New Methods & MaterialsAutofluorescence endoscopy: Feasibility of detection of GI neoplasms unapparent to white light endoscopy with an evolving technology☆
Section snippets
LIFE II instrument system
The LIFE II system (Fig. 2) operates in 2 modes: fluorescence and conventional white light imaging. The camera head that enables this weighs approximately 500 g and attaches to the eyepiece of a standard Olympus fiberoptic endoscope (Olympus Optical Co. Ltd., Tokyo, Japan). A fiberoptic endoscope is currently required because image sensors are not
Results
To date, LIFE imaging has been performed in several hundred patients, and detailed analyses of specific subgroups are in progress.18 Here, clinical cases will be presented that illustrate the capabilities of fluorescence imaging in relation to WLE in the esophagus, stomach, and colon. All lesions described are biopsy-proven. The color contrast in the still images presented is much inferior to that of the real-time display in which the moving field-of-view and angle of illumination are essential
Discussion
These examples indicate that fluorescence imaging can detect lesions that are not evident by WLE and can correctly classify such lesions as benign, malignant, or dysplastic. The extent to which LIFE increases diagnostic accuracy must now be quantified in randomized clinical trials and the potential roles for this technology in each organ must be clearly established. In the esophagus, early-stage malignant or dysplastic lesions are often difficult to detect by WLE, although some features of
Disclosure
This work was supported by Xillix Technologies Corp., B.C., Canada and Olympus Optical Co. Ltd., Tokyo, Japan. Work in Toronto was also supported by Photonics Research Ontario and the Medical Research Council of Canada.
R. Cline is an employee of Xillix Corp., and B. Wilson serves as Scientific Advisor. None of the other authors have a relationship to this company.
Acknowledgements
The following individuals contributed to the work presented: M. van Ierland-van Leeuwen, MD (Amsterdam); A. Nimihisa, MD, and A. Ohkawa, MD (Tokyo); M. Cirocco, RN, S. Hassaram, MD, L. Lilge, PhD, G. Sandha, MD, and J. Kost, MS (Toronto).
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Reprint requests: Brian C. Wilson, PhD, Ontario Cancer Institute, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada.