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Comparative study between MBI (FICE®) and magnification chromoendoscopy with indigo carmine in the differential diagnosis of neoplastic and non-neoplastic lesions of the colorectum

CONTEXT: Multiband imaging (MBI)/Fuji Intelligent Color Enhancement (FICE®) is a spectral image processing technology that helps in vivo diagnosis of colorectal neoplasias. OBJECTIVE: To compare the diagnostic accuracy of the magnification with either the electronic chromoendoscopy or indigo carmine dye in the differential diagnosis of neoplastic and non-neoplastic colorectal lesions. Methods - Seventy five patients with 157 colorectal lesions were prospectively evaluated. The capillary pattern, as well as the pit pattern according to the Kudo classification, of colorectal lesions were evaluated by means of the FICE® system. Absence and presence of meshed capillary networks were labeled as non-neoplastic and neoplastic lesions, respectively. Afterwards, indigo carmine 0.8% was instilled and a new evaluation of the pit pattern was carried out. RESULTS: One hundred and sixteen of the 157 lesions were classified as positive meshed capillary network, 115 of them were confirmed histologically as neoplasia. Other 32 lesions out of 41 with negative meshed capillary network were non-neoplastic. Sensitivity, specificity and accuracy were, respectively, 92.7%, 97% and 93.6%. Pit patterns I and II were confirmed as non-neoplastic lesions, and patterns III to V were confirmed as neoplasies. Sensitivity, specificity and accuracy for the electronic chromoendoscopy were, respectively, 94.4%, 97% and 94.9%. Meanwhile, the figures for the magnification with indigo carmine were, respectively, 97.6%, 93.9% and 96.8%. CONCLUSIONS: Both methods, either the MBI/FICE® system or the use of indigo carmine dye with magnification, achieved a high accuracy for the differential diagnosis between neoplastic and non-neoplastic colorectal lesions.

Colorectal neoplasms; Colonoscopy; Image enhancement; Coloring agents; Indigotindisulfonate sodium


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