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New Image-Enhanced Endoscopy NBI/BLI Atlas

Hisao Tajiri (Supervisor) / Mototsugu Kato, Shinji Tanaka, Yutaka Saito, Manabu Muto (Editors)

株式会社 日本メディカルセンター

236 頁  (2014年11月)

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リリース日: 2018年11月16日

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新しい内視鏡システムでの観察のポイントと診断への用い方を詳述した「新しい画像強調内視鏡システム NBI/BLIアトラス」の英語版です。

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Preface

The history of endoscopy over the past three decades has been marked by steady and rapid progress in endoscopic treatment, as arisen from the development of the video endoscope in 1983, leading to rapid advances in the subsequent years. The 1980s were characterized by improvements in endoscopic treatment of early gastrointestinal cancers using EMR, while in the 1990s, previous concepts of diagnosis and treatment of gastric diseases were overturned when the association between H. pylori and diseases of the gastrointestinal tract was verified. In the 2000s, the rapid dissemination of ESD has led to further advances in endoscopic treatment, while the introduction of the HDTV endoscope to the market in 2002, together with more recent innovations such as image-enhanced endoscopy (IEE) and magnifying endoscopy, has provided the basis for new diagnostic study. Now, thanks to the introduction of high-resolution endoscopes and magnifying endoscopes with NBI (Narrow Band Imaging), which provide clear and accurate observation of the microstructures and microvascular architectures on the mucosal surfaces, the grade of tissue atypism can be estimated with endoscopy. Soon we will enter a new era of endoscopic diagnosis, an era of what we can call "endoscopic pathology" in pretherapeutic examinations.

These minute diagnostics have triggered a quantum leap in traditional endoscopic diagnosis. Supported by the achievements of prospective multicenter studies, these developments have had a profound impact on gastrointestinal endoscopists and cancer researchers around the world. As a result, it has been propagated worldwide and made a significant contribution to actual cancer treatments, as well as to clinical studies.

Since the summer of 2012, two systems have been released which are designed to obtain images with even higher definition easily than before. They are the EVIS LUCERA ELITE system with built-in NBI from Olympus Medical Systems Corporation and the LASEREO laser endoscopy system from Fujifilm Corporation featuring another new method called BLI (Blue Laser Imaging).This book was written in order to give you an idea of what the endoscopic images obtained with the new systems look like, explain how to incorporate IEE in endoscopic diagnosis and provide tips on observation using the new IEE techniques. Drawing on a comprehensive collection of case images as ATLAS sourced from hospitals that have already introduced these new systems, this book will guide you step by step through the diagnostic process, enabling you to observe minute changes in the endoscopic images and compare those observations with the explanations given by the authors. We are confident that this book will serve as a leading reference with high quality for a wide range of people, from young physicians aiming at becoming endoscopy specialists to doctors who are already acting as specialists or trainers, providing them with the knowledge they need to understand the new image-enhanced endoscopy and the guidance they need to take advantage of.

We hope that the material included in this book will give our readers the confidence to take on the challenge of pioneering the use of second-generation NBI, which has surmounted the problems associated with conventional NBI and/or BLI in routine procedures, and to perform evaluations and studies in order to establish more sophisticated diagnostics and advance new functional studies.

Finally, we would like to express our gratitude to the many doctors who contributed to this book even though they were very busy. We would also like to express gratitude to Ms. Setsuko Kurozoe at Nihon Medical Center for her work in the editing of this book.


October 2013

Hisao Tajiri
President, Japan Gastroenterological Endoscopy Society
Professor, Department of Gastroenterology and Hepatology/
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan


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Principles of NBI and BLI

NBI (Narrow Band Imaging)

BLI (Blue Laser Imaging)

Oropharynx and Hypopharynx

General Theory:How to Observe These Regions with NBI or BLI

Tips on NBI Observation

Tips on BLI Observation


Case Atlas

Case 1 NBI Inflammatory pharyngeal lesion

Case 2 BLI Hypopharyngeal papilloma

Case 3 NBI Pharyngeal melanosis

Case 4 BLI Pharyngeal melanosis

Case 5 NBI Oropharyngeal superficial carcinoma (0-IIa)

Case 6 BLI Oropharyngeal superficial carcinoma (0-IIb)

Case 7 NBI Hypopharyngeal superficial carcinoma (0-IIb)

Case 8 BLI Hypopharyngeal superficial carcinoma (0-IIa+IIb)

