Digital chromoendoscopy for diagnosis of diminutive colorectal lesions

Abstract

Introduction. To compare the accuracy of digital and real-time chromoendoscopy for the differential diagnosis of diminutive (5 mm) neoplastic and nonneoplastic colorectal lesions. Materials and Methods. This is a prospective randomized study comparing the Fujinon intelligent color enhancement (FICE) system (65 patients/95 lesions) and indigo carmine (69 patients/120 lesions) in the analysis of capillary meshwork and pit pattern, respectively. All lesions were less than 5 mm in diameter, and magnification was used in both groups. Histopathology was the gold standard examination. Results. Of 215 colorectal lesions, 153 (71.2) were adenomas, and 62 were hyperplastic polyps (28.8). Morphological analysis revealed 132 (61.4) superficial lesions, with 7 (3.3) depressed lesions, and 83 (38.6) protruding lesions. Vascular meshwork analysis using FICE and magnification resulted in 91.7 sensitivity, 95.7 specificity, and 92.6 accuracy in differentiating neoplastic from nonneoplastic lesions. Pit pattern analysis with indigo carmine and magnification showed 96.5 sensitivity, 88.2 specificity, and 94.2 accuracy for the same purpose. Conclusion. Both magnifying virtual chromoendoscopy and indigo carmine chromoendoscopy showed high accuracy in the histopathological diagnosis of colorectal lesions less than 5 mm in diameter. © 2012 Carlos Eduardo Oliveira dos Santos et al.