title: Can image-enhanced cholangioscopy distinguish benign from malignant lesions in the biliary duct?
abstract: A new video peroral cholangioscopy (POCS) has been developed with high-quality digital imaging, and its clinical use has been reported. Additionally, direct peroral cholangioscopy (D-POCS) using an ultraslim endoscope has been proposed recently. To improve the diagnostic yield of POCS or D-POCS, image-enhanced endoscopy has been used in combination. Chromoendoscopy with methylene blue staining (ME), autofluorescence imaging (AFI), and narrow-band imaging (NBI) has been evaluated in biliary tract diseases. Observation of the mucosal structure and vessels is reportedly important for distinguishing non-neoplasms from neoplasms. Therefore, NBI is the most promising tool among image-enhanced endoscopies as it can enhance visualization of the mucosal structure and vessels simultaneously. There are currently few reports that have evaluated the utility of POCS or D-POCS based on pathological findings. Thus, endoscopic findings of the bile duct mucosa have not yet been fully established. At present, POCS-guided biopsy should be carried out.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ishida
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan. Electronic address: itoi@tokyo-med.ac.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Okabe
mesh_terms: D001652:Bile Ducts / Q000473:pathology*; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D006801:Humans; D007089:Image Enhancement; D008751:Methylene Blue / Q000378:metabolism; D061848:Optical Imaging; D013194:Staining and Labeling / Q000379:methods
chemical_list: D008751:Methylene Blue
keywords: Autofluorescence imaging; Cholangioscopy; Image-enhanced endoscopy; Methylene blue staining; Narrow-band imaging