Ignasi Puig1,2, Carlos Mármol1, Marco Bustamante3. 1. Digestive Diseases Department, Althaia Xarxa Assistencial Universitària de Manresa, Manresa. 2. Medicine Department, Universitat Internacional de Catalunya, Barcelona. 3. Digestive Diseases Department, Hospital Universitario y Politécnico de La Fe, Valencia, Spain.
Abstract
PURPOSE OF REVIEW: The detection of early colorectal cancer has improved notably since the introduction of bowel cancer screening programmes. This has created new challenges from endoscopic, histological and therapeutic perspectives. Here, we outline the limitations of current clinical practice and ways of implementing optical diagnosis to overcome these limitations. RECENT FINDINGS: Virtual chromoendoscopy without magnification for predicting or ruling out deep submucosal invasion is useful in real clinical practice for most lesions. However, magnifying virtual chromoendoscopy is needed to make an accurate diagnosis in nonulcerated narrow-band imaging international colorectal endoscopic (NICE) type 3 lesions or NICE type 2 lesions with depressed areas or of nodular mixed type. Finally, dye-based magnifying chromoendoscopy is needed in Japanese NBI Expert Team 2B lesions assessed with magnifying virtual chromoendoscopy. SUMMARY: A four-step strategy is proposed, combining white-light assessment, virtual chromoendoscopy without magnification, virtual chromoendoscopy with magnification and dye-based chromoendoscopy with magnification.
PURPOSE OF REVIEW: The detection of early colorectal cancer has improved notably since the introduction of bowel cancer screening programmes. This has created new challenges from endoscopic, histological and therapeutic perspectives. Here, we outline the limitations of current clinical practice and ways of implementing optical diagnosis to overcome these limitations. RECENT FINDINGS: Virtual chromoendoscopy without magnification for predicting or ruling out deep submucosal invasion is useful in real clinical practice for most lesions. However, magnifying virtual chromoendoscopy is needed to make an accurate diagnosis in nonulcerated narrow-band imaging international colorectal endoscopic (NICE) type 3 lesions or NICE type 2 lesions with depressed areas or of nodular mixed type. Finally, dye-based magnifying chromoendoscopy is needed in Japanese NBI Expert Team 2B lesions assessed with magnifying virtual chromoendoscopy. SUMMARY: A four-step strategy is proposed, combining white-light assessment, virtual chromoendoscopy without magnification, virtual chromoendoscopy with magnification and dye-based chromoendoscopy with magnification.
Authors: Giuseppe Biscaglia; Francesco Cocomazzi; Marco Gentile; Ilaria Loconte; Alessia Mileti; Rosa Paolillo; Antonella Marra; Stefano Castellana; Tommaso Mazza; Alfredo Di Leo; Francesco Perri Journal: Endosc Int Open Date: 2022-05-13