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Brown slits for colorectal adenoma crypts on conventional magnifying endoscopy with Narrow band imaging using the X1 system

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World Journal of Gastroenterology 2022年第24期28卷 2748-2757页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Hidenobu Watanabe Nariaki Odawara Kosuke Sakitani Toru Arano Hirotoshi Takiyama Hideyuki Kobayashi Hirofumi Kogure Mitsuhiro Fujishiro Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalChiba 286-8520Japan Department of Pathology Pathology and Cytology Laboratory JapanTokyo 166-0003Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology Sakitani Endoscopy ClinicChiba 275-0026Japan Department of Gastroenterology The Fraternity Memorial HospitalTokyo 130-8587Japan Department of Surgical Oncology The University of TokyoTokyo 113-8655Japan Department of Internal Medicine Umegaoka Ekimae ClinicTokyo 154-0022Japan

BACKGROUND Accurate diagnosis of colorectal premalignant polyps,including adenomas,is vital in clinical practice.AIM To investigate the diagnostic yields of novel findings of brown slits for adenomas.METHODS Patients who underwent colonoscopy at the Toyoshima Endoscopy Clinic were enrolled.Polyps sized≥5 mm suspected of adenomas or clinically significant serrated polyps were included in the study.We defined the surface structures of colorectal polyps,which were brown curves inside and along the tubular glands identified using a combination of a new X1 system(Olympus Corporation)and a conventional magnifying colonoscope with non-staining Narrow band imaging(NBI),as brown slits.The brown slits corresponded to slit-like lumens on endocytoscopy and histological crypt openings of an adenoma.We evaluated the diagnostic performance of brown slits for adenoma.RESULTS A total of 108 Lesions from 62 patients were eligible.The average age was 60.4 years and 41.9%were male.The mean polyp size was 7.45±2.83 mm.Fifty-seven lesions were positive for brown slits.Histopathological diagnosis comprised 59 low-grade tubular adenomas,16 sessile serrated lesions,and 33 hyperplastic polyps.Among 59 adenomas,56(94.9%)were positive for brown slits.Among 16 sessile serrated lesions,0(0%)was positive for brown slits.Among 33 hyperplastic polyps,1(3.0%)was positive for brown slits.The sensitivity,specificity,and accuracy of brown slits for adenoma were 94.9%,98.0%,and 96.3%,respectively.The positive predictive value and negative predictive value of brown slits for adenoma were also excellent for 98.2%,and 94.1%,respectively.CONCLUSION Brown slits on conventional magnifying endoscopy with non-staining NBI using the X1 system were useful for diagnosing colorectal adenoma.The new endoscopy system could be examined using new standards.

关键词： Adenoma Colonoscopy Narrow band imaging Magnifying endoscopy X1 Serrated polyp Colorectal neoplasm Endocytoscopy

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Clinical relevance of fluorodeoxyglucose positron emission tomography/computed tomography and magnifying endoscopy with Narrow band imaging in decision-making regarding the treatment strategy for esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2019年第46期25卷 6767-6780页

作者： Kazuhiro Toriyama Masahiro Tajika Tsutomu Tanaka Makoto Ishihara Yutaka Hirayama Sachiyo Onishi Nobumasa Mizuno Takamichi Kuwahara Nozomi Okuno Shinpei Matsumoto Eiichi Sasaki Tetsuya Abe Yasushi Yatabe Kazuo Hara Keitaro Matsuo Tsuneo Tamaki Yasumasa Niwa Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Endoscopy Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastroenterology Anjo Kosei HospitalAnjo 446-8602Japan Department of Pathology and Molecular Diagnostics Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastroenterological Surgery Aichi Cancer Center HospitalNagoya 464-8681Japan Division of Cancer Epidemiology and Prevention Aichi Cancer Center Research InstituteNagoya 464-8681Japan East Nagoya imaging Diagnosis Center Nagoya 464-0044Japan

