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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 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.6
White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright imagesin the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellentvisibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green colorof metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history ofHelicobacter 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 inmucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection ofearly esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinalcancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtainimages 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.
Satoru Kobayashi,Hiroyuki Kimura,Isao Kagomiya,Kay Kohn,Toshihiro Osawa,Yukio Noda 한국물리학회 2005 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.46 No.1
A ferroelectric phase transition of RMn2O5 (R = rare earth,Bi,Y) has been systematically reinvestigated by dielectric measurements. In addition to a sharp peak of the dielectric constant along the b axis at the temperature of ferroelectric phase transition, TC1, we observed a small kink at TS slightly below TC1 for R = Er, Y, Tb, Tm. Correspondingly, two-step successive magnetic phase transitions were found for R = Er, Y, Tm in a narrow temperature range of 1 K around TC1 by neutron diraction measurements. The comparison between temperatures of dielectric anomalies and magnetic phase transitions indicates that the paraelectric-ferroelectric phase transition at TC1 is induced by a commensurate magnetic ordering along the c axis in RMn2O5.
Hiraoka, Yuji,Miura, Yoshimasa,Osawa, Hiroyuki,Nomoto, Yoshie,Takahashi, Haruo,Tsunoda, Masato,Nagayama, Manabu,Ueno, Takashi,Lefor, Alan Kawarai,Yamamoto, Hironori The Korean Gastric Cancer Association 2021 Journal of gastric cancer Vol.21 No.2
Purpose: Screening image-enhanced endoscopy for gastrointestinal malignant lesions has progressed. However, the influence of the color enhancement settings for the laser endoscopic system on the visibility of lesions with higher color contrast than their surrounding mucosa has not been established. Materials and Methods: Forty early gastric cancers were retrospectively evaluated using color enhancement settings C1 and C2 for laser endoscopic systems with blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI). The visibilities of the malignant lesions in the stomach with the C1 and C2 color enhancements were scored by expert and non-expert endoscopists and compared, and the color differences between the malignant lesions and the surrounding mucosa were assessed. Results: Early gastric cancers mainly appeared orange-red on LCI and brown on BLI-bright or BLI. The surrounding mucosae were purple on LCI regardless of the color enhancement but brown or pale green with C1 enhancement and dark green with C2 enhancement on BLI-bright or BLI. The mean visibility scores for BLI-bright, BLI, and LCI with C2 enhancement were significantly higher than those with C1 enhancement. The superiority of the C2 enhancement was not demonstrated in the assessments by non-experts, but it was significant for experts using all modes. The C2 color enhancement produced a significantly greater color difference between the malignant lesions and the surrounding mucosa, especially with the use of BLI-bright (P=0.033) and BLI (P<0.001). C2 enhancement tended to be superior regardless of the morphological type, Helicobacter pylori status, or the extension of intestinal metaplasia around the cancer. Conclusions: Appropriate color enhancement settings improve the visibility of malignant lesions in the stomach and color contrast between the malignant lesions and the surrounding mucosa.
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 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.3
Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished frominflamed mucosa. We treated a patient with a small early gastric cancer that was diffcult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, bluelaser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from thesurrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even withsmall-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosaldissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinomalocalized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. Thissmall early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.
Masato Tsunoda,Yoshimasa Miura,Hiroyuki Osawa,Tsevelnorov Khurelbaatar,Mio Sakaguchi,Hisashi Fukuda,Alan Kawarai Lefor,Hironori Yamamoto 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.5
A 62-year-old man with a flat early esophageal cancer was referred for endoscopic treatment. White light imaging revealed a pale redlesion, whereas linked color imaging (LCI) and blue laser imaging (BLI) yielded purple and brown images, respectively. Iodine stainingdemonstrated a large unstained area with a homogenous but very weak pink-color sign. This area appeared more clearly as purpleand green on LCI and BLI, respectively; however, a different colored portion was observed at the 4 o’clock position inside the iodineunstainedarea. Histopathology findings of the resected specimen revealed squamous intraepithelial neoplasia at the 4 o’clock positionand an esophageal squamous cell carcinoma in the remaining iodine-unstained area. LCI and BLI combined with iodine stainingproduce characteristic images that overcomes the pink-color sign, reflecting the histological features of a flat esophageal neoplasm. Thisnew method is useful for detailed evaluation of early flat squamous cell neoplasms.
Chihiro Iwashita,Yoshimasa Miura,Hiroyuki Osawa,Takahito Takezawa,Yuji Ino,Masahiro Okada,Alan K. Lefor,Hironori Yamamoto 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.1
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.
Hironori Yamamoto,Satoshi Shinozaki,Yoshikazu Hayashi,Yoshimasa Miura,Tsevelnorov Khurelbaatar,Hiroyuki Osawa,Alan Kawarai Lefor 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.2
Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficialcolorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all beendeveloped and used worldwide. The pocket-creation method facilitates the resection of tumors in diffcult and routine locations. Earlydetection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques. However, thedetection of small, flat-shaped, or faded color lesions remains diffcult. Linked color imaging, a novel multi-light technology, facilitatesthe recognition of minor differences in tissue by enhancing the color contrast between early colorectal neoplasms and surroundingnormal mucosa in a bright field of view. The most striking feature of linked color imaging is its ability to display the color of earlyneoplastic 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. Earlydetection of superficial colorectal tumors can result in decreased mortality from colorectal cancer and maintain a good quality of life forpatients.