Navigation Links
Narrow band imaging colonoscopy identifies flat dysplastic lesions in ulcerative colitis patients
Date:11/18/2007

OAK BROOK, Ill. November 19, 2007 A pilot study from researchers at Kyushu University in Fukuoka, Japan, found that narrow band imaging (NBI) colonoscopy used in cancer surveillance for ulcerative colitis patients can identify flat dysplastic lesions. The research appears in the November issue of Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy.

Narrow band imaging (NBI) is a novel illumination technology for endoscopy characterized by light with wavelengths of narrow bands that improves the visibility of capillaries, veins and other subtle tissue structures by optimizing the absorbance and scattering characteristics of light. It enhances vasculature within and beneath the mucosa, or lining, of the gastrointestinal (GI) tract. Random biopsy has been a recommended procedure for cancer surveillance in patients with ulcerative colitis. Some studies have shown that chromoscopy, a dye spraying technique used with colonoscopy, with targeted biopsy identified dysplastic lesions (cell abnormalities that indicate progression to cancer) more frequently than did conventional colonoscopy in long-standing ulcerative colitis.

Our pilot study indicated that the GI mucosal surface structure pattern classified as tortuous, discerned by NBI colonoscopy with a magnifying instrument, may be a clue for the identification of dysplasia in ulcerative colitis, said study lead author Takayuki Matsumoto, MD, Kyushu University. Because NBI colonoscopy is an easily applicable procedure without specific dye, it may be an alternative to magnifying chromoscopy for cancer surveillance in patients with ulcerative colitis. The value of the procedure for surveillance colonoscopy needs to be examined prospectively in a larger number of patients.

Ulcerative colitis is a chronic (ongoing) disease of the colon, or large intestine. The disease is marked by inflammation and ulceration of the colon mucosa, or innermost lining. Because the inflammation makes the colon empty frequently, symptoms typically include diarrhea (sometimes bloody) and often crampy abdominal pain. According to the Crohns and Colitis Foundation of America, approximately half a million people in the United States have ulcerative colitis. Researchers do not know what causes the disease and there is no cure. The goal of treatment is to reduce the inflammatory response. Ulcerative colitis is a risk factor for developing colon cancer.

Patients and Methods

In this pilot study of 46 patients with ulcerative colitis, researchers applied NBI colonoscopy to cancer surveillance to investigate whether flat dysplastic lesions in ulcerative colitis could be identified by the procedure.

Patients, aged 18 to 67 years, who had left-sided colitis or pancolitis for more than seven years and who had clinically inactive disease were recruited for the study. Patients were examined by NBI colonoscopy. A magnifying colonoscope was connected to a prototype NBI system. Researchers first searched for sharply demarcated, protruding lesions under conventional colonoscopy and then changed the mode of observation to NBI colonoscopy.

Protruding lesions and flat mucosa were observed by NBI magnifying colonoscopy at a maximum of 70 magnification. The flat areas of interest were identified by a brownish or discolored area distinct from the surrounding mucosa. Otherwise, indistinctive flat mucosa was assessed. The surface structure was classified into honeycomb-like, villous, or tortuous pattern. The honeycomb-like pattern was defined as a crowding of round capillary vessels in honeycomb appearances. The villous pattern was characterized by a cerebriform structure (like the brain in form). The tortuous pattern was defined as a pattern composed of round or ovoid structures of various sizes. The grade of dysplasia was determined in the biopsy specimens obtained from the protrusions and from the flat mucosa.

Results

A total of 296 sites (20 protruding lesions and 276 flat areas) were examined by NBI colonoscopy. The surface pattern was determined to be honeycomb like in 161 sites, villous in 85 sites, and tortuous in 50 sites. Five dysplastic lesions were detected in three patients. A patient had three dysplastic lesions and the other two had a dysplastic lesion each. The positive rate of dysplasia was higher in protrusions (2/20 sites, 10%) than in flat mucosa (3/276 sites, 1.1%, P = .038; however, correction for the multiple testing of data removes this significance). When the surface pattern was taken into account, the rate of positive dysplasia was higher in the tortuous pattern (4/50 sites, 8%) than in the honeycomb-like or villous patterns (1/246 sites, 0.4%, P = .003).

The tortuous pattern determined by NBI colonoscopy may be a clue for the identification of dysplasia during surveillance for ulcerative colitis.


'/>"/>

Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

Related medicine news :

1. Brain imaging reveals breakdown of normal emotional processing
2. Clarity Imaging International, Inc. Rolls Out Mobile DEXA Program
3. Fry Construction Selected for High-Profile Medical Imaging Project
4. Elbit Medical Imaging Ltd. Announces Publication of a Prospectus in Israel
5. Ultrasonix Adds Global Medical Imaging Into Its North American Sales Force
6. Imaging Software Helps Track, Treat Injured Brains
7. SNM seeks novel approaches to molecular imaging to showcase at annual meeting
8. SNM seeks novel approaches to molecular imaging to showcase at annual meeting
9. Revision: Ziehm Imaging and BrainLAB Announce Partnership for Intra-Operative 3D Imaging and Computer Assisted Surgery (CAS)
10. Brain Imaging Expert Recruited to Study Autism at The Childrens Hospital of Philadelphia
11. Medical Imaging Revolutionizes Modern Medicine
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/12/2017)... ... October 12, 2017 , ... ... sleep apnea using cutting-edge Oventus O2Vent technology. As many as 18 ... characterized by frequent cessation in breathing. Oral appliances can offer significant relief to ...
(Date:10/12/2017)... Wis. (PRWEB) , ... October 12, 2017 , ... ... standard products to meet the demand of today’s consumer and regulatory authorities worldwide. ... of probiotic experts and tested to meet the highest standard. , These ...
(Date:10/12/2017)... ... 2017 , ... The American College of Medical Informatics (ACMI) will present the ... Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium ... a pioneer in the field of medical informatics, this prestigious award is presented to ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... system that we intend to develop to enable prevention of a major side ... severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss is FDA ...
(Date:10/12/2017)... , ... October 12, 2017 , ... HMP , ... recipient of a 2017 Folio Magazine Eddie Digital Award for ‘Best B-to-B Healthcare Website.’ ... on October 11, 2017. , The annual award competition recognizes editorial and design excellence ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... , Oct. 4, 2017 ... single-use, self-contained, illuminating medical devices, today announced regulatory ... Health Surveillance Agency (or Agência Nacional de Vigilância ... first single-use, cordless surgical retractor with integrated LED ... optimal access, illumination and exposure of a tissue ...
(Date:10/2/2017)... COPENHAGEN, Denmark , Oct. 2, 2017 The ... tool in the struggle to reverse the tide of prescription ... plan for regulating their medicine intake and stepping down their ... is set to launch in December 2017; the first 100,000 ... access. Learn more at http://www.rebound-solution.com/ ...
(Date:9/25/2017)... --  Montrium , an industry leader in powerful ... Trial Master Files & Inspection Readiness Conference ( ... Services has selected eTMF Connect to ... a leading European contract research organization (CRO), will ... enable greater collaboration with sponsors, improve compliance and ...
Breaking Medicine Technology: