Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach
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초록
There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is aninnovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studieshave demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared withconventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasiondepth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopywith narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations withinvasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imagingoffers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitationsof narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness inundifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use ofendoscopic submucosal dissection for the treatment of gastric tumors.
Abstract
There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is aninnovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studieshave demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared withconventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasiondepth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopywith narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations withinvasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imagingoffers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitationsof narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness inundifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use ofendoscopic submucosal dissection for the treatment of gastric tumors.
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