CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(03): E360-E367
DOI: 10.1055/a-1068-9228
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

Endocytoscopy with NBI has the potential to correctly diagnose diminutive colorectal polyps that are difficult to diagnose using conventional NBI

Shinichi Kataoka
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Shin-ei Kudo
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Masashi Misawa
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Hiroki Nakamura
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Kenichi Takeda
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Naoya Toyoshima
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Yuichi Mori
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Noriyuki Ogata
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Toyoki Kudo
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Tomokazu Hisayuki
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Takemasa Hayashi
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Kunihiko Wakamura
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Toshiyuki Baba
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Fumio Ishida
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
› Author Affiliations
Further Information

Publication History

submitted 27 June 2019

accepted after revision 14 October 2019

Publication Date:
21 February 2020 (online)

Abstract

Background and study aims Real-time diagnosis of colorectal polyps is needed to prevent unnecessary resection of benign polyps. The vessels in hyperplastic polyps sometimes mimic the characteristic meshed capillary network of neoplastic lesions on non-magnified narrow-band imaging (NBI). Endocytoscopy in conjunction with NBI (EC-NBI) enables more detailed vessel observation. The current study evaluated whether EC-NBI can accurately diagnose small colorectal lesions with visible vessels on non-magnified NBI.

Patients and methods This retrospective study was conducted from January to December 2016. During colonoscopy, lesion images were obtained using NBI and EC-NBI. On EC-NBI, lesions were classified as having “clear,” “unclear,” or “invisible” blood vessel margins. All specimens were resected and pathologically examined, and the association between vessel margin findings and pathological diagnosis was assessed. The lesion surface to vessel depth was measured in clear, unclear, and invisible lesions.

Results Among 114 adenomas, 108 were clear, while six were unclear. Among 36 hyperplastic polyps, eight were clear, while 28 were unclear. A micro-network (MN) pattern was seen in 106 of 114 adenomas, and four of 36 hyperplastic polyps. The sensitivity, specificity, correct diagnostic rate, and positive and negative predictive values of clear blood vessel margins or a MN pattern as an adenoma index were 98.2 %, 69.4 %, 91.3 %, 91.1 %, and 92.6 %, respectively. EC-NBI correctly diagnosed 69.4 % (25/36) of hyperplastic polyps. The lesion surface–blood vessel distance was greater in unclear versus clear lesions (P < 0.001), and invisible versus unclear lesions (P < 0.001).

Conclusions EC-NBI may effectively differentiate hyperplastic polyps with visible vessels from adenomas. Blood vessel depth affects visibility.