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Objectives: Narrow light observation is currently recommended as an alternative to Lugol chromoendoscopy (LCE) to detect esophageal squamous cell carcinoma (ESCC). Studies revealed little difference in sensitivity between the two modalities in expert settings; however, these included small numbers of cases. We aimed to determine whether blue light imaging (BLI) without magnification is satisfactory for preventing misses of ESCC. Methods: This was a post‐hoc analysis of a multicenter randomized controlled trial targeting patients at high risk of ESCC in expert settings. In this study, BLI without magnification followed by LCE was performed. The evaluation parameters included: (i) the diagnostic abilities of ESCC; (ii) the endoscopic characteristics of lesions with diagnostic differences between the two modalities; and (iii) the color difference between cancerous and noncancerous areas in BLI and LCE. Results: This study identified ESCC in 49 of 699 cases. Of these cases, nine (18.4%) were missed by BLI but detected by LCE. In per‐patient analysis, the sensitivity of BLI was lower than that of LCE following BLI (83.7% vs. 100.0%; P = 0.013), whereas the specificity and accuracy of BLI were higher (88.2% vs. 81.2%; P < 0.001 and 87.8% vs. 82.5%; P < 0.001, respectively). No significant endoscopic characteristics were identified, but the color difference was lower in BLI than in LCE (21.4 vs. 25.1; P = 0.003). Conclusion: LCE following BLI outperformed BLI in terms of sensitivity in patients with high‐risk ESCC. Therefore, LCE, in addition to BLI, would still be required in screening esophagogastroduodenoscopy even by expert endoscopists. [ABSTRACT FROM AUTHOR]

Since linked color imaging (LCI) has been reported to increase the color differences in Barrett's esophageal adenocarcinoma (BA) compared to white light imaging (WLI), a comparison of the visibility scores of various imaging techniques for BA is warranted to determine best practice standards. This study is to clarify the role of LCI, blue light imaging (BLI), and WLI in the evaluation of BA. A group of 19 endoscopists, comprised of 6 experts and 13 trainees, evaluated the visibility of WLI, BLI, and LCI images in 21 superficial BA cases. Visibility scores were compared between WLI, BLI, and LCI. Visibility scores were also evaluated for lesion morphology, background Barrett's mucosa, and circumferential location. The visibility scores of experts and trainees were analyzed for comparison. The visibility scores of LCI and BLI were 3.83 and 3.31, respectively, compared to three points for WLI. The visibility of LCI was better than that of WLI regardless of lesion morphology, color, background Barrett's mucosa, and circumferential location. The LCI improved visibility in BA more than the WLI for both experts and trainees. LCI improved the visibility of BA independent of lesion morphology, color, background Barrett's mucosa, circumferential location, and the endoscopist's experience. [ABSTRACT FROM AUTHOR]

Abstract Objectives Although the laser light is optically ideal for producing narrow‐band light, it has not been used in some areas of the world. Endoscopic light sources using light‐emitting diodes (LEDs) are used worldwide. The purpose of this study was to compare blue laser imaging (laser‐BLI) and LED‐blue light imaging (LED‐BLI) for the characterization of colorectal polyps using the Japan narrow band imaging expert team (JNET) classification. Methods Colorectal lesions were prospectively examined using magnifying narrow‐band light generated by a laser (laser‐BLI) or LEDs (LED‐BLI). Twelve endoscopists (six non‐experts and six experts from three institutions) evaluated each still‐magnified image of lesions using the JNET classification. Results Seven hundred and fifty‐six images from 63 lesions were reviewed. The mean polyp size was 24.5 ± 13.4 mm. Histopathology included 13 serrated lesions and 50 neoplasms. The rate of agreement between laser‐BLI and LED‐BLI using the JNET classification was 92.5% (699/756). The weighted κ‐statistic was 0.99. The percentages of “almost similar” comparing scores of surface patterns, vessel patterns, and brightness among all endoscopists were 95.4%, 95.9%, and 95.0%, respectively. Conclusions This multicenter study demonstrates that the rate of agreement between laser‐BLI and LED‐BLI using the JNET Classification is very high. The surface patterns, vessel patterns, and brightness are almost similar.

