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Endoscopic Biopsy Demonstrating High-Grade Dysplasia in Barrett’s Esophagus
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Irrespective of the endoscopy surveillance interval, it is important to apply a structured strategy to inspection of the Barrett’s esophagus segment and collection of mucosal biopsies. Narrow band imaging and high-resolution endoscopy, coupled with thorough inspection, facilitate the identification of suspicious areas within the segment. The Seattle protocol, or a modified version, is recommended. This entails careful inspection with targeted biopsy of any suspicious areas within the Barrett’s esophagus segment, followed by four quadrant (i.e. 3, 6, 9, and 12 o’clock) biopsies commencing 1 cm above the gastroesophageal junction and extending proximally at 2 cm intervals for the full length of the Barrett’s esophagus segment. A lot of biopsies will be collected from long segments. For example, at least 20 biopsies should be collected from a 10 cm length. The endoscopist must avoid cutting corners in these patients, as those with the longer segments are at a higher risk of cancer. The aim of surveillance is to identify individuals in whom the mucosa demonstrates high-grade dysplasia or, worse still, stage T1a cancer, when endoscopic therapy is likely to be curative.
Telescopes for Inner Space: Fiber Optics and Endoscopes
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
New developments in endoscopic imaging are aimed at improving the images available. For example, chromoendoscopy involves the uses of stains or pigments introduced to distinguish the appearance of polyps or other abnormal features from normal tissues. Narrow Band Imaging involves using optical filters (Chapter 3) to change the way colors are imaged, resulting in better detection of fine blood vessels, features useful in classifying polyps, for example.
Cancer in IBD
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The use of narrow-band imaging (NBI) is not recommended as the method of choice for surveillance endoscopy, since it was shown to be equally effective as white light endoscopy in a randomised crossover study.38 Another technique that is currently under investigation is autofluorescence endoscopy.39 The superiority of this technique however remains to be proven.40 A comprehensive overview of all available imaging techniques and evidence from studies have been presented in a recent systematic review.41
Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Published in Scandinavian Journal of Gastroenterology, 2022
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
All colonoscopy examinations were equally allocated to a total of 15 board-certified endoscopists experienced with over 1500 cases of colonoscopies. Colonoscopies were performed using conventional white-light colonoscopes (CF-H260 or CF-HQ290; Olympus Co, Ltd., Tokyo, Japan). Narrow-band imaging was individualized. The mean adenoma detection rate (ADR) by endoscopists was 48.2%, ranging from 34.2 to 57.8% [15]. They achieved a mean serrated detection rate of 4.8%. The cecal intubation rate was >98% for all endoscopists [16]. For bowel preparation, a split-dose regimen of 2 L polyethylene-glycol plus ascorbic acid (Coolprep; Taejoon Pharm, Seoul, Korea) was administered. The detailed regimen has been reported previously [17]. We scored the bowel preparation according to Aronchick Bowel Preparation Scale (September 2013 to July 2015) and the Boston Bowel Preparation Score (after August 2015) [18]. Excellent, good, and fair ratings by Aronchick Bowel Preparation Scale and Boston Bowel Preparation Score, and ≥6 were considered an adequate level of bowel preparation [18].
Narrow-band imaging combined with salivary pepsin to diagnose patients with laryngopharyngeal reflux
Published in Acta Oto-Laryngologica, 2021
Narrow-band imaging (NBI) uses a spectral narrow-band filter to help detect the superficial capillary and vascular network of the mucous membrane and is widely used in the early diagnosis of malignant tumors, such as the digestive tract, nasopharyngeal, head and neck, and laryngeal tumors [14]. Since neoangiogenesis and hypervascularization are specific manifestations of acute and chronic inflammation, NBI has been applied to improve the reproducibility of grading esophagitis [15] during the past few years. LPR is characterized by extensive inflammation in the laryngopharynx, which inevitably causes changes in the mucosal vessels, thus NBI could potentially become a promising method in LPR diagnosis and management. Some authors introduced the NBI scoring system based on RFS as a possible grading system of LPR disease in both children and adults, and they found that RFS scores under NBI was higher than those under white light with a significant difference, which underlines the potentiality of NBI endoscopy in LPR evaluation [16,17].
Real-time computer-aided diagnosis of diminutive rectosigmoid polyps using an auto-fluorescence imaging system and novel color intensity analysis software
Published in Scandinavian Journal of Gastroenterology, 2019
Hideka Horiuchi, Naoto Tamai, Shunsuke Kamba, Hiroko Inomata, Tomohiko R. Ohya, Kazuki Sumiyama
Diminutive (≤5 mm) polyps are notably common, with previous studies reporting their prevalence in more than half of the US screening population [4,5]. However, the resection of all diminutive colorectal polyps leads to substantial healthcare costs because of the need for pathological assessment, and it increases the risk of adverse events. To minimize these risks, the American Society for Gastrointestinal Endoscopy (ASGE) released a statement concerning the real-time endoscopic assessment of the histology of diminutive colorectal polyps. According to the statement, in order to decide not to remove a suspected diminutive rectosigmoid hyperplastic polyp, the technology should provide a ≥ 90% negative predictive value (NPV) for neoplastic histology [6]. Narrow-band imaging (NBI) is considered to be a technology that can potentially achieve the threshold proposed by ASGE, and a meta-analysis revealed that the NPV of NBI was greater than 90% for experienced endoscopists, at academic medical centers, and when the optical biopsy assessment was made with high confidence [7]. However, in a report evaluating the real-time optical biopsy of colonic polyps using NBI, only 25% of community-based gastroenterologists assessed polyps with >90% accuracy [8]. In another similar study, only half the number of community-based gastroenterologists could diagnose polyps with >90% accuracy [9]. Therefore, an objective technology that can be applied by non-experts and at nonacademic centers for differentiating diminutive colorectal polyps is required.