Clinical Endoscopy

Case Report

Underwater Endoscopic Mucosal Resection without Submucosal Injection Facilitates En bloc Resection of Colon Adenomas Extending into a Diverticulum: Yoshikazu Hayashi, Masahiro Okada, Takaaki Morikawa, Tatsuma Nomura, Hisashi Fukuda, Takahito Takezawa, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2021;54(3):436-440. Published online November 6, 2020; DOI: https://doi.org/10.5946/ce.2020.168

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Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.

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Underwater endoscopic mucosal resection for colorectal lesions: Can it be an “Underwater” revolution?
Yoji Takeuchi, Satoki Shichijo, Noriya Uedo, Ryu Ishihara
DEN Open.2022;[Epub] CrossRef

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Brief Report

Linked Color Imaging Demonstrates Characteristic Findings in Semi-Pedunculated Gastric Adenocarcinoma in Helicobacter pylori-Negative Normal Mucosa: Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Mio Sakaguchi, Masato Tsunoda, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2021;54(1):136-138. Published online August 21, 2020; DOI: https://doi.org/10.5946/ce.2020.059

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The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
Gut and Liver.2024; 18(3): 444. CrossRef
Linked Color Imaging for Stomach
Eiji Umegaki, Hiraku Misawa, Osamu Handa, Hiroshi Matsumoto, Akiko Shiotani
Diagnostics.2023; 13(3): 467. CrossRef
Role of linked color imaging for upper gastrointestinal disease: present and future
Sang Pyo Lee
Clinical Endoscopy.2023; 56(5): 546. CrossRef
Appropriate Color Enhancement Settings for Blue Laser Imaging Facilitates the Diagnosis of Early Gastric Cancer with High Color Contrast
Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Yoshie Nomoto, Haruo Takahashi, Masato Tsunoda, Manabu Nagayama, Takashi Ueno, Alan Kawarai Lefor, Hironori Yamamoto
Journal of Gastric Cancer.2021; 21(2): 142. CrossRef

3,814 View
122 Download
4 Web of Science
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Focused Review Series: Present and Future of Diagnosis and Management of Small Bowel Diseases Exploiting Artificial Intelligence and Advanced Endoscopy

Roles of Capsule Endoscopy and Balloon-Assisted Enteroscopy in the Optimal Management of Small Bowel Bleeding: Hani Abutalib, Tomonori Yano, Satoshi Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2020;53(4):402-409. Published online July 30, 2020; DOI: https://doi.org/10.5946/ce.2020.143

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The small bowel had long been considered a dark unapproachable tunnel until the invention of capsule endoscopy and doubleballoon enteroscopy in the 21st century, which revolutionized the diagnosis and management of small bowel diseases, including bleeding. Various imaging modalities such as computed tomographic enterography, angiography, capsule endoscopy, and balloonassisted enteroscopy play vital roles in the diagnosis and management of small bowel bleeding. The choice of modality to use and timing of application differ according to the availability of the modalities, patient’s history, and physician’s experience. Small bowel bleeding is managed using different strategies as exemplified by medical treatment, interventional radiology, endoscopic therapy, or surgical intervention. Balloon-assisted enteroscopy enables endoscopic interventions to control small bowel bleeding, including electrocautery, argon plasma coagulation, clip application, and tattooing as a prelude to surgery. In this article, we clarify the recent approaches to the optimal diagnosis and management of patients with small bowel bleeding.

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A practical approach for small bowel bleeding
Sung Eun Kim, Hyun Jin Kim, Myeongseok Koh, Min Cheol Kim, Joon Sung Kim, Ji Hyung Nam, Young Kwan Cho, A Reum Choe
Clinical Endoscopy.2023; 56(3): 283. CrossRef
Indication, Location of the Lesion, Diagnostic Yield, and Therapeutic Yield of Double-Balloon Enteroscopy: Seventeen Years of Experience
Sang Pyo Lee, Hyun Joo Jang, Sea Hyub Kae, Jae Gon Lee, Ji Hye Kwon
Diagnostics.2022; 12(9): 2224. CrossRef
Application of capsule endoscopy in patients with chronic and recurrent abdominal pain
Wei Yang, Zheng Li, Rui Liu, Xudong Tong, Wei Wang, Dongqiang Xu, Shan Gao
Medical Engineering & Physics.2022; 110: 103901. CrossRef

5,240 View
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Brief Report

Double-Balloon Endoscopy-Assisted Balloon Dilation of Strictures Secondary to Small-Intestinal Lymphoma: Shogo Magome, Hirotsugu Sakamoto, Satoshi Shinozaki, Masahiro Okada, Tomonori Yano, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2020;53(1):101-105. Published online July 10, 2019; DOI: https://doi.org/10.5946/ce.2019.015

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Endoscopic Diagnosis of Small Bowel Tumor
Tomonori Yano, Hironori Yamamoto
Cancers.2024; 16(9): 1704. CrossRef
Primary Gastrointestinal Follicular Lymphoma Presenting With Bowel Stenosis
Hiroto Suzuki, Yasuhiko Hamada, Kyosuke Tanaka, Noriyuki Horiki, Hayato Nakagawa
Cureus.2022;[Epub] CrossRef
Small bowel lymphoma: clinical update and challenges for the gastroenterologist
Priya Oka, Reena Sidhu
Current Opinion in Gastroenterology.2022; 38(3): 270. CrossRef

4,561 View
147 Download
3 Web of Science
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Case Report

New Diagnostic Approach for Esophageal Squamous Cell Neoplasms Using Linked Color Imaging and Blue Laser Imaging Combined with Iodine Staining: Masato Tsunoda, Yoshimasa Miura, Hiroyuki Osawa, Tsevelnorov Khurelbaatar, Mio Sakaguchi, Hisashi Fukuda, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2019;52(5):497-501. Published online April 16, 2019; DOI: https://doi.org/10.5946/ce.2018.195

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A 62-year-old man with a flat early esophageal cancer was referred for endoscopic treatment. White light imaging revealed a pale red lesion, whereas linked color imaging (LCI) and blue laser imaging (BLI) yielded purple and brown images, respectively. Iodine staining demonstrated a large unstained area with a homogenous but very weak pink-color sign. This area appeared more clearly as purple and green on LCI and BLI, respectively; however, a different colored portion was observed at the 4 o’clock position inside the iodineunstained area. Histopathology findings of the resected specimen revealed squamous intraepithelial neoplasia at the 4 o’clock position and an esophageal squamous cell carcinoma in the remaining iodine-unstained area. LCI and BLI combined with iodine staining produce characteristic images that overcomes the pink-color sign, reflecting the histological features of a flat esophageal neoplasm. This new method is useful for detailed evaluation of early flat squamous cell neoplasms.

Citations

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Linked color imaging vs Lugol chromoendoscopy for esophageal squamous cell cancer and precancerous lesion screening: A noninferiority study
Zi-Xin Wang, Long-Song Li, Song Su, Jin-Ping Li, Bo Zhang, Nan-Jun Wang, Sheng-Zhen Liu, Sha-Sha Wang, Shuai Zhang, Ya-Wei Bi, Fei Gao, Qun Shao, Ning Xu, Bo-Zong Shao, Yi Yao, Fang Liu, En-Qiang Linghu, Ning-Li Chai
World Journal of Gastroenterology.2023; 29(12): 1899. CrossRef
Usefulness of linked color imaging in the early detection of superficial esophageal squamous cell carcinomas
Koki Nakamura, Yuji Urabe, Shiro Oka, Naoko Nagasaki, Naoki Yorita, Kosaku Hata, Kazuhiko Masuda, Mio Kurihara, Takahiro Kotachi, Tomoyuki Boda, Shinji Tanaka, Kazuaki Chayama
Esophagus.2021; 18(1): 118. CrossRef
Inter‐observer variability of experts and trainees for the diagnosis of reflux esophagitis: Comparison of linked color imaging, blue laser imaging, and white light imaging
Sang Pyo Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Eun Suk Jung
Journal of Digestive Diseases.2021; 22(7): 425. CrossRef

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Focused Review Series: Endoscopic Submucosal Dissection for Colorectal Tumors

Advanced Treatment and Imaging in Colonoscopy: The Pocket-Creation Method for Complete Resection and Linked Color Imaging for Better Detection of Early Neoplastic Lesions by Colonoscopy: Hironori Yamamoto, Satoshi Shinozaki, Yoshikazu Hayashi, Yoshimasa Miura, Tsevelnorov Khurelbaatar, Hiroyuki Osawa, Alan Kawarai Lefor; Clin Endosc 2019;52(2):107-113. Published online January 10, 2019; DOI: https://doi.org/10.5946/ce.2018.189