Objectives: Blue light imaging (BLI) and linked color imaging (LCI) are superior to conventional white light imaging for detecting esophageal squamous cell carcinoma (ESCC). Hence, we compared their diagnostic performances in ESCC screening. Methods: This open‐labeled, randomized controlled trial was performed at seven hospitals. Patients with a high risk of ESCC were randomly assigned to the BLI group (BLI followed by LCI) and LCI group (LCI followed by BLI). The primary end‐point was the detection rate of ESCC in the primary mode. The main secondary end‐point was its miss rate in the primary mode. Results: In total, 699 patients were enrolled. The detection rate of ESCC did not significantly differ between the BLI and LCI groups (4.0% [14/351] vs. 4.9% [17/348]; P = 0.565); however, the number of patients with ESCC tended to be smaller in the BLI group (19 vs. 30). Notably, the miss rate of ESCC was lower in the BLI group (26.3% [5/19] vs. 63.3% [19/30]; P = 0.012) and LCI detected no ESCCs missed by BLI. The sensitivity was higher in BLI (75.0% vs. 47.6%; P = 0.042); on the other hand, the positive predictive value in BLI tended to be lower (28.8% vs. 45.5%; P = 0.092). Conclusions: The detection rates of ESCC did not significantly differ between BLI and LCI. Although BLI may have the potential to be advantageous over LCI for the diagnosis of ESCC, it is still unclear whether BLI is superior to LCI, and a further large‐scale study is needed. Trial registration: Japan Registry of Clinical Trials (jRCT1022190018‐1). [ABSTRACT FROM AUTHOR]

Introduction: In light-emitting diode (LED) and LASER colonoscopy, linked color imaging (LCI) and blue light/laser imaging (BLI) are used for lesion detection and characterization worldwide. We analyzed the difference of LCI and BLI images of colorectal lesions between LED and LASER in a multinational study. Methods: We prospectively observed lesions with white light imaging (WLI), LCI, and BLI using both LED and LASER colonoscopies from January 2020 to August 2021. Images were graded by 27 endoscopists from nine countries using the polyp visibility score: 4 (excellent), 3 (good), 2 (fair), and 1 (poor) and the comparison score (LED better/similar/LASER better) for WLI/LCI/BLI images of each lesion. Results: Finally, 32 lesions (polyp size: 20.0 ± 15.2 mm) including 9 serrated lesions, 13 adenomas, and 10 T1 cancers were evaluated. The polyp visibility scores of LCI/WLI for international and Japan-expert endoscopists were 3.17 ± 0.73/3.17 ± 0.79 (p = 0.92) and 3.34 ± 0.78/2.84 ± 1.22 (p < 0.01) for LED and 3.30 ± 0.71/3.12 ± 0.77 (p < 0.01) and 3.31 ± 0.82/2.78 ± 1.23 (p < 0.01) for LASER. Regarding the comparison of lesion visibility about between LED and LASER colonoscopy in international endoscopists, a significant difference was achieved not for WLI, but for LCI. The rates of LED better/similar/LASER better for brightness under WLI were 54.5%/31.6%/13.9% (International) and 75.0%/21.9%/3.1% (Japan expert). Those under LCI were 39.2%/35.4%/25.3% (International) and 31.3%/53.1%/15.6% (Japan expert). There were no significant differences in the diagnostic accuracy and the comparison score of BLI images between LED and LASER. Conclusions: The differences of lesion visibility for WLI/LCI/BLI between LED and LASER in international endoscopists could be compared to those in Japanese endoscopists. [ABSTRACT FROM AUTHOR]

