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World J Gastrointest Endosc. Dec 16, 2012; 4(12): 545-555
Published online Dec 16, 2012. doi: 10.4253/wjge.v4.i12.545
Image-enhanced endoscopy for diagnosis of colorectal tumors in view of endoscopic treatment
Naohisa Yoshida, Nobuaki Yagi, Akio Yanagisawa, Yuji Naito
Naohisa Yoshida, Nobuaki Yagi, Yuji Naito, Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
Akio Yanagisawa, Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
Author contributions: All of the authors contributed equally to this work.
Correspondence to: Naohisa Yoshida, MD, PhD, Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. naohisa@koto.kpu-m.ac.jp
Telephone: +81-75-2515519 Fax: +81-75-2510710
Received: December 8, 2011
Revised: October 29, 2012
Accepted: November 25, 2012
Published online: December 16, 2012
Abstract

Recently, image-enhanced endoscopy (IEE) has been used to diagnose gastrointestinal tumors. This method is a change from conventional white-light (WL) endoscopy without dyeing solution, requiring only the push of a button. In IEE, there are many advantages in diagnosis of neoplastic tumors, evaluation of invasion depth for cancerous lesions, and detection of neoplastic lesions. In narrow band imaging (NBI) systems (Olympus Medical Co., Tokyo, Japan), optical filters that allow narrow-band light to pass at wavelengths of 415 and 540 nm are used. Mucosal surface blood vessels are seen most clearly at 415 nm, which is the wavelength that corresponds to the hemoglobin absorption band, while vessels in the deep layer of the mucosa can be detected at 540 nm. Thus, NBI also can detect pit-like structures named surface pattern. The flexible spectral imaging color enhancement (FICE) system (Fujifilm Medical Co., Tokyo, Japan) is also an IEE but different to NBI. FICE depends on the use of spectral-estimation technology to reconstruct images at different wavelengths based on WL images. FICE can enhance vascular and surface patterns. The autofluorescence imaging (AFI) video endoscope system (Olympus Medical Co., Tokyo, Japan) is a new illumination method that uses the difference in intensity of autofluorescence between the normal area and neoplastic lesions. AFI light comprises a blue light for emitting and a green light for hemoglobin absorption. The aim of this review is to highlight the efficacy of IEE for diagnosis of colorectal tumors for endoscopic treatment.

Keywords: Flexible spectral imaging color enhancement; Narrow band imaging; Autofluorescence imaging; Colorectal polyps; Image-enhanced endoscopy