The Experts below are selected from a list of 5208 Experts worldwide ranked by ideXlab platform
Helmut Neumann - One of the best experts on this subject based on the ideXlab platform.
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High-definition endoscopy with digital Chromoendoscopy for histologic prediction of distal colorectal polyps.
BMC gastroenterology, 2015Co-Authors: Timo Rath, Gian Eugenio Tontini, Markus F Neurath, Arthur Hoffman, Andreas Nägel, Michael Vieth, Steffen Zopf, Claudia Günther, Helmut NeumannAbstract:Background: Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital Chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement. Methods: In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital Chromoendoscopy and the accuracy of predicting histology with digital Chromoendoscopy was assessed. Results: The overall accuracy of digital Chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital Chromoendoscopy were correctly predicted with >90 % accuracy. Conclusions: High-definition endoscopy in combination with digital Chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps. Trial registration: ClinicalTrials NCT02217449.
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review article newer optical and digital Chromoendoscopy techniques vs dye based Chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease
Alimentary Pharmacology & Therapeutics, 2013Co-Authors: Gian Eugenio Tontini, Maurizio Vecchi, Markus F Neurath, Helmut NeumannAbstract:Summary Background Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based Chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ Chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. Aim To review available optical and digital Chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. Methods A literature search on the use of dye-less and dye-based Chromoendoscopy in IBD patients was performed. Results In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2–247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. Conclusions Although the potential benefits of newer optical and digital dye-less Chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
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Present and future perspectives of virtual Chromoendoscopy with i-scan and optical enhancement technology
Digestive Endoscopy, 2013Co-Authors: Helmut Neumann, Mitsuhiro Fujishiro, C. Mel Wilcox, Klaus MönkemüllerAbstract:Despite being the current gold standard, white-light endoscopy may miss a significant proportion of lesions within the colorectum, thus leading to a misinterpretation of various disease findings. Traditionally, dye-based Chromoendoscopy is used to improve both detection and characterization of lesions during luminal gastrointestinal (GI) endoscopy. Recently introduced dye-less Chromoendoscopy (DLC) techniques have overcome many of the limitations of dye-based Chromoendoscopy, thereby potentially improving lesion recognition and characterization. In detail, DLC techniques allow for better detection of esophageal lesions, gastric cancer and colorectal pathologies including colorectal polyps and inflammatory bowel diseases. Moreover, DLC techniques enable a more precise characterization of lesions throughout the whole luminal GI tract, thereby potentially enabling more accurate endoscopic therapies. In the present review we focus on the newly introduced dye-less Chromoendoscopy technique i-scan and give an additional outlook on the recent development of optical enhancement technology.
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Review article: newer optical and digital Chromoendoscopy techniques vs. dye‐based Chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease
Alimentary pharmacology & therapeutics, 2013Co-Authors: Gian Eugenio Tontini, Maurizio Vecchi, Markus F Neurath, Helmut NeumannAbstract:Summary Background Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based Chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ Chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. Aim To review available optical and digital Chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. Methods A literature search on the use of dye-less and dye-based Chromoendoscopy in IBD patients was performed. Results In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2–247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. Conclusions Although the potential benefits of newer optical and digital dye-less Chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
Markus F Neurath - One of the best experts on this subject based on the ideXlab platform.
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High-definition endoscopy with digital Chromoendoscopy for histologic prediction of distal colorectal polyps.
BMC gastroenterology, 2015Co-Authors: Timo Rath, Gian Eugenio Tontini, Markus F Neurath, Arthur Hoffman, Andreas Nägel, Michael Vieth, Steffen Zopf, Claudia Günther, Helmut NeumannAbstract:Background: Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital Chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement. Methods: In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital Chromoendoscopy and the accuracy of predicting histology with digital Chromoendoscopy was assessed. Results: The overall accuracy of digital Chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital Chromoendoscopy were correctly predicted with >90 % accuracy. Conclusions: High-definition endoscopy in combination with digital Chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps. Trial registration: ClinicalTrials NCT02217449.