Esophagus

General Theory:How to Observe These Regions with NBI or BLI

Tips on NBI Observation

Tips on BLI Observation


Case Atlas

Case 9 NBI Glycogenic acanthosis(GA)

Case 10 BLI Esophageal papilloma

Case 11 NBI NERD

Case 12 BLI NERD

Case 13 NBI GERD

Case 14 BLI GERD

Case 15 NBI Type 0-I superficial esophageal carcinoma

Case 16 BLI Type 0-Is superficial esophageal carcinoma

Case 17 BLI Type 0-IIa superficial esophageal carcinoma

Case 18 BLI Type 0-IIb superficial esophageal carcinoma

Case 19 NBI/BLI Type 0-IIc superficial esophageal cancer

Case 20 NB/BLI Type 0-IIc superficial esophageal cancer

Case 21 BLI Type 0-IIc superficial esophageal carcinoma

Case 22 NBI Barrett's esophagus

Case 23 BLI Barrett's esophagus

Case 24 NBI Barrett's esophageal adenocarcinoma

Case 25 BLI Barrett's esophageal adenocarcinoma

Stomach and Duodenum

General Theory:How to Observe These Regions with NBI or BLI

Tips on NBI Observation

Tips on BLI Observation


Case Atlas

Stomach

Case 26 NBI Chronic gastritis

Case 27 BLI Chronic gastritis

Case 28 NBI Gastric adenoma

Case 29 BLI Gastric adenoma

Case 30 NBI Differential diagnosis of adenoma and gastric carcinoma

Case 31 BLI Differential diagnosis of erosion and early gastric carcinoma

Case 32 NBI Diagnosis of extent of early gastric cancer

Case 33 BLI Diagnosis of extent of early gastric carcinoma

Case 34 BLI Diagnosis of extent of early gastric carcinoma

Case 35 NBI Type 0-IIc differentiated early gastric carcinoma

Case 36 NBI Diagnosis of histological type of early gastric carcinoma

Case 37 BLI Diagnosis of histological type of early gastric carcinoma

Case 38 BLI Diagnosis of histological type of early gastric carcinoma

Case 39 NBI Transnasal endoscopic observation of early gastric carcinoma

Case 40 NBI Early carcinoma in gastric remnant

Case 41 NBI MALT lymphoma

Case 42 BLI MALT lymphoma


Duodenum

Case 43 NBI Duodenal adenoma

Case 44 BLI Duodenal adenoma

Case 45 NBI Duodenal carcinoma

Case 46 BLI Duodenal carcinoma

Case 47 BLI Duodenal carcinoma


Featured Article

Pathological correlative approach to magnified images

Colon and Rectum

General Theory:How to Observe These Regions with NBI or BLI

NBI Observation―Basic Principles and Operation Tips

Tips on BLI Observation


Case Atlas

Case 48 NBI Hyperplastic polyp

Case 49 NBI SSA/P (sessile serrated adenoma/polyp)

Case 50 BLI SSA/P (sessile serrated adenoma/polyp)

Case 51 BLI SSA/P (sessile serrated adenoma/polyp)

Case 52 NBI Protruding serrated adenoma

Case 53 NBI Elevated tubular adenoma

Case 54 NBI Superficial tubular adenoma

Case 55 NBI Tubulovillous adenoma

Case 56 BLI Villous adenoma

Case 57 NBI Protruding M carcinoma

Case 58 NBI Slightly elevated M carcinoma

Case 59 NBI Slightly depressed M carcinoma

Case 60 NBI Elevated SM carcinoma

Case NBI Slightly depressed SM carcinoma

Case 62 BLI Composite (IIa+IIc) SM carcinoma

Case 63 BLI Composite (IIa+IIc) SM carcinoma

Case 64 NBI Composite (IIa+IIc) SM carcinoma

Case 65 NBI Composite (Is+IIc) SM carcinoma

Case 66 NBI LST-G, homogeneous type

Case 67 BLI LST-G, nodular mixed type

Case 68 NBI LST-NG, pseudo-depressed type

Case 69 BLI LST-NG, pseudo-depressed type

Case 70 NBI/BLI LST-NG, pseudo-depressed type

Case 71 NBI LST-NG, pseudo-depressed type

Case 72 BLI LST-NG, pseudo-depressed type

Case 73 BLI Ulcerative colitis

Case 74 NBI Tumor associated with inflammatory colon diseases(carcinoma/dysplasia)


Featured Articles

Magnifications in Near Focus electronic zoom observation of the LUCERA ELITE system

Importance of structure enhancement in NBI magnifying observation

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