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RED DICHROMATIC IMAGING IMPROVES THE RECOGNITION OF BLEEDING POINTS DURING ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE UPPER GASTROINTESTINAL TRACT

Taro Iwatsubo 1, Yosuke Mori 2, Akitoshi Hakoda 2, Shin Kameishi 3, Kazuki Takayama 4, Shun Sasaki 4, Ryoji Koshiba 5, Shinya Nishida 5, Satoshi Harada 6, Hironori Tanaka 2, Noriaki Sugawara 2, Kazuhiro Ota 1, Toshihisa Takeuchi 1, Hiroki Nishikawa 2

Affiliations

1 Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan

2 Osaka Medical and Pharmaceutical University, Takatsuki, Japan

3 Moriguchi Keijinnkai Hospital, Moriguchi, Japan

4 First Towakai Hospital, Takatsuki, Japan

5 Midorigaoka Hospital, Takatsuki, Japan

6 Katsuragi Hospital, Kishiwada, Japan

Summary

AI Generated

Red dichromatic imaging significantly improved recognition of bleeding points compared with white light imaging during endoscopic submucosal dissection in a retrospective video-based study of 58 bleeding episodes.

Red dichromatic imaging achieved a median visibility score of 2.17 versus 1.42 for white light imaging (p<0.001) and a recognition rate of 62.1% versus 27.6% (p<0.001) when six endoscopists evaluated 116 paired videos.
Red dichromatic imaging demonstrated superior visibility scores across both oozing and pulsating hemorrhage patterns and under conditions with or without blood pooling.
The visibility advantage of red dichromatic imaging was consistent for both trainee and expert endoscopists, with median scores of 2.00 versus 1.33 (p<0.001) and 2.67 versus 1.67 (p<0.001) respectively.
The median color difference was significantly higher with red dichromatic imaging (8.97 versus 3.69, p<0.001), showing strong correlation with visibility scores (correlation coefficient 0.712).
This study provides quantitative evidence for red dichromatic imaging in bleeding point recognition during endoscopic submucosal dissection; further studies are needed to assess impact on clinical outcomes.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Recently, red dichromatic imaging (RDI), a novel image-enhanced endoscopy, which comprises wavelengths of amber (600 nm), red (630 nm) and green (540 nm), was launched. Previous studies have indicated that RDI improved the visibility of gastrointestinal bleeding. However, visibility assessments have been based on the subjective decision of evaluators. Herein, we investigated the recognition of bleeding points during endoscopic submucosal dissection (ESD) under RDI compared with that under white light imaging (WLI).

Aims & Methods

Consecutive patients scheduled to undergo esophageal or gastric ESD at a single center were enrolled. Paired videos of active bleeding during ESD under both WLI and RDI were created. Six endoscopists identified the virtual hemostasis point on still images after random video viewing. The distance between the virtual hemostasis and actual bleeding points was scored in four levels (0–3 points), and the association with the color value was analyzed in both WLI and RDI.

Results

We retrospectively evaluated 116 videos for 58 bleeding points. The median visibility score and recognition rate for RDI were significantly higher than those for WLI (2.17 vs. 1.42, p<0.001 and 62.1% vs 27.6%, p<0.001). The median visibility scores were significantly higher for RDI than for WLI under blood pooling (2.00 vs. 1.00, p<0.0016) and no blood pooling (2.50 vs. 1.67, p<0.001). The median visibility scores for RDI were significantly higher than those for WLI in oozing hemorrhage (2.17 vs. 1.33, p<0.001) and pulsating hemorrhage (2.17 vs. 1.50, p=0.030). The median visibility scores in RDI were significantly higher than those in WLI between trainees (2.00 vs. 1.33, p<0.001) and experts (2.67 vs. 1.67, p<0.001). The median color difference of RDI was significantly higher than that of WLI (8.97 vs. 3.69, p<0.001). The correlation coefficient between the visibility score and color difference was 0.712 (strong correlation).

Conclusion

RDI can provide better recognition of bleeding points than WLI during ESD, regardless of the bleeding pattern and experience of the endoscopist. Further studies are warranted to investigate whether RDI improves ESD outcomes.

Disclosure

The authors declare no conflict of interest for this article.

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

PP 01 Oesophageal, gastric and duodenal disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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NANO-FAT AUTOLOGOUS TRANSPLANTATION: A REGENERATIVE BREAKTHROUGH IN THE MANAGEMENT OF ANOVAGINAL FISTULA

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