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review article newer optical and digital Chromoendoscopy techniques vs dye based Chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease
Alimentary Pharmacology & Therapeutics, 2013Co-Authors: Gian Eugenio Tontini, Maurizio Vecchi, Markus F Neurath, Helmut NeumannAbstract:Summary Background Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based Chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ Chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. Aim To review available optical and digital Chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. Methods A literature search on the use of dye-less and dye-based Chromoendoscopy in IBD patients was performed. Results In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2–247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. Conclusions Although the potential benefits of newer optical and digital dye-less Chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
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Review article: newer optical and digital Chromoendoscopy techniques vs. dye‐based Chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease
Alimentary pharmacology & therapeutics, 2013Co-Authors: Gian Eugenio Tontini, Maurizio Vecchi, Markus F Neurath, Helmut NeumannAbstract:Summary Background Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based Chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ Chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. Aim To review available optical and digital Chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. Methods A literature search on the use of dye-less and dye-based Chromoendoscopy in IBD patients was performed. Results In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2–247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. Conclusions Although the potential benefits of newer optical and digital dye-less Chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
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Chromoendoscopy in inflammatory bowel disease.
Gastroenterology clinics of North America, 2012Co-Authors: Ralf Kiesslich, Markus F NeurathAbstract:Chromoendoscopy with methylene blue or indigo carmine significantly increases the diagnostic yield of finding intraepithelial neoplasia in patients with longstanding colitis. The number needed to treat is 14 for panChromoendoscopy to identify 1 additional patient with dysplasia. Chromoendoscopy can greatly facilitate the identification of flat lesions harboring intraepithelial neoplasia. Chromoendoscopy can guide biopsies and clearly reduces the amount of biopsies that are needed per patient. Magnifying endoscopy or CLE are additional techniques, which can be used in conjunction with Chromoendoscopy to further reduce the amount of biopsies and to further increase the diagnostic yield. Chromoendoscopy is an established clinical procedure and recommended by many gastroenterological societies for surveillance of patients with longstanding ulcerative colitis. Thus, intravital staining should be an essential part of the diagnostic armamentarium of every colonoscopist.
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Recognition and characterization of small colonic neoplasia with high-definition colonoscopy using i-Scan is as precise as Chromoendoscopy.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2009Co-Authors: Arthur Hoffman, Markus F Neurath, C. Kagel, Martin Goetz, Achim Tresch, Jonas Mudter, Stefan Biesterfeld, Peter R. Galle, Ralf KiesslichAbstract:Abstract Background The EPKi system (Pentax, Japan) enables resolution above HDTV. Aim of the study was to test the efficacy of HD+ alone and with the new post-processing digital filter i-Scan or Chromoendoscopy (Methylene blue 0.1%) in screening for colorectal cancer. We focused on lesions less than 5 mm as a surrogate marker for the optical possibilities of the EPKi system. Methods The last 30 cm of the colon in a screening population were inspected with HD+ alone, in combination with i-Scan (2:1 randomisation) and subsequently with Chromoendoscopy. All lesions were characterized and targeted biopsies were performed. Results i-Scan augmented in 69 patients the identification of lesions from 176 to 335 (p Conclusions HD+ colonoscopy with and without i-Scan unmask a plethora of small lesions but Chromoendoscopy can even advance the number. However, i-Scan was able to predict neoplasia as precisely as Chromoendoscopy and might shortly replace Chromoendoscopy as a more time efficient tool.
Ralf Kiesslich - One of the best experts on this subject based on the ideXlab platform.
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Chromoendoscopy in inflammatory bowel disease.
Gastroenterology clinics of North America, 2012Co-Authors: Ralf Kiesslich, Markus F NeurathAbstract:Chromoendoscopy with methylene blue or indigo carmine significantly increases the diagnostic yield of finding intraepithelial neoplasia in patients with longstanding colitis. The number needed to treat is 14 for panChromoendoscopy to identify 1 additional patient with dysplasia. Chromoendoscopy can greatly facilitate the identification of flat lesions harboring intraepithelial neoplasia. Chromoendoscopy can guide biopsies and clearly reduces the amount of biopsies that are needed per patient. Magnifying endoscopy or CLE are additional techniques, which can be used in conjunction with Chromoendoscopy to further reduce the amount of biopsies and to further increase the diagnostic yield. Chromoendoscopy is an established clinical procedure and recommended by many gastroenterological societies for surveillance of patients with longstanding ulcerative colitis. Thus, intravital staining should be an essential part of the diagnostic armamentarium of every colonoscopist.
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confocal laser endomicroscopy and Chromoendoscopy a new option of surveillance in patients with ureterosigmoidostomy or rectosigmoid pouch
Journal of Pediatric Urology, 2010Co-Authors: Raimund Stein, Stefan Biesterfeld, M Gotz, Arthur Hoffamnn, Annette Schroder, J W Thuroff, Ralf KiesslichAbstract:Purpose In patients with bladder exstrophy-epispadias-complex (BEEC) or in selected patients with bladder loss for other reasons, ureterosigmoidostomy (USIG) & rectosigmoid pouch (Mainz Pouch (MZP) II) has been used at our institution. This diversion carries a lifelong risk for secondary malignancies. Therefore annual colonoscopy is recommended. Identification of potentially malignant structures can be challenging, and biopsies are taken in doubt, with the risk of injuring the ureterocolic implantation site. Using confocal laser endomicroscopy (CLE) and Chromoendoscopy, the uretero-intestinal anastomosis is better visualized compared to conventional colonoscopy, and target biopsies could be taken to exclude malignancy. In this study we analyzed the feasibility and accuracy using the new technique in these patients for the first time. Material and Methods Over the last 3 years endomicroscopy and Chromoendoscopy was used in patients with USIG or MZP II for surveillance colonoscopy. A high resolution coloscop (Hi-Line, Pentax, Japan) was used to identify ureteral orifices or other lesions. Chromoendoscopy using 0.1% Methylene blue spray was used to recognize macroscopically abnormal mucosal areas. The CLE allows a high magnification (1000x) and in-vivo imaging of deeper parts of the mucosal layer - up to 250μm. Results Endomicroscopy was performed in 68 patients (BEEC n=48, traumatic incontinence/tumor n=20). A total of 156 lesions with average size of 0.9 cm were identified by Chromoendoscopy and CLE, verified by histology (9 Adenoma, 25 inflammatory changes, 122 hyperplasia). Prediction accuracy with Chromoendoscopy was 94%, and with CLE 98%. Conclusions The newly developed high-resolution Chromoendoscopy and endomicroscopy was used for the first time for surveillance sigmoidoscopy in patients with USIG or MZPII. Chromoendoscopy allows targeting biopsies; CLE has the advantage of accurate prediction concerning the malignant potential of the lesion. Allowing a unique visualisation at detailed cellular architecture, unnecessary biopsies can be avoided, reducing the risk of injuries of the ureteral implantation site.
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Recognition and characterization of small colonic neoplasia with high-definition colonoscopy using i-Scan is as precise as Chromoendoscopy.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2009Co-Authors: Arthur Hoffman, Markus F Neurath, C. Kagel, Martin Goetz, Achim Tresch, Jonas Mudter, Stefan Biesterfeld, Peter R. Galle, Ralf KiesslichAbstract:Abstract Background The EPKi system (Pentax, Japan) enables resolution above HDTV. Aim of the study was to test the efficacy of HD+ alone and with the new post-processing digital filter i-Scan or Chromoendoscopy (Methylene blue 0.1%) in screening for colorectal cancer. We focused on lesions less than 5 mm as a surrogate marker for the optical possibilities of the EPKi system. Methods The last 30 cm of the colon in a screening population were inspected with HD+ alone, in combination with i-Scan (2:1 randomisation) and subsequently with Chromoendoscopy. All lesions were characterized and targeted biopsies were performed. Results i-Scan augmented in 69 patients the identification of lesions from 176 to 335 (p Conclusions HD+ colonoscopy with and without i-Scan unmask a plethora of small lesions but Chromoendoscopy can even advance the number. However, i-Scan was able to predict neoplasia as precisely as Chromoendoscopy and might shortly replace Chromoendoscopy as a more time efficient tool.
