Autofluorescence Imaging Makes it Easy to Differentiate Neoplastic Lesions from Nonneoplastic Lesions in the Colon

Abstract

The autofluorescence imaging (AFI) system is a newly developed videoscope system which is incorporated with another charge coupled device (CCD) for white light (WL) mode. The purpose of this study was to differentiate neoplastic from nonneoplastic lesions by using the AFI system. This prospective study covered 190 lesions which had been examined by WL and AFI before endoscopic or surgical resection was performed. In the AFI observations, the intensity of the change to a magenta color was classified into levels 0–3. Level 0 means no change, and the color remains the same dark green as the surrounding mucosa. Level 1 is a weak color change toward magenta in the tumor area. In contrast, level 3 is a strong color change in the area of the tumor. Level 0 was found in 25 cases. In the 190 cases which were in levels 1–3, there were 27 hyperplastic polyps (HP), 12 serrated adenomas (SA), 46 tubular adenomas (TA), 61 intramucosal cancers (M-Ca), and 44 submucosal invasive cancers (SM-Ca). Under the diagnostic criteria that neoplastic lesions were at grade 1 or above, the sensitivity, specificity, and accuracy were 97.6%, 92.0% and 98.8%, respectively. These results suggested that AFI might be easily be used to distinguish neoplastic from nonneoplastic lesions in the colon.