Pernicious anemia is still a neglected disorder in many medical contexts and is underdiagnosed in many patients. Pernicious anemia is linked to but different from autoimmune gastritis. Pernicious anemia occurs in a later stage of autoimmune atrophic gastritis when gastric intrinsic factor deficiency and consequent vitamin B12 deficiency may occur. The multifaceted nature of pernicious anemia is related to the important role of cobalamin, which, when deficient, may lead to several dysfunctions, and thus, the proteiform clinical presentations of pernicious anemia. Indeed, pernicious anemia may lead to potentially serious long-term complications related to micronutrient deficiencies and their consequences and the development of gastric cancer and type 1 gastric neuroendocrine tumors. When not recognized in a timely manner or when pernicious anemia is diagnosed with delay, these complications may be potentially life-threatening and sometimes irreversible. The current review aimed to focus on epidemiology, pathogenesis, and clinical presentations of pernicious anemia in an attempt to look beyond borders of medical specialties. It aimed to focus on micronutrient deficiencies besides the well-known vitamin B12 deficiency, the diagnostic approach for pernicious anemia, its long-term complications and optimal clinical management, and endoscopic surveillance of patients with pernicious anemia. [ABSTRACT FROM AUTHOR]

Background: Blue light imaging (BLI) has been shown to improve the characterization of colorectal polyps among the endoscopy experts. We aimed to determine if this technology could be taught to endoscopy trainees while maintaining high accuracy and interobserver agreement. Methods: Twenty‐one gastroenterology trainees (fellows) from two academic institutions participated in this prospective study. Each trainee completed a web‐based learning comprising four modules: pre‐test, didactic videos explaining the BLI Adenoma Serrated International Classification (BASIC), interactive examples, and post‐test assessment. The pre‐ and post‐test modules consisted of reviewing video images of colon polyps in high definition white light imaging and BLI and then applying the BASIC classification to determine if the polyps were likely to be adenomatous. Confidence in adenoma identification (rated '1' to '5'), accuracy in polyp (adenoma vs. non‐adenoma) identification, and agreement in characterization per BASIC criteria were derived. Results: Trainee accuracy in the adenoma diagnosis improved from 74.7% (pre‐test) to 85.4% (post‐test) (P < 0.01). There was a trend towards higher accuracy in polyp characterization with subsequent years of training (1st year fellows 77.4%, 2nd year 88.5%, and final year 94.0%) with consistent improvements after the e‐learning across years of trainees. Overall, trainees were able to identify adenoma with a high sensitivity of 86.9%, specificity 83.9%, positive predictive value of 84.4%, and negative predictive value of 86.5%. However, their interobserver agreement in adenoma diagnosis was moderate (k = 0.52). Conclusion: The novel BLI classification can be easily taught to gastroenterology trainees using an online module and accuracy improves with years of training reaching >90% for colorectal polyp characterization. [ABSTRACT FROM AUTHOR]

Background and Aim: Recently, the BLI Adenoma Serrated International Classification (BASIC) system was developed by European experts to differentiate colorectal polyps. Our aim was to validate the BASIC classification system among the US‐based endoscopy experts. Methods: Participants utilized a web‐based interactive learning system where the group was asked to characterize polyps using the BASIC criteria: polyp surface (presence of mucus, regular/irregular and [pseudo]depressed), pit appearance (featureless, round/non‐round with/without dark spots; homogeneous/heterogeneous distribution with/without focal loss), and vessels (present/absent, lacy, peri‐cryptal, irregular). The final testing consisted of reviewing BLI images/videos to determine whether the criteria accurately predicted the histology results. Confidence in adenoma identification (rated "1" to "5") and agreement in polyp (adenoma vs non‐adenoma) identification and characterization per BASIC criteria were derived. Strength of interobserver agreement with kappa (k) value was reported for adenoma identification. Results: Ten endoscopy experts from the United States identified conventional adenoma (vs non‐adenoma) with 94.4% accuracy, 95.0% sensitivity, 93.8% specificity, 93.8% positive predictive value, and 94.9% negative predictive value using BASIC criteria. Overall strength of interobserver agreement was high: kappa 0.89 (0.82–0.96). Agreement for the individual criteria was as follows: surface mucus (93.8%), regularity (65.6%), type of pit (40.6%), pit visibility (66.9%), pit distribution (57%), vessel visibility (73%), and being lacy (46%) and peri‐cryptal (61%). The confidence in diagnosis was rated at high ≥4 in 67% of the cases. Conclusions: A group of US‐based endoscopy experts have validated a simple and easily reproducible BLI classification system to characterize colorectal polyps with >90% accuracy and a high level of interobserver agreement. [ABSTRACT FROM AUTHOR]