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Is Chromoendoscopy the new standard for cancer surveillance in patients with ulcerative colitis
Nature clinical practice. Gastroenterology & hepatology, 2009Co-Authors: Markus F Neurath, Ralf KiesslichAbstract:Chromoendoscopy was introduced in 2003 as a novel 'red flag' technique that aimed to increase the sensitivity of identifying flat, neoplastic lesions in patients with ulcerative colitis. The improved sensitivity of Chromoendoscopy over standard white-light endoscopy has been confirmed in European and Asian centers. This commentary discusses the findings from a prospective, controlled study from the Mount Sinai Hospital in New York. The findings of this study provide unequivocal evidence that Chromoendoscopy is superior to white-light endoscopy in the detection of neoplasias in patients with IBD. The authors of this study identified a greater number of lesions and a higher number of patients with dysplasia by use of this method and targeted biopsy sampling compared with standard endoscopy with random biopsy sampling. Chromoendoscopy in combination with targeted biopsies, therefore, has emerged as the new standard of cancer surveillance in patients with ulcerative colitis, and we can expect this technique to be incorporated into clinical guidelines shortly.
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clinical alimentary tract Chromoendoscopy and narrow band imaging compared with high resolution magnification endoscopy in barrett s esophagus
2008Co-Authors: W L Curvers, Krish Ragunath, Ralf Kiesslich, Lubbertus C Baak, Arnoud H Van Oijen, Thomas Rabenstein, Pieter Scholten, U Seitz, Fiebo Ten Kate, Paul FockensAbstract:Background & Aims: The aim of this study was to compare magnified still images obtained with high-resolution white light endoscopy, indigo carmine Chromoendoscopy, acetic acid Chromoendoscopy, and narrow-band imaging to determine the best technique for use in Barrett’s esophagus. Methods: We obtained magnified images from 22 areas with the 4 aforementioned techniques. Seven endoscopists with no specific expertise in Barrett’s esophagus or advanced imaging techniques and 5 international experts in thisfield evaluated these 22 areas for overall image quality, mucosal image quality, and vascular image quality. In addition, the regularity of mucosal and vascular patterns and the presence of abnormal blood vessels were evaluated, and this was correlated with histology. Results: The interobserver agreement for the 3 features of mucosal morphology with white light images ranged from 0.51 (95% confidence interval [CI]: 0.46‐0.55) to 0.53 (95% CI: 0.50‐0.57) for all observers, from 0.43 (95% CI: 0.33‐0.54) to 0.53 (95% CI: 0.41‐0.64) for experts, and from 0.51 (95% CI: 0.15‐0.33) to 0.64 (95% CI: 0.58‐0.70) for nonexperts. The interobserver agreement in these groups did not improve by adding one of the enhancement techniques. The yield for identifying early neoplasia with white light images was 86% for all observers, 90% for experts, and 84% for nonexperts. The addition of enhancement techniques did not improve the yield neoplasia. Conclusions: The addition of indigo carmine Chromoendoscopy, acetic acid Chromoendoscopy, or narrow-band imaging to white light images did not improve interobserver agreement or yield identifying early neoplasia in Barrett’s esophagus. C hromoendoscopy is a technique in which staining agents are sprayed on the mucosal surface of the gastrointestinal tract to enhance the endoscopic evaluation of the mucosa. This enables endoscopic detection of surface patterns or functional characteristics that may predict the presence of early neoplasia, lesions that may be difficult to detect with standard endoscopy only. Chromoendoscopy is usually combined with magnifying endoscopy for best results. In Barrett’s esophagus (BE), the typically used contrast enhancement agents are indigo carmine and acetic acid. Indigo carmine enhances the mucosal surface by pooling in the grooves between the mucosal villi, thus enabling the visualization of the pattern formed by mucosal folds and pits. Acetic acid achieves the same goal by means of reversible denaturation of superficial mucosal proteins. Both agents have been reported to recognize typical arrangements of the mucosal pit patterns that may corre
Gian Eugenio Tontini - One of the best experts on this subject based on the ideXlab platform.
