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Improvement in the visibility of colorectal polyps by using blue laser imaging (with video)

Published:April 04, 2015DOI:https://doi.org/10.1016/j.gie.2015.01.030

      Background

      Fujifilm developed blue laser imaging (BLI) via a laser light source with a narrow-band light observation function. It has a brighter BLI bright mode for tumor detection.

      Objective

      To investigate whether the BLI bright mode can improve the visibility of colorectal polyps compared with white light (WL).

      Design

      We studied 100 colorectal polyps (protruding, 42; flat, 58; size, 2–20 mm) and recorded videos of the polyps by using the BLI bright mode and WL at Kyoto Prefectural University of Medicine and Fukuoka Chikushi University Hospital. The videos were evaluated by 4 expert endoscopists and 4 nonexperts. Each endoscopist evaluated the videos in a randomized order. Each polyp was assigned a visibility score from 4 (excellent visibility) to 1 (poor visibility).

      Setting

      Japanese academic units.

      Main Outcome Measurements

      The visibility scores in each mode and their relationship to the clinical characteristics were analyzed.

      Results

      The mean visibility scores of the BLI bright mode were significantly higher than those of WL for both experts and nonexperts (experts, 3.10 ± 0.95 vs 2.90 ± 1.09; P = .00013; nonexperts, 3.04 ± 0.94 vs 2.78 ± 1.03; P < .0001). For all nonexperts, the visibility scores of the BLI bright mode were significantly higher than those of WL; however, these scores were significantly higher in only 2 experts. For experts, the mean visibility scores of the BLI bright mode was significantly higher than those of WL for flat polyps, neoplastic polyps, and polyps located on the left side of the colon and the rectum.

      Limitations

      Small sample size and review of videos.

      Conclusions

      Our study showed that polyps were more easily visible with the BLI bright mode compared with WL. (Clinical trial registration number: UMIN000013770.)

      Abbreviations:

      BLI (blue laser imaging), FICE (flexible spectral imaging color enhancement), IEE (image-enhanced endoscopy), NBI (narrow-band imaging), WL (white light)
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