A laser endoscopy system was developed in 2012. The system allows blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI) to be performed as modes of narrow-band light observation; these modes have been reported to be useful for tumor detection and characterization. Furthermore, an innovative endoscopy system using four-light emitting diode (LED) multilight technology was released in 2016 to 2017 in some areas in which laser endoscopes have not been approved for use, including the United States and Europe. This system enables blue light imaging (this is also known as BLI) and LCI with an LED light source instead of a laser light source. Several reports have shown that these modes have improved tumor detection. In this paper, we review the efficacy of BLI and LCI with laser and LED endoscopes in tumor detection and characterization.

Introduction: An innovative endoscopic system using 4-color light-emitting diodes (LED) was released between 2016 and 2017 in locations that had not approved laser endoscopes for use, including the United States and Europe. Objective: This study compared the diagnostic efficacy between magnifying blue light imaging with an LED light source (LED-BLI) and magnifying blue laser imaging with a laser light source (Laser-BLI) for early gastric cancer (EGC). Methods: In this prospective, single-center, noninferiority study, 80 gastric lesions were evaluated between January 2017 and July 2017. The magnifying findings of gastric lesions – including the demarcation line (DL), microvascular pattern (MVP), and microsurface pattern (MSP) – were evaluated using Laser-BLI and LED-BLI according to the vessel plus surface classification system (VSCS). The primary end point was to determine whether the diagnostic accuracy of LED-BLI for EGC was noninferior to that of conventional Laser-BLI. Results: Overall, we evaluated 79 gastric lesions histopathologically diagnosed as adenocarcinomas from the specimens obtained via endoscopic submucosal dissection. A DL was observed by Laser-BLI and LED-BLI in 98.7% (78/79) and 96.2% (76/79) of EGCs, respectively. The MVP observed using Laser-BLI and LED-BLI was irregular in 92.4% (73/79) and 89.9% (71/79), respectively. The MSP observed using Laser-BLI and LED-BLI was irregular in 83.5% (66/79) and 82.2% (65/79), respectively. According to the VSCS, diagnosable cancers were found in 94.9% (75/79) and 93.7% (74/79) of cases when using Laser-BLI and LED-BLI, respectively (p = 0.73; difference ratio, 1.2%; 95% CI –8.5 to 6.0%). Conclusions: LED-BLI could accurately visualize the DL, MVP, and MSP of EGCs and was not inferior to Laser-BLI. Therefore, LED-BLI can be used to diagnose EGC accurately according to the VSCS-based diagnosis criteria. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of reflux esophagitis according to the Los Angeles classification minimal change (LA‐M) has a low inter‐observer agreement. We aimed to investigate whether the inter‐observer agreement of reflux esophagitis was better when expert endoscopists read the endoscopic images, or when the linked color imaging (LCI) or blue laser imaging (BLI)‐bright mode was used. In addition, whether the inclusion of LA‐M in the definition of reflux esophagitis affected the consistency of the diagnosis was investigated. Methods: During upper endoscopy, endoscopic images of the gastroesophageal junction were taken using white light imaging (WLI), BLI‐bright, and LCI modes. Four expert endoscopists and four trainees reviewed the images to diagnose reflux esophagitis according to the modified LA classification. Results: The kappa values for the inter‐observer variability for the diagnosis of reflux esophagitis were poor to fair among the experts (κ = 0.22, 0.17, and 0.27 for WLI, BLI‐bright, and LCI, respectively) and poor among the trainees (κ = 0.18, 0.08, and 0.14 for WLI, BLI‐bright, and LCI). The inter‐observer variabilities for the diagnosis of reflux esophagitis excluding LA‐M were fair to moderate (κ = 0.42, 0.35, and 0.42 for WLI, BLI‐bright, and LCI) among the expert endoscopists and moderate among the trainees (κ = 0.48, 0.43, and 0.51 for WLI, BLI‐bright, and LCI). Conclusions: The inter‐observer agreement for the diagnosis of reflux esophagitis was very low for both the expert endoscopists and the trainees, even using BLI‐bright or LCI mode. However, when reflux esophagitis LA‐M was excluded from the diagnosis of esophagitis, the degree of inter‐observer agreement increased. [ABSTRACT FROM AUTHOR]