BACKGROUND Recent advances in endoscopic technology,especially magnifying endoscopy with Narrow band imaging(ME-NBI)enable us to detect superficial esophageal squamous cell carcinoma(ESCC),but determining the appropriate method of resection,endoscopic resection(ER)vs surgical resection,is often challenging.Recently,several studies have reported that 18F-fluorodeoxyglucose positron emission tomography(FDG-PET)is a useful indicator for decision-making regarding treatment for superficial ESCC.Although,there are not enough reports on association between FDG-PET uptake and clinicopathological characteristics of superficial ESCC.And,there are not enough reports on evaluating the usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.This study evaluated clinical relevance of FDG-PET and ME-NBI in decision-making regarding the treatment strategy for ESCC.AIM To investigate the association between FDG uptake and the clinicopathological characteristics of superficial ESCC and its usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.METHODS A database of all patients with superficial ESCC who had undergone both MENBI and FDG-PET for pre-treatment staging at Aichi Cancer Center Hospital between January 2008 and November 2018 was retrospectively analyzed.FDG uptake was defined positive or negative whether the primary lesion was visualized or could be distinguished from the background,or not.The invasion depth of ESCC was classified according to the Japan Esophageal Society.Primary endpoint is to evaluate the association between FDG uptake and clinicopathological characteristics of superficial ESCC.Secondary endpoint is to investigate the efficacy of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial ESCC.RESULTS A total of 82 lesions in 82 patients were included.FDG-PET showed positive uptake in 29(35.4%)lesions.Univariate analysis showed that uptake of FDG-PET had significant corr

关键词： ^18F-fluorodeoxyglucose positron emission tomography Magnifying endoscopy Narrow band imaging Superficial esophageal cancer Squamous cell carcinoma Treatment strategy

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Narrow band imaging for bladder cancer

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Asian Journal of Urology 2016年第3期3卷 126-129页

作者： Thomas Y.Hsueh Allen W.Chiu Division of Urology Department of SurgeryTaipei City Hospital Renai BranchTaipei Department of Urology School of MedicineNational Yang-Ming UniversityTaipei

Narrow band imaging(NBI)is a newly developed technology aiming to provide additional endoscopic information for patients with bladder cancer.This review focuses on the diagnostic accuracy and treatment outcome using NBI cystoscopy for the treatment of nonmuscle invasive bladder cancer.Current results showed improved sensitivity of NBI cystoscopy compared to conventional white light cystoscopy,although lower specificity and increased false-positive results were reported using NBI cystoscopy.The treatment outcome using NBI technology in transurethral resection of bladder tumor had a positive impact while decreased number of residual tumors and tumor recurrence at follow-up were reported.In the future,the application of NBI technology might refine the treatment and follow-up protocol in patients with non-muscle invasive bladder cancer.However,this large scale prospective studies are required to confirm the real cost-effectiveness of this new technology.

关键词： Non-muscle invasive bladder cancer Narrow band imaging Diagnosis Treatment

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Esophageal superficial adenosquamous carcinoma resected by endoscopic submucosal dissection:A rare case report

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World Journal of Clinical Cases 2021年第6期9卷 1336-1342页

作者： Guan-Yi Liu Ji-Xin Zhang Long Rong Wei-Dong Nian Bi-Xiao Nian Yuan Tian Endoscopy Center Peking University First HospitalBeijing 100032China Department of Pathology Peking University First HospitalBeijing 100032China