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Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficial colorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all been developed and used worldwide. The pocket-creation method facilitates the resection of tumors in difficult and routine locations. Early detection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques. However, the detection of small, flat-shaped, or faded color lesions remains difficult. Linked color imaging, a novel multi-light technology, facilitates the recognition of minor differences in tissue by enhancing the color contrast between early colorectal neoplasms and surrounding normal mucosa in a bright field of view. The most striking feature of linked color imaging is its ability to display the color of early neoplastic lesions as distinct from inflammatory changes, both of which have similar “redness” when viewed using white light imaging. To increase the detection rate of neoplasms, linked color imaging should be used from the outset for endoscopic observation. Early detection of superficial colorectal tumors can result in decreased mortality from colorectal cancer and maintain a good quality of life for patients.

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Comparison of blue laser imaging and light‐emitting diode‐blue light imaging for the characterization of colorectal polyps using the Japan narrow‐band imaging expert team classification: The LASEREO and ELUXEO COLonoscopic study
Masahiro Okada, Naohisa Yoshida, Hiroshi Kashida, Yoshikazu Hayashi, Satoshi Shinozaki, Shiori Yoshimoto, Toshihiro Fujinuma, Hirotsugu Sakamoto, Keijiro Sunada, Yuri Tomita, Osamu Dohi, Ken Inoue, Ryohei Hirose, Yoshito Itoh, Yoriaki Komeda, Ikue Sekai,
DEN Open.2024;[Epub] CrossRef
Linked color imaging versus white light imaging in the diagnosis of colorectal lesions: a meta-analysis of randomized controlled trials
Yining Sun, Xiu-He Lv, Xian Zhang, Jin Wang, Huimin Wang, Jin-Lin Yang
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
The Pocket-Creation Method Facilitates Endoscopic Submucosal Dissection of Gastric Neoplasms Along the Lesser Curvature at the Gastric Angle
Masafumi Kitamura, Yoshimasa Miura, Satoshi Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto
Frontiers in Medicine.2022;[Epub] CrossRef
Development and validation of the linked color imaging classification for endoscopic prediction of colorectal polyp histology
Min Min, Shou Bin Ning, Duan Min Hu, Yoshikazu Hayashi, Yan Liu
Journal of Digestive Diseases.2022; 23(5-6): 310. CrossRef
Combination of endoscopic submucosal dissection techniques, a practical solution for difficult cases
Dong-Hoon Yang
Clinical Endoscopy.2022; 55(5): 626. CrossRef
Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis
Juan Francisco Ortega-Morán, Águeda Azpeitia, Luisa F. Sánchez-Peralta, Luis Bote-Curiel, Blas Pagador, Virginia Cabezón, Cristina L. Saratxaga, Francisco M. Sánchez-Margallo
BMC Cancer.2021;[Epub] CrossRef
Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer
Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2021; 94(2): 394. CrossRef
The pocket-creation method facilitates gastric endoscopic submucosal dissection and overcomes challenging situations
Masafumi Kitamura, Yoshimasa Miura, Satoshi Shinozaki, Hironori Yamamoto
VideoGIE.2021; 6(9): 390. CrossRef
Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
Shanshan Wang, Lei Shen, Hesheng Luo
Therapeutic Advances in Gastroenterology.2021; 14: 175628482110259. CrossRef
Colon polyp detection using linked color imaging compared to white light imaging: Systematic review and meta‐analysis
Satoshi Shinozaki, Yasutoshi Kobayashi, Yoshikazu Hayashi, Hirotsugu Sakamoto, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
Digestive Endoscopy.2020; 32(6): 874. CrossRef
The Role of Cholangioscopy in the Management of Primary Sclerosing Cholangitis
Aldo J. Montano-Loza, Maryam Ebadi, Gurpal Sandha
Current Hepatology Reports.2020; 19(2): 78. CrossRef
Linked color imaging for the detection of early gastrointestinal neoplasms
Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
Therapeutic Advances in Gastroenterology.2019; 12: 175628481988524. CrossRef

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218 Download
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Focused Review Series: Current Status of Image-Enhanced Endoscopy (IEE)

Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening: Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2018;51(6):513-526. Published online November 2, 2018; DOI: https://doi.org/10.5946/ce.2018.132

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White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication.
LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.

