ratio for each lesion on the AFI images was calculated automatically using a computer-assisted color analysis system that permits real-time color analysis during endoscopic ***:A total of 88 patients with 163 lesions were enrolled in this *** were significant differences in the G/R ratios of hyperplastic polyps(non-neoplastic lesions),adenoma/intramucosal cancer/submucosal(SM)superficial cancer,and SM deep cancer(P0.89 was applied to determine non-neoplastic lesions,the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy were 83.9%,82.6%,53.1%,95.6%and 82.8%,*** neoplastic lesions,the mean G/R ratio was 0.834±0.080 in adenoma/intramucosal cancer/SM superficial cancer and 0.746±0.045 in SM deep *** G/R ratio of adenoma/intramucosal cancer/SM superficial cancer was significantly higher than that of SM deep cancer(P<0.01).When a G/R ratio cut-off value of<0.77 was applied to distinguish SM deep cancers,the sensitivity,specificity,PPV,NPV,and accuracy were80

关键词： Autofluorescence imaging Computer-aided diagnosis Colon Neoplasia Colonoscopy

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Serrated polyps of the colon and rectum: Endoscopic features including image enhanced endoscopy

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World Journal of Gastrointestinal Endoscopy 2015年第9期7卷 860-871页

作者： shoichi saito Hisao Tajiri Masahiro Ikegami Department of Endoscopy the Jikei University School of Medicine Department of Internal Medicine Division of Gastroenterology and Hepatologythe Jikei University School of Medicine Department of Pathology the Jikei University School of Medicine

In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classified into the following three types based: hyperplastic polyps(HPs), traditional serrated adenomas(TSAs), and sessile serrated adenoma/polyps(SSA/Ps). Both HP and SSA/P often present as dark-green colors on auto fluorescence imaging(AFI) colonoscopy that are similar to the normal surrounding mucosa. In contrast, TSAs often have elevated shapes and present as magenta colors that are similar to the tubular adenomas. The superficial type of TSA also includes many lesions that present as magenta colors. When SSA/Ps are associated with cytological dysplasia, many lesions present with magenta colors, whereas lesions that are not associated with cytological dysplasia present with dark-green colors. When observed via narrow band imaging(NBI), many SSA/P include lesions with strong mucous adhesions. Because these lesions are observed with reddish mucous adhesions, we refer to them as "red cap sign" and place such signs among the typical findings of SSA/P. Because the dilatation of the pit in SSA/P is observed as a round/oval black dot on magnified observations, we refer to this finding as Ⅱ-dilatation pit(Ⅱ-D pit) and also positioned it as a characteristic finding of SSA/P. In contrast, dilatations of the capillary vessels surrounding the glands, such as those that occur in tubular adenoma, are not considered to be useful for differentiating HPs from SSA/Ps. However, in cases in which SSA/P is associated with cytological dysplasia, the dilatation of capillary vessels is observed in the same area. When submucosal layer invasion occurs in the same area, the blood flow presents with irregularities that are similar to those of common colorectal cancer at an early stage and disappears as the invasion proceeds deeply. The surface pattern of invasive cancer that is obs

关键词： Image enhanced endoscopy Hyperplasticpolyp Early colon cancer Traditional serrated adenoma Sessile serrated adenoma/polyp

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BRIEF ARTICLE New reduced volume preparation regimen in colon capsule endoscopy

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World Journal of Gastroenterology 2012年第17期18卷 2092-2098页

作者： Yasuo Kakugawa Yutaka saito shoichi saito Kenji Watanabe Naoki Ohmiya Mitsuyuki Murano Shiro Oka Tetsuo Arakawa Hidemi Goto Kazuhide Higuchi Shinji Tanaka Hideki Ishikawa Hisao Tajiri Division of Screening Technology and Development Research Center for Cancer Prevention and ScreeningNational Cancer CenterTokyo 104-0045Japan Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan Department of Endoscopy Jikei University School of MedicineTokyo 105-8461Japan Department of Gastroenterology Osaka City University Graduate School of MedicineOsaka 545-8685Japan Department of Therapeutic Medicine Nagoya University Graduate School of MedicineNagoya 466-8560Japan Second Department of Internal Medicine Osaka Medical CollegeOsaka 569-8686Japan Department of Endoscopy Hiroshima University HospitalHiroshima 734-8551Japan Department of Molecular-Targeting Cancer Prevention Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyoto 602-0841Japan

AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule ***:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method"(group A) with the "conventional volume method"(group B) preparation *** A did not drink polyethylene glycol electrolyte lavage solution(PEGELS) the day before the capsule procedure,while group B drank 2 *** the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule(PillCam COLON capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that *** videos were reviewed for grading of cleansing level,RESULTS:Sixty-four subjects were enrolled,with results from 60 *** A and B included 31 and 29 subjects,***-nine(94%) subjects in group A and 25(86%) subjects in group B had adequate bowel preparation(ns).Twenty-two(71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16(55%) of the 29 subjects in group B(ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than ***:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.

关键词： Colon capsule endoscopy Polyethylene glycol electrolyte lavage solution Colon cleanliness Reduced volume preparation method Isotonic magnesium citrate

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