BACKGROUND Adenosquamous carcinoma(ASC),which is comprised of squamous cell carcinoma(SCC)and adenocarcinoma elements,is a rare histological type of esophageal carcinoma.Few reports have focused on the endoscopic findings and the effectiveness of the endoscopic treatment of early ASC.CASE SUMMARY A 77-year-old man underwent esophagogastroduodenoscopy for heartburn.A flat lesion with an uneven and slightly elevated central portion was found in the distal esophagus.Magnifying endoscopy with narrow-band imaging showed a well-demarcated brownish area with dendritically branched abnormal vessels and highly irregular intrapapillary capillary loops.A histopathological diagnosis of SCC was obtained by endoscopic biopsy.Endoscopic ultrasonography revealed a hypoechoic mass confined to the mucosa layer.The lesion was suspected to be SCC with invasion into the muscularis mucosa.The lesion was resected en bloc by endoscopic submucosal dissection and histologically diagnosed as esophageal ASC limited within the muscularis mucosa,which was completely resected without lymphovascular or neural invasion.The SCC element was the predominant element.The adenocarcinoma element formed ductal and nested structures distributed in a focal pattern.The patient underwent only endoscopic submucosal dissection and has been under annual endoscopic and radiographic surveillance for 3 years without recurrence.CONCLUSION For early ASC confined within the mucosal layer,complete endoscopic resection might also be a curative treatment.

关键词： Adenosquamous carcinoma Esophageal neoplasms Endoscopy Narrow band imaging Endoscopic submucosal dissection Case report

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Texture and color enhancement imaging for detecting colorectal adenomas: Good, but not good enough

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World Journal of Gastrointestinal Endoscopy 2022年第7期14卷 471-473页

作者： Ying Wang Chen-Yu Sun Lowe Scott Dan-Dan Wu Xia Chen South District of Endoscopic Center The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina AMITA Health Saint Joseph Hospital Chicago ChicagoIL 60657United States College of Osteopathic Medicine Kansas City UniversityKansas CityKS 64106United States Department of Nursing The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina

Texture and color enhancement imaging(TXI)has been developed as a novel image-enhancing endoscopy.However,the effectiveness of TXI detecting adenomas is inferior to Narrow band imaging.Thus,future studies will need to focus on investigating the feasibility of such combination in clinical settings in order to provide patients with more accurate diagnoses.

关键词： White light imaging Texture and color enhancement imaging Narrow band imaging Colorectal adenomas

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Texture and color enhancement imaging in magnifying endoscopic evaluation of colorectal adenomas

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World Journal of Gastrointestinal Endoscopy 2022年第2期14卷 96-105页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Tomoharu Yamada Nariaki Odawara Tatsuya Matsuno Miho Obata Ken Kurokawa Chie Uekura Mitsuhiro Fujishiro Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520ChibaJapan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan

BACKGROUND Olympus Corporation has developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic technique.AIM To investigate the effectiveness of TXI in identifying colorectal adenomas using magnifying observation.METHODS Colorectal adenomas were observed by magnified endoscopy using white light imaging(WLI),TXI,Narrow band imaging(NBI),and chromoendoscopy(CE).This study adopted mode 1 of TXI.Adenomas were confirmed by histological examination.TXI visibility was compared with the visibility of WLI,NBI,and CE for tumor margin,and vessel and surface patterns of the Japan NBI expert team(JNET)classification.Three expert endoscopists and three non-expert endoscopists evaluated the visibility scores,which were classified as 1,2,3,and 4.RESULTS Sixty-one consecutive adenomas were evaluated.The visibility score for tumor margin of TXI(3.47±0.79)was significantly higher than that of WLI(2.86±1.02,P<0.001),but lower than that of NBI(3.76±0.52,P<0.001),regardless of the endoscopist’s expertise.TXI(3.05±0.79)had a higher visibility score for the vessel pattern of JNET classification than WLI(2.17±0.90,P<0.001)and CE(2.47±0.87,P<0.001),but lower visibility score than NBI(3.79±0.47,P<0.001),regardless of the experience of endoscopists.For the visibility score for the surface pattern of JNET classification,TXI(2.89±0.85)was superior to WLI(1.95±0.79,P<0.01)and CE(2.75±0.90,P=0.002),but inferior to NBI(3.67±0.55,P<0.001).CONCLUSION TXI provided higher visibility than WLI,lower than NBI,and comparable to or higher than CE in the magnified observation of colorectal adenomas.

关键词： Texture and color enhancement imaging Adenoma Colonoscopy Narrow band imaging Japan NBI Expert Team Olympus

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