Colorectal polyps are critical indicators of colorectal cancer (CRC). Blue Laser Imaging and Linked Color Imaging are two modalities that allow improved visualization of the colon. In conjunction with the Blue Laser Imaging (BLI) Adenoma Serrated International Classification (BASIC) classification, endoscopists are capable of distinguishing benign and pre-malignant polyps. Despite these advancements, this classification still prevails a high misclassification rate for pre-malignant colorectal polyps. This work proposes a computer aided diagnosis (CADx) system that exploits the additional information contained in two novel imaging modalities, enabling more informative decision-making during colonoscopy. We train and benchmark six commonly used CNN architectures and compare the results with 19 endoscopists that employed the standard clinical classification model (BASIC). The proposed CADx system for classifying colorectal polyps achieves an area under the curve (AUC) of 0.97. Furthermore, we incorporate visual explanatory information together with a probability score, jointly computed from White Light, Blue Laser Imaging, and Linked Color Imaging. Our CADx system for automatic polyp malignancy classification facilitates future advances towards patient safety and may reduce time-consuming and costly histology assessment. [ABSTRACT FROM AUTHOR]

Blue light imaging (BLI) and narrow-band imaging (NBI) are two modalities that enable narrow-band light observation. We aimed to compare the diagnostic ability of magnifying endoscopy with BLI (ME-BLI) and NBI (ME-NBI) for determining the invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by the Japanese Esophageal Society’s intrapapillary capillary loop (IPCL) classification. We enrolled 81 patients between 2014 and 2018, and the still endoscopic images for diagnosing the invasion depth at the same part in ME-BLI and ME-NBI were registered. Two blinded investigators reviewed them and diagnosed the invasion depth by the IPCL classification. Subsequently, the diagnostic yields in two modalities were compared. The overall accuracies for the invasion depth by the IPCL classification in ME-BLI and ME-NBI did not differ significantly (67.9–71.6% vs. 72.8–74.1%). In the analysis based on the invasion depth, the sensitivities and positive predictive values in tumors invading the muscularis mucosa or submucosa ≤200 µm were low (23.1–30.8% and 16.7–25.0%, respectively) in both modalities. In conclusion, the diagnostic ability for determining the invasion depth of SESCC by the IPCL classification was relatively similar in ME-BLI and ME-NBI, but diagnosis by magnifying endoscopy alone might not be satisfactory.

Background: Blue light imaging (BLI) and linked color imaging (LCI) are new imaging modalities for the endoscopic evaluation of mucosal changes within the digestive tract. There is little experience with these modalities in the characterization of chronic gastritis (CG) intestinal metaplasia (IM) and atrophy in the stomach. Aims and Methods: In a single-center observational pilot study, we correlated endoscopic findings with histology in selected patients. Results: Findings from 29 patients were included in the analysis. Six patients had macroscopically normal gastric mucosa at endoscopy, and this was confirmed histologically in 5 of them. At endoscopy, 15 patients had the presence of IM in the antrum predicted, and this was confirmed histologically in 11 (73%). In the corpus, we predicted the presence of IM in 14 patients, and this was confirmed in 11 (78%) at histology. Eleven patients had the endoscopic suspicion of atrophy in antrum, which was confirmed in 9 patients (82%). In total, 14 patients had endoscopic suspicion of atrophy in corpus mucosa at endoscopy, but only 10 were confirmed in histology (71%). The concordance of endoscopic classification and histology was 93% for antrum and 88% for corpus. The positive predictive value and negative predictive value for IM were 0.74 and 0.83 and for atrophy 0.63 and 0.97, respectively. Conclusions: LCI and BLI are helpful in characterization of mucosal changes in CG. The ability to rule out premalignant conditions by endoscopy only reflects the clinical use and harbors significant clinical implications. [ABSTRACT FROM AUTHOR]

