title: Two-stage optical system for colorectal polyp assessments.
abstract: OBJECTIVE
  Macroscopic real-time evaluations of the histopathology and degree of invasion of colorectal polyps help to select the most suitable endoscopic treatment method. Dual-focus (DF) narrow-band imaging (NBI) is a new imaging enhancement system that uses digital and optical methods to enhance the view of blood vessels on mucosal surfaces. However, the superiority of this technique over standard imaging techniques has not been previously reported. The aim of this study was to determine whether the two-stage optical systems in a new generation of endoscopes will increase the diagnostic accuracy of colorectal polyp recognition.
  
  
  METHODS
  The study included 270 patients, and 386 colorectal polyps were diagnosed and removed. The polyps were assessed with white light and NBI using one- and two-stage optical systems, respectively. After being classified according to the Kudo pit pattern schemes, the polyps were removed and histopathologically verified.
  
  
  RESULTS
  Regarding non-neoplastic lesions (Kudo I and II), no difference was observed in the recognition of polyps when using the NBI-DF function. We observed improved accuracy in the preliminary diagnoses of Kudo IIIL lesions (from 87.16 to 90.09%, p < 0.05) and Kudo IIIS lesions (from 87.29 to 92.79%, p < 0.01). NBI-DF also increased the accuracy of preliminary diagnoses of Kudo IV lesions (from 88.24 to 94.12%, p < 0.01). The Kudo V pit patterns were also more distinct with NBI-DF imaging, increasing the diagnostic accuracy from 91.67 to 100%.
  
  
  CONCLUSIONS
  Using a two-stage optical system with electronic colorization of the mucosa increased diagnostic accuracy for differentiating colorectal polyps with neoplastic potential.
authors.affiliation: First Department, General, Oncological and Gastrointestinal Surgery, Jagiellonian University Medical College, 40th Kopernika St., 31-501, Kraków, Poland. msszura@gmail.com.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Szura
authors.affiliation: First Department, General, Oncological and Gastrointestinal Surgery, Jagiellonian University Medical College, 40th Kopernika St., 31-501, Kraków, Poland. artur.pasternak@uj.edu.pl.|Department of Anatomy, Jagiellonian University Medical College, 12th Kopernika St., 31-034, Kraków, Poland. artur.pasternak@uj.edu.pl.
authors.forename: Artur
authors.initials: A
authors.lastname: Pasternak
authors.affiliation: MEDICINA - Specialist Diagnostic & Therapeutic Centre, 5th Rogozinskiego St., 31-559, Kraków, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bucki
authors.affiliation: Department of Pathomorphology, Jagiellonian University Medical College, 16th Grzegórzecka St., 31-531, Kraków, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Urbańczyk
authors.affiliation: First Department, General, Oncological and Gastrointestinal Surgery, Jagiellonian University Medical College, 40th Kopernika St., 31-501, Kraków, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Matyja
mesh_terms: D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D020685:Colonoscopes; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D055096:Optical Devices; D016037:Single-Blind Method
keywords: Colonoscopy; Colorectal cancer; Dual-focus magnification; Narrow-band imaging
references.citation: Gastric Cancer. 2012 Apr;15(2):170-8
references.pmid: 22407064
references.citation: Am J Gastroenterol. 2009 Oct;104(10):2422-30
references.pmid: 19584829
references.citation: Gastrointest Endosc. 2011 Mar;73(3):419-22
references.pmid: 21353837
references.citation: Gastroenterology. 2012 Sep;143(3):599-607.e1
references.pmid: 22609383
references.citation: Int J Oncol. 2000 May;16(5):927-34
references.pmid: 10762628
references.citation: J Gastroenterol. 2000;35 Suppl 12:121-5
references.pmid: 10779231
references.citation: J Biomed Opt. 2004 May-Jun;9(3):568-77
references.pmid: 15189095
references.citation: J Clin Pathol. 1994 Oct;47(10):880-5
references.pmid: 7962600
references.citation: Semin Surg Oncol. 1995 Nov-Dec;11(6):399-405
references.pmid: 8607008
references.citation: Gastrointest Endosc. 1996 Jul;44(1):8-14
references.pmid: 8836710
references.citation: Gastroenterol Clin North Am. 1996 Dec;25(4):737-54
references.pmid: 8960890
references.citation: Kurume Med J. 1998;45(1):87-94
references.pmid: 9658757
references.citation: Endoscopy. 2005 Jun;37(6):570-8
references.pmid: 15933932
references.citation: Gastrointest Endosc. 2006 Oct;64(4):604-13
references.pmid: 16996357
references.citation: Radiology. 2008 Sep;248(3):717-20
references.pmid: 18710970
references.citation: Ann Intern Med. 2008 Nov 4;149(9):627-37
references.pmid: 18838716
references.citation: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references.pmid: 21296855