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Higher detectability of gastric cancer after Helicobacter pylori eradication in texture and color enhancement imaging mode 2 in screening endoscopy
Yuichiro Kemmoto, Shun‐ichiro Ozawa, Ryota Sueki, Keiichi Furuya, Daimon Shirose, Satoshi Wakao, Kuniaki Shindo, Atsushi Nagata, Tadashi Sato
DEN Open.2024;[Epub] CrossRef
Simultaneous detection of Helicobacter pylori infection comparing between white light and image-enhanced endoscopy
Boonyaorn Chatrangsun, Natsuda Aumpan, Bubpha Pornthisarn, Soonthorn Chonprasertsuk, Sith Siramolpiwat, Patommatat Bhanthumkomol, Pongjarat Nunanan, Navapan Issariyakulkarn, Varocha Mahachai, Yoshio Yamaoka, Ratha-korn Vilaichone
BMC Gastroenterology.2024;[Epub] CrossRef
Linked Color Imaging of Barrett’s Esophageal Adenocarcinoma: Effects on Visibility
Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Yohei Ogata, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani, Atsushi Masamune
Gastroenterology Insights.2024; 15(1): 145. CrossRef
A Case of Duodenal Adenocarcinoma Effectively Highlighted by Linked Color Imaging and Confirmed by Histopathology
Kimitoshi Kubo, Xinhan Zhang, Ikko Tanaka, Noriko Kimura
Cureus.2024;[Epub] CrossRef
Surveillance esophagogastroduodenoscopy using linked color imaging and narrow‐band imaging: A multicenter randomized controlled trial
Marina Kubo, Shoko Ono, Osamu Dohi, Hayato Fukui, Takuto Hikichi, Tsunetaka Kato, Momoko Tsuda, Mio Matsumoto, Sosuke Kato, Rieko Mukai, Nobuaki Yagi, Ryo Takagi, Naoya Sakamoto, Mototsugu Kato
Journal of Gastroenterology and Hepatology.2024; 39(6): 1065. CrossRef
The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
Gut and Liver.2024; 18(3): 444. CrossRef
Diagnostic performance of blue laser imaging for early detection of gastric cancer: A systematic review and meta-analysis
Mohammed Rifat Shaik, Andrew Canakis, Nishat Anjum Shaik, Shivanand Bomman, Dushyant Singh Dahiya, Emily Gorman, Mohammad Bilal, Saurabh Chandan
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
Cromoendoscopia virtual utilizando BLI en el diagnóstico endoscópico de esófago de Barrett neoplásico y no neoplásico
Juan Carlos González
Revista GEN.2024; 77(4): 140. CrossRef
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Krizelle Acibal, Belgundi Preeti Vidyasagar, Harikishan Gonuguntla
Respirology Case Reports.2024;[Epub] CrossRef
Current status and future perspective of linked color imaging for gastric cancer screening: a literature review
Kazuo Yashima, Takumi Onoyama, Hiroki Kurumi, Yohei Takeda, Akira Yoshida, Koichiro Kawaguchi, Naoyuki Yamaguchi, Hajime Isomoto
Journal of Gastroenterology.2023; 58(1): 1. CrossRef
Improvement of detection sensitivity of upper gastrointestinal epithelial neoplasia in linked color imaging based on data of eye tracking
Masayuki Higashino, Shoko Ono, Shogo Matsumoto, Marina Kubo, Naohiro Yasuura, Shuhei Hayasaka, Ikko Tanaka, Yoshihiko Shimoda, Yusuke Nishimura, Masayoshi Ono, Keiko Yamamoto, Yuji Ono, Naoya Sakamoto
Journal of Gastroenterology and Hepatology.2023; 38(5): 710. CrossRef
Linked Color Imaging for Stomach
Eiji Umegaki, Hiraku Misawa, Osamu Handa, Hiroshi Matsumoto, Akiko Shiotani
Diagnostics.2023; 13(3): 467. CrossRef
Impact of linked color imaging and blue laser imaging on the diagnosis of esophageal squamous cell carcinoma in iodine unstained areas
Masato Tsunoda, Yoshimasa Miura, Hiroyuki Osawa, Manabu Nagayama, Yuka Kagaya, Yohei Funayama, Takuma Kobayashi, Mami Togashi, Hiroki Hayashi, Yuji Hiraoka, Yoshie Nomoto, Chihiro Iwashita, Yuji Ino, Haruo Takahashi, Hisashi Fukuda, Alan Kawarai Lefor, Hi