Colorectal polyps are critical indicators of colorectal cancer (CRC). Blue Laser Imaging and Linked Color Imaging are two modalities that allow improved visualization of the colon. In conjunction with the Blue Laser Imaging (BLI) Adenoma Serrated International Classification (BASIC) classification, endoscopists are capable of distinguishing benign and pre-malignant polyps. Despite these advancements, this classification still prevails a high misclassification rate for pre-malignant colorectal polyps. This work proposes a computer aided diagnosis (CADx) system that exploits the additional information contained in two novel imaging modalities, enabling more informative decision-making during colonoscopy. We train and benchmark six commonly used CNN architectures and compare the results with 19 endoscopists that employed the standard clinical classification model (BASIC). The proposed CADx system for classifying colorectal polyps achieves an area under the curve (AUC) of 0.97. Furthermore, we incorporate visual explanatory information together with a probability score, jointly computed from White Light, Blue Laser Imaging, and Linked Color Imaging. Our CADx system for automatic polyp malignancy classification facilitates future advances towards patient safety and may reduce time-consuming and costly histology assessment.

Objective: The first goal of this study was to investigate the coverage of laryngeal structures using two potential administration techniques for synthetic mucus: inhalation and lozenge ingestion. As a second research question, the study investigated the potential effects of these techniques on standardized voice assessment parameters., Methods: Fluorescein was added to throat lozenges and to an inhalation solution to visualize the coverage of laryngeal structures through blue light imaging. The study included 70 vocally healthy subjects. Fifty subjects underwent administration via lozenge ingestion and 20 subjects performed the inhalation process. For the first research question, the recordings from the blue light imaging system were categorized to compare the extent of coverage on individual laryngeal structures objectively. Secondly, a standardized voice evaluation protocol was performed before and after each administration to determine any measurable effects of typical voice parameters., Results: The administration via inhalation demonstrated complete coverage of all laryngeal structures, including the vocal folds, ventricular folds, and arytenoid cartilages, as visualized by the fluorescent dye. In contrast, the application of the lozenge predominantly covered the pharynx and laryngeal surface toward the aryepiglottic fold, but not the inferior structures. All in all, the comparison before and after administration showed no clear effect, although a minor deterioration of the acoustic signal was noted in the shimmer and cepstral peak prominence after the inhalation., Conclusions: Our findings indicate that the inhalation process is a more effective technique for covering deeper laryngeal structures such as the vocal folds and ventricular folds with synthetic mucus. This knowledge enables further in vivo studies on the role of laryngeal mucus in phonation in general, and how it can be substituted or supplemented for patients with reduced glandular activity as well as for heavy voice users., Competing Interests: Declaration of Competing Interest Marion Semmler reports financial support was provided by Medical Research Foundation at the University Hospital Erlangen., (Copyright © 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Blue light imaging (BLI) and narrow-band imaging (NBI) are two modalities that enable narrow-band light observation. We aimed to compare the diagnostic ability of magnifying endoscopy with BLI (ME-BLI) and NBI (ME-NBI) for determining the invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by the Japanese Esophageal Society's intrapapillary capillary loop (IPCL) classification. We enrolled 81 patients between 2014 and 2018, and the still endoscopic images for diagnosing the invasion depth at the same part in ME-BLI and ME-NBI were registered. Two blinded investigators reviewed them and diagnosed the invasion depth by the IPCL classification. Subsequently, the diagnostic yields in two modalities were compared. The overall accuracies for the invasion depth by the IPCL classification in ME-BLI and ME-NBI did not differ significantly (67.9–71.6% vs. 72.8–74.1%). In the analysis based on the invasion depth, the sensitivities and positive predictive values in tumors invading the muscularis mucosa or submucosa ≤200 µm were low (23.1–30.8% and 16.7–25.0%, respectively) in both modalities. In conclusion, the diagnostic ability for determining the invasion depth of SESCC by the IPCL classification was relatively similar in ME-BLI and ME-NBI, but diagnosis by magnifying endoscopy alone might not be satisfactory. [ABSTRACT FROM AUTHOR]

