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Diagnostic and Therapeutic Endoscopy
Volume 2012 (2012), Article ID 279521, 7 pages
http://dx.doi.org/10.1155/2012/279521
Research Article

Digital Chromoendoscopy for Diagnosis of Diminutive Colorectal Lesions

1Department of Endoscopy and Gastroenterology, Dr Mario Araujo University Hospital, 96400-130 Bagé, RS, Brazil
2Department of Endoscopy and Gastroenterology, Santa Casa Hospital and Fundação Riograndense Universitária de Gastroenterologia (FUGAST), 90610-210 Porto Alegre, RS, Brazil
3Department of Endoscopy 9 de Julho Hospital, 01409-902 São Paulo, SP, Brazil

Received 14 July 2012; Accepted 21 August 2012

Academic Editor: Klaus Mönkemüller

Copyright © 2012 Carlos Eduardo Oliveira dos Santos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. To compare the accuracy of digital and real-time chromoendoscopy for the differential diagnosis of diminutive (<5 mm) neoplastic and nonneoplastic colorectal lesions. Materials and Methods. This is a prospective randomized study comparing the Fujinon intelligent color enhancement (FICE) system (65 patients/95 lesions) and indigo carmine (69 patients/120 lesions) in the analysis of capillary meshwork and pit pattern, respectively. All lesions were less than 5 mm in diameter, and magnification was used in both groups. Histopathology was the gold standard examination. Results. Of 215 colorectal lesions, 153 (71.2%) were adenomas, and 62 were hyperplastic polyps (28.8%). Morphological analysis revealed 132 (61.4%) superficial lesions, with 7 (3.3%) depressed lesions, and 83 (38.6%) protruding lesions. Vascular meshwork analysis using FICE and magnification resulted in 91.7% sensitivity, 95.7% specificity, and 92.6% accuracy in differentiating neoplastic from nonneoplastic lesions. Pit pattern analysis with indigo carmine and magnification showed 96.5% sensitivity, 88.2% specificity, and 94.2% accuracy for the same purpose. Conclusion. Both magnifying virtual chromoendoscopy and indigo carmine chromoendoscopy showed high accuracy in the histopathological diagnosis of colorectal lesions less than 5 mm in diameter.