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Advances in Endoscopic Diagnosis of Early Gastric Cancer
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Advances in Clinical Medicine.2023; 13(04): 6577. CrossRef
Helicobacter pylori Infection: Conventional and Molecular Strategies for Bacterial Diagnosis and Antibiotic Resistance Testing
Reza Ranjbar, Amir Ebrahimi, Amirhossein Sahebkar
Current Pharmaceutical Biotechnology.2023; 24(5): 647. CrossRef
Linked color imaging versus conventional white light colonoscopy for the detection of colorectal polyps
Jun Watanabe, Takeshi Kanno, Eiichi Kakehi, Kazuma Rifu, Takehiro Kagaya, Kazuhiko Kotani, Yuki Kataoka
Cochrane Database of Systematic Reviews.2023;[Epub] CrossRef
Role of linked color imaging for upper gastrointestinal disease: present and future
Sang Pyo Lee
Clinical Endoscopy.2023; 56(5): 546. CrossRef
Landscape of Innovative Methods for Early Diagnosis of Gastric Cancer: A Systematic Review
Alexandra Orășeanu, Mihaela Cristina Brisc, Octavian Adrian Maghiar, Horia Popa, Ciprian Mihai Brisc, Sabina Florina Șolea, Teodor Andrei Maghiar, Ciprian Brisc
Diagnostics.2023; 13(24): 3608. CrossRef
Diagnostic ability of linked color imaging in ultraslim endoscopy to identify neoplastic lesions in the upper gastrointestinal tract
Ken Haruma, Mototsugu Kato, Kenro Kawada, Takahisa Murao, Shoko Ono, Mitsuhiko Suehiro, Shinichiro Hori, Fumisato Sasaki, Tomoyuki Koike, Shinji Kitamura, Osamu Dohi, Hiromitsu Kanzaki, Nobuaki Yagi, Keiichi Hashiguchi, Shiro Oka, Kazuhiro Katada, Ryo Shi
Endoscopy International Open.2022; 10(01): E88. CrossRef
Incidence of Infection among Subjects with Helicobacter pylori Seroconversion
Young Jung Kim, Sun-Young Lee, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park
Clinical Endoscopy.2022; 55(1): 67. CrossRef
Linked color imaging effectively detects the endoscopic atrophic border in transnasal endoscopy
Yusuke Kawai, Mitsushige Sugimoto, Mariko Hamada, Eri Iwata, Ryota Niikura, Naoyoshi Nagata, Masakatsu Fukuzawa, Takao Itoi, Takashi Kawai
Journal of Clinical Biochemistry and Nutrition.2022; 70(3): 290. CrossRef
Linked color imaging improves identification of early gastric cancer lesions by expert and non-expert endoscopists
Kiki Fockens, Jeroen de Groof, Joost van der Putten, Tsevelnorov Khurelbaatar, Hisashi Fukuda, Takahito Takezawa, Yoshimasa Miura, Hiroyuki Osawa, Hironori Yamamoto, Jacques Bergman
Surgical Endoscopy.2022; 36(11): 8316. CrossRef
Improved detection of early gastric cancer with linked color imaging using an ultrathin endoscope: a video-based analysis
Tsevelnorov Khurelbaatar, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Takahito Takezawa, Chihiro Iwashita, Yoshie Nomoto, Masato Tsunoda, Takashi Ueno, Haruo Takahashi, Manabu Nagayama, Hisashi Fukuda, Alan Kawarai Lefor, Hironori Yamamoto
Endoscopy International Open.2022; 10(05): E644. CrossRef
Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis
Hee Seok Moon
Journal of the Korean Medical Association.2022; 65(5): 259. CrossRef
Diagnostic accuracy of linked colour imaging versus white light imaging for early gastric cancers: a prospective, multicentre, randomized controlled trial study
Min Min, Xiaotian Sun, Jianying Bai, Qinsheng Zhang, Xiaocui Yang, Qiang Guo, Rong Wang, Bangmao Wang, Zhiwu Lv, Jie Pan, Chunmeng Jiang, Duanmin Hu, Bing Nong, Enqiang Linghu, Yan Liu
Annals of Medicine.2022; 54(1): 3305. CrossRef
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Mitsushige Sugimoto, Yohei Koyama, Takao Itoi, Takashi Kawai
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Young-Eun Joo
The Korean Journal of Gastroenterology.2022; 80(5): 207. CrossRef
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Roumen Kountchev, Alexander Bekiarski, Rumen Mironov, Snezhana Pleshkova
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Yukinari Yoshida, Hiroaki Takahashi, Tomoyuki Ohuchi, Satoshi Okahara, Yoshifumi Ishii, Toshinao Takenouchi, Toshiyuki Kubo, Takefumi Kikuchi, Hiroaki Mita, Yasuyo Adachi, Norikazu Iwata, Masahiro Nakamura, Yasushi Adachi, Yasuo Kato, Takao Endo
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Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Mio Sakaguchi, Masato Tsunoda, Alan Kawarai Lefor, Hironori Yamamoto
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Clement Chun Ho Wu, Vikneswaran Namasivayam, James Weiquan Li, Chris JL Khor, Kwong Ming Fock, Ngai Moh Law, Lai Mun Wang, Tiing Leong Ang
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What Is New in Helicobacter pylori Diagnosis. An Overview
Maria Pina Dore, Giovanni Mario Pes
Journal of Clinical Medicine.2021; 10(10): 2091. CrossRef
Inter‐observer variability of experts and trainees for the diagnosis of reflux esophagitis: Comparison of linked color imaging, blue laser imaging, and white light imaging
Sang Pyo Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Eun Suk Jung
Journal of Digestive Diseases.2021; 22(7): 425. CrossRef
Appropriate Color Enhancement Settings for Blue Laser Imaging Facilitates the Diagnosis of Early Gastric Cancer with High Color Contrast
Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Yoshie Nomoto, Haruo Takahashi, Masato Tsunoda, Manabu Nagayama, Takashi Ueno, Alan Kawarai Lefor, Hironori Yamamoto
Journal of Gastric Cancer.2021; 21(2): 142. CrossRef
Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
Shanshan Wang, Lei Shen, Hesheng Luo
Therapeutic Advances in Gastroenterology.2021; 14: 175628482110259. CrossRef
Association between abdominal symptoms and gastric body redness in Linked Color Imaging in patients without Helicobacter pylori infection
Tsutomu Takeda, Daisuke Asaoka, Hisanori Utsunomiya, Shotaro Oki, Nobuyuki Suzuki, Daiki Abe, Atsushi Ikeda, Noboru Yatagai, Yoichi Akazawa, Kohei Matsumoto, Kumiko Ueda, Hiroya Ueyama, Kenshi Matsumoto, Mariko Hojo, Shuko Nojiri, Akihito Nagahara
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Hang Yang, Bing Hu
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Taku Sakamoto, Hourin Cho, Yutaka Saito
Clinical Endoscopy.2021; 54(4): 488. CrossRef
Application of Current Image-Enhanced Endoscopy in Gastric Diseases
Wansik Lee
Clinical Endoscopy.2021; 54(4): 477. CrossRef
Linked-color Imaging May Help Improve the Visibility of Superficial Barrett's Esophageal Adenocarcinoma by Increasing the Color Difference
Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Kenichiro Nakagawa, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani, Atsushi Masamune
Internal Medicine.2021; 60(21): 3351. CrossRef
Potential of automatic diagnosis system with linked color imaging for diagnosis of Helicobacter pylori infection
Takeshi Yasuda, Tomoyuki Hiroyasu, Satoru Hiwa, Yuto Okada, Sadanari Hayashi, Yuki Nakahata, Yuriko Yasuda, Tatsushi Omatsu, Akihiro Obora, Takao Kojima, Hiroshi Ichikawa, Nobuaki Yagi
Digestive Endoscopy.2020; 32(3): 373. CrossRef
Linked Color Imaging of Eosinophilic Esophagitis
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Case Reports

Blue Laser Imaging with a Small-Caliber Endoscope Facilitates Detection of Early Gastric Cancer: Haruo Takahashi, Yoshimasa Miura, Hiroyuki Osawa, Takahito Takezawa, Yuji Ino, Masahiro Okada, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2019;52(3):273-277. Published online August 14, 2018; DOI: https://doi.org/10.5946/ce.2018.100

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Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished from inflamed mucosa. We treated a patient with a small early gastric cancer that was difficult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, blue laser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from the surrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even with small-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosal dissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinoma localized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. This small early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.

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Indian Journal of Gastroenterology.2024;[Epub] CrossRef
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Laser Imaging Facilitates Early Detection of Synchronous Adenocarcinomas in Patients with Barrett’s Esophagus: Chihiro Iwashita, Yoshimasa Miura, Hiroyuki Osawa, Takahito Takezawa, Yuji Ino, Masahiro Okada, Alan K. Lefor, Hironori Yamamoto; Clin Endosc 2017;50(1):81-86. Published online May 9, 2016; DOI: https://doi.org/10.5946/ce.2016.027

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Barrett’s adenocarcinoma may occur in multiple sites, and recurrence and metachronous lesions are the major problems with endoscopic resection. Therefore, early detection of such lesions is ideal to achieve complete resection and obtain improved survival rates with minimally invasive treatment. Laser imaging systems allow multiple modalities of endoscopic imaging by using white light laser, flexible spectral imaging color enhancement (FICE), blue laser imaging (BLI), and linked color imaging even at a distant view. However, the usefulness of these modalities has not been sufficiently reported regarding Barrett’s adenocarcinoma. Here, we report on a patient with three synchronous lesions followed by one metachronous lesion in a long segment with changes of Barrett’s esophagus, all diagnosed with this new laser endoscopic imaging system and enhanced by using FICE and/or BLI with high contrast compared with the surrounding mucosa. Laser endoscopic imaging may facilitate the detection of malignancies in patients with early Barrett’s adenocarcinoma.

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Laterally Spreading Tumor of the Rectum Delineated with Linked Color Imaging Technology: Masahiro Okada, Hirotsugu Sakamoto, Takahito Takezawa, Yoshikazu Hayashi, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto; Clin Endosc 2016;49(2):207-208. Published online February 12, 2016; DOI: https://doi.org/10.5946/ce.2015.077

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Erratum

An Ultrathin Endoscope with a 2.4-mm Working Channel Shortens the Esophagogastroduodenoscopy Time by Shortening the Suction Time: Satoshi Shinozaki, Yoshimasa Miura, Yuji Ino, Kenjiro Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2016;49(1):100-100. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.100; Corrects: Clin Endosc 2015;48(6):516

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Animal experimental studies using small intestine endoscope
Jin-Hua Liu, Dan-Yang Liu, Li Wang, Li-Ping Han, Zhe-Yu Qi, Hai-Jun Ren, Yan Feng, Feng-Ming Luan, Liang-Tian Mi, Shu-Mei Shan
World Journal of Gastroenterology.2017; 23(20): 3684. CrossRef

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Original Article

An Ultrathin Endoscope with a 2.4-mm Working Channel Shortens the Esophagogastroduodenoscopy Time by Shortening the Suction Time: Satoshi Shinozaki, Yoshimasa Miura, Yuji Ino, Kenjiro Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2015;48(6):516-521. Published online November 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.6.516; Correction in: Clin Endosc 2016;49(1):100

Abstract PDF PubReader ePub

Background
/Aims: Poor suction ability through a narrow working channel prolongs esophagogastroduodenoscopy (EGD). The aim of this study was to evaluate suction with a new ultrathin endoscope (EG-580NW2; Fujifilm Corp.) having a 2.4-mm working channel in clinical practice.
Methods
To evaluate in vitro suction, 200 mL water was suctioned and the suction time was measured. The clinical data of 117 patients who underwent EGD were retrospectively reviewed on the basis of recorded video, and the suction time was measured by using a stopwatch.
Results
In vitro, the suction time with the EG-580NW2 endoscope was significantly shorter than that with the use of an ultrathin endoscope with a 2.0-mm working channel (EG-580NW; mean ± standard deviation, 22.7±1.1 seconds vs. 34.7±2.2 seconds; p<0.001). We analyzed the total time and the suction time for routine EGD in 117 patients (50 in the EG-580NW2 group and 67 in the EG-580NW group). In the EG-580NW2 group, the total time for EGD was significantly shorter than that in the EG-580NW group (275.3±42.0 seconds vs. 300.6±46.5 seconds, p=0.003). In the EG-580NW2 group, the suction time was significantly shorter than that in the EG-580NW group (19.2±7.6 seconds vs. 38.0±15.9 seconds, p<0.001).
Conclusions
An ultrathin endoscope with a 2.4-mm working channel considerably shortens the routine EGD time by shortening the suction time, in comparison with an endoscope with a 2.0-mm working channel.

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