• With the conventional video-endoscope systems, during PDT, the system only recognizes the strong white light, while color information is lost. This is called "white-out". This interferes not only with visualization of the cancer lesion, but also inaccurate laser light irradiation of the lesion. • ELUXEO 7000® (ELUXEO®, Fujifilm, Japan), which is a simultaneous-type electronic video-endoscope system, has been shown to enable detailed observation of mucous lesions. A major advantage of this system is that it adopts a simultaneous display method, whereby the laser irradiation can be performed while simultaneously visualizing the lesion. • After the administration of talaporfin sodium for PDT, the tumor lesion was not visualized in magenta color with AFI, yielding false-negative results. • Using the ELUXEO® system in the blue light imaging (BLI) mode, we were able to deliver a red laser light while observing the extent of the tumor. Missed laser exposure was avoided and the accuracy of PDT was improved with the use of this system. • ELUXEO® is useful for accurate evaluation of the extent of centrally located lung cancer and therefore, for accurate laser irradiation of the tumor lesion. Background: Photodynamic therapy (PDT) is established as one of the standard treatment options for centrally located early lung cancer. In order to improve the effectiveness of PDT, it is very important to accurately diagnose the extent of the tumor and focus the laser irradiation accurately. With the use of the conventional video-endoscope system, which adopts the frame-sequential (RGB-based) display method, mainly used in Japan, for PDT laser irradiation, the system only recognizes the strong white light, and color information is lost. Therefore, it is difficult to irradiate the lesion while simultaneously observing the lesion. In this study, we investigated the usefulness of a new type of video-endoscope system during PDT. Methods: We used ELUXEO 7000® (FUJIFILM, Japan), which is a simultaneous-type video-endoscope system that has been in use at Nippon Medical School Hospital since October 2018. We analyzed the clinical usefulness of the ELUXEO® system for PDT as compared to other endoscope systems, such as EVIS LUCERA ELITE® (Olympus, Japan), an autofluorescence imaging (AFI) system. Results: After the administration of talaporfin sodium for PDT, the tumor lesion was not visualized in magenta color with AFI, yielding false-negative results. On the other hand, no false-negative results after the administration of talaporfin sodium were obtained with the use of ELUXEO®. Using the ELUXEO® system in the blue light imaging (BLI) mode, we were able to deliver a red laser light while observing the extent of the tumor. Missed laser exposure was avoided and the accuracy of PDT was improved with the use of this system. Conclusions: ELUXEO® is useful for accurate evaluation of the extent of centrally located lung cancer and therefore, for accurate laser irradiation of the tumor lesion. [ABSTRACT FROM AUTHOR]

The development of high-definition endoscopes with optical zoom, along with the use of the digital chromoendoscopy and staining, has given endoscopists the possibility to study the microanatomy of the gastrointestinal mucosa in vivo. The recognition of the changes in the microstructure of the surface and microvascular architecture such as those that occur in neoplastic lesions allow us to characterize these lesions in order to decide on the best course of clinical action. The current greater availability of endoscopes with optical zoom in western countries has allowed the use of this technology in routine clinical practice to spread. In this article we review the basic concepts of magnifying endoscopy and the normal endoscopic microanatomy of the oesophageal, gastric, duodenal, ileal and colonic mucosa., (Copyright © 2018 Elsevier España, S.L.U. All rights reserved.)

Over the past several decades, blue light technology used in endoscopy (eg, colonoscopy) has evolved. The most recent advances include second-generation, high-definition narrow-band imaging and blue laser imaging. However, these technologies do not necessarily improve adenoma detection rates or miss rates, according to recent studies. [ABSTRACT FROM AUTHOR]