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High-definition endoscopy with digital Chromoendoscopy for histologic prediction of distal colorectal polyps.
BMC gastroenterology, 2015Co-Authors: Timo Rath, Gian Eugenio Tontini, Markus F Neurath, Arthur Hoffman, Andreas Nägel, Michael Vieth, Steffen Zopf, Claudia Günther, Helmut NeumannAbstract:Background: Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital Chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement. Methods: In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital Chromoendoscopy and the accuracy of predicting histology with digital Chromoendoscopy was assessed. Results: The overall accuracy of digital Chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital Chromoendoscopy were correctly predicted with >90 % accuracy. Conclusions: High-definition endoscopy in combination with digital Chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps. Trial registration: ClinicalTrials NCT02217449.
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review article newer optical and digital Chromoendoscopy techniques vs dye based Chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease
Alimentary Pharmacology & Therapeutics, 2013Co-Authors: Gian Eugenio Tontini, Maurizio Vecchi, Markus F Neurath, Helmut NeumannAbstract:Summary Background Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based Chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ Chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. Aim To review available optical and digital Chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. Methods A literature search on the use of dye-less and dye-based Chromoendoscopy in IBD patients was performed. Results In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2–247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. Conclusions Although the potential benefits of newer optical and digital dye-less Chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
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Review article: newer optical and digital Chromoendoscopy techniques vs. dye‐based Chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease
Alimentary pharmacology & therapeutics, 2013Co-Authors: Gian Eugenio Tontini, Maurizio Vecchi, Markus F Neurath, Helmut NeumannAbstract:Summary Background Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based Chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ Chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. Aim To review available optical and digital Chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. Methods A literature search on the use of dye-less and dye-based Chromoendoscopy in IBD patients was performed. Results In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2–247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. Conclusions Although the potential benefits of newer optical and digital dye-less Chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
Nicholas J. Durr - One of the best experts on this subject based on the ideXlab platform.
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feature space optimization for virtual Chromoendoscopy augmented by topography
Medical Image Computing and Computer-Assisted Intervention, 2014Co-Authors: Germán González, Vicente Parot, Benjamin J. Vakoc, Nicholas J. DurrAbstract:Optical colonoscopy is the preferred modality for the screening and prevention of colorectal cancer. Chromoendoscopy can increase lesion detection rate by highlighting tissue topography with a colored dye, but is too time-consuming to be adopted in routine colonoscopy screening. We developed a fast and dye-free technique that generates virtual Chromoendoscopy images that incorporate topography features acquired from photometric stereo endoscopy. We demonstrate that virtual Chromoendoscopy augmented by topography achieves similar image quality to conventional Chromoendoscopy in ex-vivo swine colon.
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MICCAI (1) - Feature space optimization for virtual Chromoendoscopy augmented by topography.
Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Inte, 2014Co-Authors: Germán González, Vicente Parot, Benjamin J. Vakoc, Nicholas J. DurrAbstract:Optical colonoscopy is the preferred modality for the screening and prevention of colorectal cancer. Chromoendoscopy can increase lesion detection rate by highlighting tissue topography with a colored dye, but is too time-consuming to be adopted in routine colonoscopy screening. We developed a fast and dye-free technique that generates virtual Chromoendoscopy images that incorporate topography features acquired from photometric stereo endoscopy. We demonstrate that virtual Chromoendoscopy augmented by topography achieves similar image quality to conventional Chromoendoscopy in ex-vivo swine colon.