title: Endocytoscopic microvasculature evaluation is a reliable new diagnostic method for colorectal lesions (with video).
abstract: BACKGROUND
  We previously reported on the efficacy of endocytoscopic classification (EC-C). However, the correlation of the endocytoscopic vascular (EC-V) pattern with diagnoses was unclear.
  
  
  OBJECTIVE
  To assess the diagnostic accuracy of the EC-V pattern for colorectal lesions.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Patients who underwent endocytoscopy between January 2010 and March 2013.
  
  
  METHODS
  We evaluated 198 consecutive lesions according to the EC-V pattern (EC-V1, obscure surface microvessels; EC-V2, clearly observed surface microvessels of a uniform caliber and arrangement; and EC-V3, dilated surface microvessels of a nonhomogeneous caliber or arrangement).
  
  
  METHODS
  The diagnostic accuracy for predicting hyperplastic polyps and invasive cancer were compared between the EC-V pattern and other modalities (narrow-band imaging, pit pattern, and EC-C).
  
  
  RESULTS
  The sensitivity, specificity, and accuracy of the EC-V1 pattern for diagnosing hyperplastic polyps were 95.5%, 99.4%, and 99.0%, respectively. The sensitivity, specificity, and accuracy of the EC-V3 pattern for diagnosing invasive cancer were 74.6%, 97.2%, and 88.6%, respectively. The diagnostic accuracy of the EC-V pattern for predicting hyperplastic polyps was comparable to the other modalities. For predicting invasive cancer, the EC-V pattern was comparable to narrow-band imaging and pit pattern, although EC-C was slightly more accurate (P = .04). In the substudy, the diagnosis time by using the EC-V pattern was shorter than that with the EC-C pattern (P < .001).
  
  
  CONCLUSIONS
  A single-center, retrospective study.
  
  
  CONCLUSIONS
  The EC-V pattern saved more time than the EC-C pattern and had a diagnostic ability comparable to that of other optical biopsy modalities.
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shin-Ei
authors.initials: SE
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Misawa
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan; Department of Gastroenterology and Hepatology, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Wada
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kataoka
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Toyoshima
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kutsukawa
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Oikawa
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ogata
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Hisayuki
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Takemasa
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Wakamura
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyachi
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Ishida
authors.affiliation: Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
mesh_terms: D001706:Biopsy / Q000379:methods*; D002196:Capillaries / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000098:blood supply / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008833:Microcirculation; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors