title: Magnified endoscopic observation of early colorectal cancer by linked color imaging with crystal violet staining (with video).
abstract: OBJECTIVE
  Many reports have shown the usefulness of magnification endoscopy with crystal violet (CV) staining for delineating the pit pattern in the diagnosis of colorectal carcinoma. However, the diagnostic accuracy of this method is not adequate for assessing the depth of invasion of early stage cancers. The novel technology of linked color imaging (LCI) combined with CV staining is expected to improve the accuracy of determining the depth of invasion.
  
  
  METHODS
  We studied 3 patients with early stage colorectal cancer who were referred to our hospital. After CV spraying, high-magnification endoscopy was conducted by using the LCI mode. Efficacy of this modality was evaluated by comparing the preoperative diagnostic endoscopic images with posttreatment histopathologic findings.
  
  
  RESULTS
  In 2 cases of rectal cancer, although conventional endoscopic examination could not exclude the possibility of submucosal cancer, use of the LCI mode with CV staining confirmed mucosal cancer. Eventually, EMR was conducted and achieved curative resection. In 1 case of sigmoid colon cancer, both conventional and CV magnification endoscopy suggested submucosal cancer. However, mucosal cancer was diagnosed by the novel method, and EMR achieved curative resection.
  
  
  CONCLUSIONS
  LCI high-magnification endoscopy combined with CV staining provides images close to histopathologic findings and is expected to improve the accuracy of endoscopic diagnosis of the depth of invasion for early stage colorectal cancer.
authors.affiliation: Department of Endoscopy, Chiba Cancer Center, Chiba City, Japan.
authors.forename: Takuto
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Endoscopy, Chiba Cancer Center, Chiba City, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Endoscopy, Chiba Cancer Center, Chiba City, Japan.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Kitagawa
authors.affiliation: Department of Gastroenterology, Chiba Cancer Center, Chiba City, Japan.
authors.forename: Taketo
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D003952:Diagnostic Imaging / Q000379:methods; D000069916:Endoscopic Mucosal Resection; D005840:Gentian Violet; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery
chemical_list: D004396:Coloring Agents; D005840:Gentian Violet